Follitropin alfa with lutropin alfa

How it works

Follitropin alfa stimulates ovarian follicular growth and granulosa-cell oestrogen production, while lutropin alfa supports follicular maturation and theca-cell androgen substrate supply, together mimicking physiological gonadotrophin drive.

Prescribing in practice

• Ovarian hyperstimulation syndrome is the key risk, potentially severe with fluid shifts, ascites and thromboembolism, so treatment must be individualised with ultrasound and hormonal monitoring under specialist supervision.
• Multiple pregnancy risk is increased with gonadotrophin stimulation and should be discussed and minimised by careful cycle monitoring.
• This combination is reserved for women with significant LH as well as FSH deficiency and is initiated only within specialist reproductive medicine services.

Monitoring

Monitor ovarian response with serial transvaginal ultrasound and serum oestradiol to titrate stimulation and detect early hyperstimulation.

Counselling the patient

• Report abdominal swelling, severe pain, breathlessness or reduced urine output promptly, as these can signal ovarian hyperstimulation.
• You will be taught how to give the injection under the skin and how to rotate sites.
• Attend all scan and blood-test appointments so the dose can be adjusted safely.

Evidence & guidelines

Use is supported by NICE fertility guidance and the SPC, which recommend specialist monitoring to balance follicular response against the risks of hyperstimulation and multiple pregnancy.