Pergoveris Dosage/Direction for Use

Treatment with pergoveris should be initiated under the supervision of a physician experienced in the treatment of fertility disorders.
Pergoveris is intended for SC administration. The injection site should be alternated daily. The powder should be reconstituted immediately prior to use with the solvent provided.
In LH and FSH deficient women (hypogonadotrophic, hypogonadism), the objective of Pergoveris therapy is to develop a single mature Graafian follicle from which the oocyte will be liberated after the administration of human chorionic gonadotrophin (hCG). Pergoveris should be given as a course of daily injections. Since these patients are amenorrhoeic and have low endogenous oestrogen secretion, treatment can commence at any time.
Treatment should be tailored to the individual patient's response as assessed by measuring follicle size by ultrasound and oestrogen response. A recommended regimen commences with 1 vial of Pergoveris daily.
If <1 vial of Pergoveris daily is used, the follicular response may be unsatisfactory because the amount of lutropin α may be insufficient (see Pharmacology under Actions).
If an FSH dose increase is deemed appropriate, dose adaptation should preferably be after 7-14 day intervals and preferably by 37.5-75 IU increments using a licensed follitropin α preparation. It may be acceptable to extend the duration of stimulation in any 1 cycle to up to 5 weeks.
When an optimal response is obtained, a single injection of choriogonadotropin α (r-hCG) 250 mcg or 5000 IU-10,000 IU hCG should be administered 24-48 hrs after the last pergoveris injection. The patient is recommended to have coitus on the day of, and on the day following, hCG administration. Alternatively, intrauterine insemination (IUI) may be performed. Luteal phase support may be considered since lack of hormones with luteotrophic activity (LH/hCG) after ovulation may lead to premature failure of the corpus luteum.
If an excessive response is obtained, treatment should be stopped and hCG withheld. Treatment should recommend in the next cycle at a dose of FSH lower than that of the previous cycle.
In clinical trials, patients with severe FSH and LH deficiency were defined by an endogenous serum LH level <1.2 IU/L as measured in a central laboratory.
However, it should be taken into account that there are variations between LH measurements performed in different laboratories. In these trials, the ovulation rate per cycle was 70-75%.