Follitropin Alfa

This article summarizes key findings from clinical trials investigating the use of follitropin alfa, a recombinant human follicle-stimulating hormone (FSH), in assisted reproductive technology procedures like in vitro fertilization (IVF). The trials examined the efficacy and safety of follitropin alfa compared to other gonadotropins for ovarian stimulation in women undergoing fertility treatments. Key outcomes assessed include number of oocytes retrieved, pregnancy rates, and safety profiles.

Table of Contents

What is Follitropin Alfa?

Follitropin alfa is a medication used in fertility treatments. It is a type of hormone known as a recombinant human follicle-stimulating hormone (r-hFSH). This means it is a laboratory-made version of the natural hormone that stimulates egg production in women[1]. Follitropin alfa is known by several brand names, including Gonal-F, Puregon, Primapur, and Gonapure[2][3].

How Does It Work?

Follitropin alfa works by stimulating the ovaries to produce more than one egg at a time. In a natural menstrual cycle, usually only one egg matures and is released. However, for certain fertility treatments, it’s beneficial to have multiple mature eggs available[4]. The medication mimics the action of the body’s natural follicle-stimulating hormone, encouraging the growth and development of ovarian follicles, which contain the eggs[5].

Conditions Treated

Follitropin alfa is primarily used to treat infertility in women. It is prescribed for various conditions and procedures, including:

  • Assisted Reproductive Technologies (ART): This includes treatments like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)[6].
  • Ovulation Induction: For women who do not ovulate regularly or at all[7].
  • Controlled Ovarian Stimulation: To produce multiple eggs for fertility treatments[8].
  • Female Infertility: Various causes of infertility in women[3].

Administration

Follitropin alfa is typically administered as a subcutaneous injection, meaning it is injected just under the skin. The medication often comes in pre-filled pens or syringes for easy self-administration at home[2]. The dosage and duration of treatment can vary depending on the individual patient and the specific fertility treatment plan. Generally, the starting dose is between 75-150 IU (International Units) per day, and treatment may last for 7-16 days[6][2].

Effectiveness

The effectiveness of follitropin alfa is typically measured by several factors:

  • Number of oocytes retrieved: This refers to the number of eggs collected after stimulation. A higher number of eggs generally increases the chances of successful fertilization and pregnancy[2].
  • Quality of oocytes: The medication aims to produce mature, high-quality eggs suitable for fertilization[3].
  • Pregnancy rates: This includes biochemical pregnancies (early positive pregnancy test) and clinical pregnancies (confirmed by ultrasound)[2].
  • Live birth rates: The ultimate measure of success in fertility treatments[9].

Studies have shown that follitropin alfa is effective in stimulating ovarian follicle development and increasing the number of mature eggs available for fertility treatments[6].

Side Effects

Like all medications, follitropin alfa can cause side effects. Common side effects may include:

  • Injection site reactions (redness, pain, itching, swelling, bruising)[8]
  • Headache
  • Abdominal pain or bloating
  • Nausea
  • Ovarian Hyperstimulation Syndrome (OHSS): A condition where the ovaries become swollen and painful. This is a serious but rare side effect that requires immediate medical attention[3].

It’s important to discuss potential side effects with your healthcare provider before starting treatment.

Comparison with Other Treatments

Follitropin alfa is one of several gonadotropins used in fertility treatments. Other similar medications include:

  • Corifollitropin alfa (Elonva): This is a long-acting FSH that requires less frequent injections[4].
  • Follitropin beta (Puregon): Another type of recombinant FSH[10].
  • Follitropin delta (Rekovelle): A newer recombinant FSH that is dosed based on the patient’s weight and AMH levels[8].

Studies have been conducted to compare the efficacy and safety of these different treatments. Generally, they have been found to have similar effectiveness, with some differences in dosing schedules and individualization of treatment[4][8].

Ongoing Research

Research on follitropin alfa and other fertility treatments is ongoing. Current areas of study include:

  • Comparing different dosing protocols to optimize treatment outcomes[9].
  • Investigating the effects of different stimulation protocols on embryo development[4].
  • Studying the efficacy and safety of biosimilar versions of follitropin alfa[6].
  • Exploring combination treatments with other medications to improve outcomes[7].

These ongoing studies aim to further improve the effectiveness and safety of fertility treatments using follitropin alfa and related medications.

Aspect Details
Drug Follitropin alfa (recombinant human FSH)
Indication Ovarian stimulation for assisted reproductive technologies
Administration Subcutaneous injection, typically 150-300 IU daily for up to 16 days
Efficacy Comparable to other gonadotropins in number of oocytes retrieved and pregnancy rates
Safety Generally well-tolerated; main risks include OHSS and multiple pregnancies
Monitoring Ultrasound and blood tests to assess ovarian response and adjust dosing
Comparators Gonal-F, corifollitropin alfa, urinary gonadotropins

Ongoing Clinical Trials on Follitropin Alfa

  • Study of Semaglutide on Embryo Quality in Overweight and Obese Women Undergoing In Vitro Fertilization for Infertility

    Recruiting

    1 1 1 1
    Investigated diseases:
    Spain
  • Study Comparing Progesterone and Ganirelix for Preventing LH Surge in Women Undergoing Ovarian Stimulation for Egg Donation

    Recruiting

    1 1 1 1
    Spain
  • Study on Letrozole and Gonadotropins for Women with Polycystic Ovary Syndrome (PCOS) to Improve Live Birth Rates

    Recruiting

    1 1 1 1
    Investigated diseases:
    The Netherlands
  • Study on Infertility Treatment with Follitropin Alfa and Lutropin Alfa for Women Over 35 with Low Ovarian Response

    Recruiting

    1 1 1 1
    Spain
  • Study on Pregnancy Rates in Women with Polycystic Ovary Syndrome Using Letrozole and Gonadotropins

    Recruiting

    1 1 1 1
    Investigated diseases:
    Spain
  • Study on Random Start Ovarian Stimulation with Follitropin Alfa, Dydrogesterone, and Triptorelin Acetate for Women Undergoing Elective Oocyte Cryopreservation to Prevent Infertility

    Recruiting

    1 1 1 1
    Investigated diseases:
    Belgium
  • Follitropin Alfa and Chorionic Gonadotrophin for Men with Male Infertility, Low Testosterone, and Low Sperm Count

    Not yet recruiting

    1 1 1 1
    Investigated diseases:
    Investigated drugs:
    Germany Italy Spain
  • Study of transdermal testosterone gel to improve ovarian response in women with low ovarian reserve and androgen receptor polymorphism undergoing fertility treatment

    Not yet recruiting

    1 1 1
    Investigated diseases:
    Spain
  • Study of testosterone gel treatment for women with low ovarian reserve and androgen receptor polymorphism undergoing fertility treatment

    Not yet recruiting

    1 1 1 1
    Investigated diseases:
    Spain
  • Study on Infertility Risk from Chemotherapy in Young Breast Cancer Patients Using Follitropin Beta and Follitropin Alfa for Egg/Embryo Preservation

    Not recruiting

    1 1 1
    Investigated drugs:
    France

Glossary

  • Follitropin alfa: A synthetic form of follicle-stimulating hormone (FSH) used to stimulate ovarian follicle development in fertility treatments.
  • Oocyte: An immature egg cell in the ovary that can potentially develop into a mature egg.
  • Ovarian hyperstimulation syndrome (OHSS): A potential complication of ovarian stimulation where the ovaries become swollen and painful.
  • Gonadotropin: A hormone that stimulates the gonads (ovaries or testes). FSH and LH are examples of gonadotropins.
  • Intracytoplasmic sperm injection (ICSI): A procedure where a single sperm is injected directly into an egg to facilitate fertilization.
  • Embryo transfer: The procedure of placing embryos created through IVF into a woman's uterus.
  • Follicle: A fluid-filled sac in the ovary that contains a developing egg.
  • Human chorionic gonadotropin (hCG): A hormone used to trigger final egg maturation before retrieval in IVF cycles.
  • Recombinant DNA technology: A method of producing proteins like FSH by inserting genes into host cells.
  • Subcutaneous injection: An injection given into the fatty tissue just beneath the skin.

References

  1. https://clinicaltrials.gov/study/NCT03857230
  2. https://clinicaltrials.gov/study/NCT03088137
  3. https://clinicaltrials.gov/study/NCT03057574
  4. https://clinicaltrials.gov/study/NCT04142190
  5. https://clinicaltrials.gov/study/NCT01121666
  6. https://clinicaltrials.gov/study/NCT04854707
  7. https://clinicaltrials.gov/study/NCT01286051
  8. https://clinicaltrials.gov/study/NCT03296527
  9. https://clinicaltrials.gov/study/NCT01794208
  10. https://clinicaltrials.gov/study/NCT02471677