Endogen HP Dosage/Direction for Use

Dosage: Infertile patients with oligo-anovulation: The dose of Urofollitropin (Endogen HP) to stimulate development of ovarian follicles must be individualized for each patient. The lowest dose consistent with achieving good results based on clinical experience and reported clinical data should be used. The recommended initial dose of Urofollitropin (Endogen HP) for patients who have received GnRH agonist or antagonist pituitary suppression is 150 IU daily administered SC or IM for the first 5days of treatment.
Based on clinical monitoring (including serum estradiol levels and vaginal ultrasound results) subsequent dosing should be adjusted according to individual patient response. Adjustments in dose should not be made more frequently than once every 2 days and should not exceed more than 75 to 150 IU per adjustment. The maximum daily dose of Urofollitropin (Endogen HP) should not exceed 450 IU and in most cases dosing beyond 12 days is not recommended.
If patient response to Urofollitropin (Endogen HP) is appropriate, hCG 7500 IU units, should be given 1 day following the last dose of Urofollitropin (Endogen HP) or the follicle attains a size greater than 18 mm, hCG should be withheld if the serum estradiol is greater than 2000 pg/mL, if the ovaries are abnormally enlarged or if abdominal pain occurs, and the patient should be advised to refrain from intercourse. These precautions may reduce the risk of Ovarian Hyperstimulation Syndrome and multiple gestations. Patients should be followed closely for at least 2 weeks after hCG administration. If there is inadequate follicle development or ovulation without subsequent pregnancy, the course of treatment with Urofollitropin (Endogen HP) may be repeated.
Assisted Reproductive Technologies: The recommended initial dose of Urofollitropin (Endogen HP) for patients undergoing IVF and donor egg patients who have received GnRH agonist or antagonist pituitary suppression is 225 IU daily administered SC for the first 5 days of treatment. Based on clinical monitoring (including serum estradiol levels and vaginal ultrasound results) subsequent dosing should be adjusted according to individual patient response. Adjustments in dose should not be made more frequently than once every 2 days and should not exceed more than 75 to 150 IU per adjustment. The maximum daily dose of Urofollitropin (Endogen HP) given should not exceed 450 IU and in most cases dosing beyond 12 days is not recommended.
Once adequate follicular development is evident, highly purified hCG 7500 IU should be administered to induce final follicular maturation in preparation for oocyte retrieval The administration of hCG must be withheld in case where the ovaries are abnormally enlarged on the last day of therapy. This should reduce the chance of developing OHSS.