Gonadotropins

Gonadotropins are the injectable medications that form the backbone of controlled ovarian stimulation for IVF and high-order IUI cycles. They include recombinant FSH (e.g., Gonal-F, Follistim), recombinant LH (e.g., Luveris), urinary hMG containing both FSH and LH (e.g., Menopur), and combination products.

Patients self-inject nightly subcutaneously for 8–14 days. Dose is individualized based on age, AFC, AMH, and body weight. Monitoring (ultrasound + estradiol) occurs every 1–3 days to adjust dosing and prevent overstimulation. Gonadotropins are significantly more potent than oral agents like clomiphene and carry a higher risk of multiple pregnancy and OHSS.