Gonal-F (Follitropin Alfa)

Gonal‑F is indicated for several fertility‑related conditions in both women and men, administered under specialist guidance.

• Induction of ovulation in women with anovulation or oligo‑ovulation, such as those with polycystic ovary syndrome.
• Stimulation of multiple follicular development during assisted reproductive technology cycles, including in vitro fertilisation (IVF) protocols.
• Support of follicular growth in women undergoing egg‑retrieval procedures for donor programmes or fertility preservation.
• Treatment of hypogonadotropic hypogonadism in men to promote spermatogenesis and increase sperm count.
• Adjunct therapy in combination with luteinising hormone analogues for controlled ovarian hyperstimulation.

The safety profile of Gonal‑F includes a range of observed effects that vary in frequency and severity.

Common

• Mild injection‑site reactions such as redness, swelling, bruising or tenderness at the administration site.
• Headache or transient dizziness, often resolving without intervention.
• Nausea, abdominal discomfort, bloating or mild gastrointestinal upset.
• Ovarian enlargement causing mild pelvic discomfort or a sensation of fullness.

Serious

• Ovarian hyperstimulation syndrome (OHSS), characterized by rapid weight gain, abdominal distension, ascites, or shortness of breath, requiring medical monitoring.
• Increased risk of multiple pregnancy when several follicles develop and are fertilised.
• Rare allergic reactions, including rash, urticaria, angioedema or anaphylaxis, which need immediate attention.

When prescribing Gonal‑F, clinicians consider several precautionary measures to minimise risks and optimise outcomes.

• Assess baseline ovarian reserve and hormonal profile before initiating therapy.
• Monitor follicular response with serial ultrasound and estradiol measurements throughout treatment.
• Use caution in women with known hypersensitivity to any component of the formulation.
• Evaluate for contraindications such as active ovarian cysts, uncontrolled thyroid disease, or severe liver impairment.
• Counsel patients on the signs of OHSS and advise immediate medical attention if symptoms develop.

Gonal‑F may interact with other medications or hormonal agents, influencing its efficacy or safety profile.

Avoid

• Concomitant use of high‑dose estrogen‑containing oral contraceptives that suppress endogenous FSH production.
• Co‑administration with medications that markedly increase ovarian response, such as excessive gonadotropin‑releasing hormone (GnRH) analogues, without specialist supervision.

Use with caution

• Use with other fertility drugs (e.g., hCG, LH analogues) requires careful dosing and monitoring.
• Concurrent thyroid hormone therapy may affect ovarian response; monitor thyroid function tests.
• Anticoagulant therapy may increase risk of injection‑site bruising; observe for bleeding.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) may mask symptoms of OHSS; assess patient closely.