Injectable FSH products are also referred to as HMG, human menopausal gonadotropins, or gonadotropins. Brand names for these drugs (hormones) in the USA include Pergonal, Follistim, Gonal-F, Repronex and Humegon.
The FSH shots are usually given as part of "controlled ovarian hyperstimulation" where injectible FSH shots are given to stimulate the ovaries to develop multiple follicles and ovulate. This process is usually carefully monitored with sonograms and estrogen levels to avoid overstimulation and the development of too many follicles. This treatment can also be coupled with intrauterine insemination (IUI).
Here is a general outline of the FSH shots:
- The first day of the menstrual cycle is the first day you see red blood
- Cycle day 2 or 3: Baseline sonogram to assess the ovaries as well as to measure the endometrial thickness and blood estradiol level
- Instruction to indicate the dosage of FSH to be injected by yourself at home. The dosage varies depending on your age and past stimulation cycles.
- The typical stimulation lasts about 8 days starting on cycle day 3 until about cycle day 10. In general it is preferable to take the injections in the evening if possible as this allows more rapid dosing adjustments based on estradiol levels.
- Often on the last day of injections another shot containing hCG (human chorionic gonadotropin) is given (usually CD 10)
- The hCG shot also depends on how your ovaries repond to the FSH injections. A follicle measuring around 18-20 mm should be found as it indicates ovulation may happen shortly afterwards.
- Ovulation is expected and if necessary IUI intrauterine insemination is done 2 days after the hCG shot (CD 12 if hCG was given CD 10).