Pergonal and PCOS
Polycystic ovarian syndrome (PCOS) is an endocrine disorder that affects about 5% of the female population. The main symptoms of the syndrome are obesity, the absence of a menstrual period, excessive hair growth, and insulin resistance. PCOS is the most common reason for female infertility.
Half Become Pregnant
While birth control pills are a superb method of managing the syndrome by means of the regulation of the menses, they suppress ovulation, making conception impossible.
The drug known as Clomiphene was designed for women with PCOS as a means of increasing female sex hormones (FHS), which in turn, can lead to ovulation. 90% of women with PCOS ovulate after being treated with Clomiphene, and about half of them go on to become pregnant.
However, some cases of PCOS are stubborn in their refusal to respond to Clomiphene. Even when the maximum dose is used, such patients fail to ovulate. These women are then considered to be candidates for ovulation induction through the use of the class of medicines known as gonadotropins. These may be given alone or in combination with gonadotropin-releasing hormone agonist (GnRH).
Pergonal and Humegon are gonadotropins which are a combination of luteinizing hormone (LH) and female sex hormone (FSH). Metrodin, Fertinex, Follistim, and Gonal-F consist of FSH alone. There is very little difference in the actions of these various preparations and their use is interchangeable. The pituitary gland's job is to produce both LH and FSH so as to stimulate the ovaries. Gonadotropins do the same job, but stimulate these hormones in increased amounts.
The administration of this treatment can be tricky since women with PCOS tend to produce large numbers of eggs in response to gonadotropins. This increases their risk for ovarian hyperstimulation, which can turn into a life-threatening condition. However, this risk can be avoided by the performance of an assisted reproductive technique (ART) in which the physician removes all the eggs, and then returns the number of eggs deemed appropriate for the woman to carry to term.
There are drawbacks to the use of gonadotropins. For one thing, they are expensive and most health plans refuse to cover such treatment. One cycle of Pergonal can cost $1000.00 or even more.
The other drawback is the type of delivery system used with these drugs. Intramuscular injection in the hip is the delivery method used with Pergonal, Humegon, and Metrodin. Most times, the male partner is taught how to administer the injections. Fertinex, Follistim, and Gonal-F are also injected, but most women can manage to inject themselves with these drugs since their administration is subcutaneous (under the skin).