Rekovelle

Controlled ovarian stimulation for multiple follicles development in women undergoing assisted reproductive technologies (eg, in vitro fertilisation or intracytoplasmic sperm inj cycle).

SC Individualised dosage. Women w/ anti-Müllerian hormone (AMH) <15 pmol/L 12 mcg daily, irrespective of body wt, ≥15 pmol/L Decrease daily dose from 0.19 to 0.10 mcg/kg by increasing AMH conc. Round off the dose to the nearest 0.33 mcg to match the dosing scale on the inj pen. Max daily dose: 12 mcg for the 1st treatment cycle. Initiate treatment on day 2 or 3 after menstrual bleeding started; continue until adequate follicular development has been achieved. Inj a single dose of 250 mcg recombinant hCG or 5,000 IU hCG to induce final follicular maturation. Subsequent treatment cycles: Maintain & modify daily dose according to patient's ovarian response in previous cycle. Patient who developed ovarian hyperstimulation syndrome (OHSS) or at risk of OHSS in previous cycle Lower dose used from previous cycle where OHSS or risk of OHSS occurred by 33% for subsequent cycle. Max daily dose: 24 mcg.

Hypersensitivity. Hypothalamus or pituitary gland tumours. Ovarian enlargement or cyst not due to PCOS. Gynaecological haemorrhages of unknown aetiology. Ovarian, uterine or mammary carcinoma. Not to be used when an effective response cannot be obtained (eg, primary ovarian failure, sexual organ malformations & uterus fibroid tumours incompatible w/ pregnancy). Pregnancy & lactation.

Triggering of final follicular maturation should not be performed in patients w/ excessive follicular development of ≥25 follicles ≥12 mm. Regularly monitor ovarian response w/ ultrasound alone or in combination w/ measurement of serum estradiol levels. Assess couple's infertility as appropriate & evaluate putative CI for pregnancy prior to treatment; particularly evaluate patients for hypothyroidism & hyperprolactinemia. Not recommended to use results obtained w/ other assays than the ELECSYS AMH Plus immunoassay & ACCESS AMH Advanced for Rekovelle dose determination. Patients undergoing follicular growth stimulation may experience ovarian enlargement & may be at risk of developing OHSS. Carefully & frequently monitor follicular development to reduce risk of OHSS. Advise patient to refrain from coitus or to use barrier contraceptive methods for at least 4 days in cases of OHSS wherein it is prudent to w/hold hCG. Possible late OHSS development; follow patients for at least 2 wk after hCG administration. Women w/ recent or ongoing thromboembolic disease or generally recognised risk factors for thromboembolic events (eg, personal or family history, severe obesity or thrombophilia). Possible occurrence of ovarian torsion. Potential risk of multiple pregnancy; increased risk of adverse maternal & perinatal outcomes. Higher incidence of pregnancy loss by miscarriage or abortion in patients undergoing controlled ovarian stimulation for ART. Risk of ectopic pregnancy in women w/ tubal disease history. Possible ovarian & other reproductive system neoplasms (both benign & malignant) in women who have undergone multiple infertility treatment regimens. Possible congenital malformation. PCOS patients w/ anovulatory disorders. Contains Na <1 mmol/dose. Renal & hepatic impairment. No relevant use in paed population for the indication. Elderly >65 yr.

Headache; nausea; OHSS, pelvic & adnexa uteri pain, pelvic discomfort; fatigue.

Combined Sex Hormones

G03GA10 - follitropin delta ; Belongs to the class of gonadotropins. Used as ovulation stimulants.

POM