Meriofert 150 IU
Indonesia • Dexa Medica
Indication
Controlled ovarian hyperstimulation (COH) within a medically assisted reproduction technology (ART): induction of multiple follicular development in women undergoing assisted reproduction techniques such as in vitro fertilization (IVF).
Composition
Each freeze-dried vial contains 150 IU Menotrophin corresponding to 150 IU human follicle stimulating hormone activity (FSH) and 150 IU human luteinising hormone activity (LH). Human Chorionic Gonadotrophin (hCG), a hormone naturally present in urine of pregnant women, is added to contribute to the total LH activity.
Package
Dosage Forms
Powder for InjectionATC Classification
Warning
Anaphylactic reactions may occur, particularly in patients with known hypersensitivity to gonadotrophins. The first injection of Meriofert should be always performed under direct medical supervision and in settings with facilities for cardio-pulmonary resuscitation. The first injection of Meriofert should be performed under direct medical supervision.
Self-injections of Meriofert should be performed only by motivated, trained and well informed patients. Prior to self-injections, the patient must be shown how to perform a subcutaneous injection, showing her where the injection can be given and how to prepare the solution to be injected.
Before starting the treatment, the couple’s infertility should be assessed as appropriate and putative contraindications for pregnancy evaluated. In particular, patients should be evaluated for hypothyroidism, adrenocortical deficiency, hyperprolactinemia and pituitary or hypothalamic tumours, for which appropriate specific treatments are given.
Dosage
Females undergoing ovary stimulation for induction of multiple follicular development – as part of assisted reproductive technology: Pituitary down-regulation in order to suppress the endogenous LH peak and to control basal levels of LH is now commonly achieved by administration of a gonadotrophin releasing hormone agonist (GnRH- Agonist) or gonadotrophin releasing hormone antagonist (GnRH Antagonist). In a commonly used protocol the administration of Meriofert begins approximately two weeks after the start of the agonist treatment, both treatments are then continued until adequate follicular development has been achieved. For example, following two weeks of pituitary down-regulation with agonist, 150 to 225 IU of Meriofert are administered for the first five-seven days. The dose is then adjusted according to the patient’s ovarian response.
An alternative protocol for controlled ovarian hyperstimulation involves the administration of 150 to 225 IU of Meriofert daily starting on the 2nd or 3rd day of the cycle. The treatment is continued until sufficient follicular development has been achieved (assessed by monitoring of serum oestrogen concentrations and/or ultrasound) with the dose adjusted according to the patient’s response (usually not higher than 450 IU daily). Adequate follicular development is usually achieved on average around the tenth day of treatment (5 to 20 days).
When an optimal response is obtained a single injection of 5,000 IU to 10,000 IU of hCG administered 24 to 48 hours after the last Meriofert injection, to induce final follicular maturation. Oocyte retrieval is performed 34-35 hours later.