Always use Fertavid exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Dosage in women
Your doctor will decide on your starting dose. This dose may be adjusted during your treatment period. Further details on the treatment schedule are given below.
There are large differences between women in the response of the ovaries to FSH, which makes it impossible to set a dosage schedule which is suitable for all patients. To find the right dosage, your doctor will check your follicle growth by means of ultrasound scanning, and measurement of the amount of estradiol (female sex hormone) in blood or urine.
- Women who are not ovulating A starting dose is set by your doctor. This dose is continued for at least seven days. If there is no ovarian response, the daily dose will then be gradually increased until follicle growth and/or plasma estradiol levels indicate a proper response. The daily dose is then maintained until a follicle of proper size is present. Usually, 7 to 14 days of treatment are sufficient. Fertavid treatment is then stopped and ovulation will be induced by giving human chorionic gonadotrophin (hCG).
- Medically assisted reproduction programs, for instance IVF A starting dose is set by your doctor. This dose is continued for at least the first four days. After this, your dose may be adjusted based upon your ovarian response. When a sufficient number of follicles of proper size are present, the final phase of maturation of the follicles is induced by giving hCG. Retrieval of the egg(s) is performed 34-35 hours later.
Dosage in men
Fertavid is usually prescribed at a dose of 450 IU per week, mostly in 3 dosages of 150 IU, in combination with another hormone (hCG), for at least 3 to 4 months. The treatment period equals the development time of sperm and the time in which improvement can be expected. If your sperm production has not started after this period, your treatment may carry on for at least 18 months.
How are the injections given?
The very first injection of Fertavid should only be given in the presence of a doctor or nurse. Injections may be given slowly into a muscle (for instance in the buttock, upper leg or upper arm) or under the skin (in the lower stomach, for example).
When given into a muscle the injection should be given by the doctor or nurse.
When given under the skin the injection may, in some cases, be given by yourself or your partner. Your doctor will tell you when and how to do this. If you inject yourself with Fertavid, follow the instructions for use in the next section, to give Fertavid properly and with minimal discomfort.
Instructions for use
Step 1 - Preparing the syringe
You should use sterile disposable syringes and needles for the administration of Fertavid. The volume of the syringe should be small enough so that the prescribed dose can be given with reasonable accuracy.
Fertavid solution for injection comes in a glass vial. Do not use the solution if it contains particles or is not clear. First, you should remove the flip-off cap of the vial. Place a needle on a syringe and pierce the needle through the rubber stopper of the vial (a). Draw the solution up into the syringe (b), and replace the needle with an injection needle (c). Finally hold the syringe with the needle pointing upwards and gently tap the side to force any air bubbles up to the top; then squeeze the plunger until all the air has been expelled, and only Fertavid solution is left in the syringe (d). If necessary, the plunger may be squeezed further, to adjust the volume to be administered.
Step 2 - The injection site
The best site for an injection under the skin is in the lower stomach around the navel (e) where there is a lot of loose skin and layers of fatty tissue. You should vary the injection site a little with each injection.
It is possible to inject in other areas. Your doctor or nurse will tell you where to inject.
Step 3 - Preparing the area
A few taps at the injection site will stimulate tiny nerve endings and help reduce discomfort when the needle goes in. Wash your hands and swab the injection site with disinfectant (for example chlorohexidine 0.5%) to remove any surface bacteria. Clean about two inches around the point where the needle will go in and let the disinfectant dry for at least one minute before you proceed.
Step 4 - Inserting the needle
Pinch the skin a little. With the other hand, insert the needle at an angle of 90 degrees into the skin?s surface, as shown in the picture (f).
Step 5 - Checking the correct needle position
If the needle position is correct the plunger should be quite difficult to draw back. Any blood sucked back into the syringe means that the needle tip has penetrated a vein or artery. If this happens pull out the syringe, cover the injection site with a swab containing disinfectant and apply pressure; the site will stop bleeding in a minute or two. Do not use this solution. Start again with Step 1 using a new syringe, new needle and a new vial of Fertavid .
Step 6 - Injecting the solution
Depress the plunger slowly and steadily, so the solution is correctly injected and the skin tissues are not damaged.
Step 7 - Removing the syringe
Pull the syringe out quickly and apply pressure to the injection site with a swab containing disinfectant. A gentle massage of the site - while still maintaining pressure - helps disperse the Fertavid solution and relieve any discomfort.
Any remaining solution should be discarded.
Do not mix Fertavid with any other medicines.
If you use more Fertavid than you should
Tell your doctor.
Too high a dose of Fertavid may cause hyperstimulation of the ovaries. This may be noticed as pain in the stomach. If you are troubled by stomach pains, tell your doctor immediately. See also section 4 on Possible side effects.
If you forget to use Fertavid
If you forget a dose do not use a double dose to make up for a missed dose.
Contact your doctor.