Female infertility
Adult: Dose should be individualised. Recommended initial dose: 75 IU/day; may increase dose by up to 37.5 IU after 14 days; further increases of the same magnitude can be made, if needed, every 7 days. Max: 300 IU/day. If response is appropriate, hCG (5,000 USP IU) is given 1 day after the last dose. Withhold hCG if serum estradiol is >2000 pg/ml, if the ovaries are abnormally enlarged or if abdominal pain occurs. Generally, therapy should not exceed 35 days.
Subcutaneous
Spermatogenesis induction
Adult: Start treatment with hCG until serum testosterone is in normal range. Initiate with 150 IU 3 times/wk combined with continued chorionic gonadotrophin. Treatment should be given for at least 4 mths and may continue for >18 mth. Max: 300 IU 3 times wkly.
Subcutaneous
Assisted reproductive technologies
Adult: Initially, 150-225 IU/day for at least 4 days, to be started in the early follicular phase (cycle day 2 or 3), until follicular development is adequate. Generally, therapy should not exceed 10 days. In patients ≥35 yr old with suppressed endogenous gonadotropin levels, initiate at 225 IU/day. Continue until follicular development is adequate. Adjust dose based on ovarian response; adjust subsequent doses every 3-5 days by ≤75-150 IU additionally at each adjustment. Adequate follicular development usually occurs within 5-10 days of treatment. Usual max: 450 IU/day.. Once follicular development is adequate, administer hCG to induce final follicular maturation. Withhold hCG if ovaries are abnormally enlarged.