Folliclestimulating hormone

Follicle-stimulating hormone (FSH) promotes follicle growth. Follicles are the fluid-filled cysts in the ovaries where the eggs develop and mature. You take the drug in the form of a daily injection for as few as six days to possibly up to two weeks (and rarely more) if the dose has to be increased. The dose required to grow between 10 and 15 follicles varies between women: Your doctor calculates your dose and then may increase or decrease this amount depending on how your body responds.

The most common side effects of FSH are

^ Abdominal discomfort ^ Feeling bloated ^ Influenza-like symptoms (rare) ^ Irritability

Believe it or not

After menopause women still produce FSH, but since they have no follicles or eggs in their ovaries the hormone is simply excreted in their urine. Originally, drug companies used to produce FSH for fertility treatment by extracting the hormone from postmenopausal women's urine. The hormone was purified and turned into powdered form. The quality of this drug varied between batches and there was an element of uncertainty about its purity and exact bioactivity. These days synthetic FSH is produced using DNA technology, which means that the end product is uncontaminated and batches don't differ in bioactivity.

Another improvement is that today the drug is given subcutaneously with a tiny needle just under the skin, whereas the original product had to be given deep into the muscle with a huge needle.

I Irritation at the injection site i Over-response, which can lead to ovarian hyperstimulation syndrome (OHSS) (I explain OHSS in Chapter 10)

i Tender breasts

FSH for IVF is provided for free under Medicare's Pharmaceutical Benefits Scheme (PBS) — which is great, because this drug is very expensive. Refer to Chapter 3 for more about the PBS.

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