Before you and your partner begin fertility treatment, your fertility specialist will discuss its likelihood of success, and any associated risks.
The most common fertility treatment options include:
- Fertility medications
- Surgery to restore fertility
- Ovulation Induction (OI)
- Intrauterine Insemination (IUI)
- Assisted Reproductive Technologies (ART)
Assisted Reproductive Technology (ART) helps to create an embryo by bypassing common factors that often cause fertility problems.
An ART procedure known as in vitro fertilization (IVF) involves retrieval of fluid from a woman’s egg-containing ovarian follicles. The fluid is microscopically examined for an egg by the embryologist. The retrieved eggs are combined with your partner's or donor's sperm in the laboratory to create an embryo, which is then transferred to the womb.
Typically, Assisted Reproductive Technologies use medications such as Gonal-f® (follitropin alfa for injection) that supplement or replace a woman's natural supply of FSH hormones to help mature eggs by stimulating the growth of multiple egg-containing follicles in the ovary. Other medications may also be used to control the timing of the reproductive cycle.
As well as IVF treatment, other ART procedures may include:
- Intracytoplasmic Sperm Injection (ICSI)
- Assisted hatching
- Egg donation
- Preimplantation Genetic Diagnosis (PGD)
- Egg/embryo freezing (Cryopreservation)
- Gamete Intrafallopian Transfer (GIFT)
- Zygote Intrafallopian Transfer (ZIFT)
IMPORTANT INFORMATION ABOUT THE PROPER USE AND RISKS OF Gonal-f® (follitropin alfa for injection) and Gonal-f® RFF* Redi-ject™ (follitropin alfa for injection):
Gonal-f® RFF* Redi-ject™ (follitropin alfa injection) is an injection Pen that delivers a prescription medicine containing follicle-stimulating hormone (FSH) used in infertile women to:
- help healthy ovaries develop (mature) and release an egg
- cause your ovaries to make multiple (more than 1) eggs as part of an Assisted Reproductive Technology (ART) program
Do not use the Gonal-f® RFF* Redi-ject™ if you:
- are allergic to recombinant human FSH or any of the ingredients listed here: follitropin alfa (r-hFSH), sucrose, meta-cresol, di-sodium hydrogen phosphate dihydrate, sodium dihydrogen phosphate monohydrate, methionine, Poloxamer 188, O-phosphoric acid, sodium hydroxide
- have ovaries that no longer make eggs (primary ovarian failure)
- are pregnant or think you may be pregnant
- have uncontrolled thyroid or adrenal problems
- have a tumor in your female organs, including your ovaries, breast, or uterus
- have a tumor in your brain, such as a tumor in your pituitary or hypothalamus
- have abnormal bleeding from your uterus or vagina
- have ovarian cysts or large ovaries, not due to polycystic ovary syndrome (PCOS)
Before you use Gonal-f® RFF* Redi-ject™, tell your healthcare provider if you:
- have or have had asthma
- have been told by a healthcare provider that you have an increased risk for blood clots (thrombosis)
- have ever had a blood clot (thrombosis), or anyone in your family has ever had a blood clot (thrombosis)
- have had abdominal surgery
- have had twisting of your ovary (ovarian torsion)
- had or have a cyst on your ovary
- have polycystic ovarian disease
- have any other medical conditions
- are breastfeeding or plan to breastfeed
- are taking any other prescription or over-the-counter medicines, vitamins, and herbal supplements
Gonal-f® RFF* Redi-ject™ may cause serious side effects, including:
- severe allergic reactions in women who have used Gonal-f®, Gonal-f® RFF, or Gonal-f® RFF Redi-ject™ in the past. New allergic reactions can occur immediately after an injection. Severe allergic reaction may lead to death. If you have any of the following symptoms of a severe allergic reaction, stop using Gonal-f® RFF Redi-ject™ and go to the hospital right away:
- shortness of breath
- swelling of your face
- itchy, red bumps or rash on your skin (hives)
- ovaries that are too large; symptoms of bloating or pain in your lower stomach (pelvic) area.
- ovarian hyperstimulation syndrome (OHSS); a serious medical condition that can happen when your ovaries produce too many eggs (overstimulated). OHSS can cause fluid to suddenly build up in the area of your stomach, chest, and heart, and can cause blood clots to form. In rare cases OHSS has caused death. OHSS may also happen after you stop using Gonal-f® RFF Redi-ject™. Stop using Gonal-f® RFF Redi-ject™ and call your healthcare provider right away if you have symptoms of OHSS, including:
- trouble breathing
- severe lower stomach (pelvic) area pain
- decreased urine output
- weight gain
- lung problems; that cause trouble breathing (acute respiratory distress syndrome, atelectasia) and worsening of asthma.
- blood clots can cause:
- blood vessel problems (thrombophlebitis)
- loss of your arm or leg
- blood clot in your lung (pulmonary embolism)
- twisting (torsion) of your ovary if you already have certain conditions such as ovarian cysts, OHSS, pregnancy and previous abdominal surgery. Twisting of your ovary may lead to blood flow being cut off to your ovary.
- pregnancy with more than 1 baby and birth of multiple babies. Having a pregnancy and giving birth to more than 1 baby at a time increases the health risk for you and your babies. Your healthcare provider should tell you about your chances of multiple births.
- birth defects in a baby born after an ART cycle (IVF or ICSI). Your chances of having a baby with birth defects may increase depending on:
- your age
- certain sperm problems
- your genetic background and that of your partner
- a pregnancy with more than 1 baby at a time
- ectopic pregnancy (pregnancy outside your womb). Your chance of having a pregnancy outside of your womb is increased if you also have fallopian tube problems.
- miscarriage. Your chance of loss of an early pregnancy may be increased if you had difficulty becoming pregnant.
- tumors of the ovary. If you have used fertility medicines like Gonal-f® RFF Redi-ject™ before to get pregnant, you may have an increased chance of having tumors in your ovary(ies) (including cancer).
The most common side effects of Gonal-f® RFF* Redi-ject™ include:
- stomach pain
- stomach bloating
- bruising at the injection site
These are not all the possible side effects of Gonal-f® RFF Redi-ject™. For more information, call your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
Do not share your Gonal-f® RFF Redi-ject™ and needles with another person. You may give another person an infection or get an infection from them.
Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Also read the Gonal-f® RFF* Redi-ject™ “Instructions for Use” that comes with Pen for information about the correct use of Gonal-f® RFF Redi-ject™ and follow all training and instruction provided by your healthcare provider.
*RFF, Revised Formulation Female