Monitor ovarian response w/ ultrasound alone, or in combination w/ measurement of serum estradiol levels regularly. Assess couple's infertility before starting treatment. Evaluate for hypothyroidism & hyperprolactinemia. Not recommended to use results other than from ELECSYS AMH Plus immunoassay from Roche for dose determination. Risk of ovarian enlargement & ovarian hyperstimulation syndrome (OHSS). Carefully & frequently monitor follicular development to reduce risk of OHSS; follow for at least 2 wk after triggering of final follicular maturation. Withhold hCG in OHSS & advise patient to refrain from coitus or to use barrier contraceptive methods for at least 4 days. May have increased risk of venous or arterial thromboembolic events during or following treatment w/ gonadotropins in women w/ thromboembolic disease, risk factors for thromboembolic events eg, personal or family history, severe obesity (BMI >30 kg/m2
) or thrombophilia; pregnancy, OHSS; reproductive system neoplasms in infertile women; potential risk of multiple births before starting treatment; ectopic pregnancy in women w/ tubal disease history. Ovarian torsion; miscarriage or abortion; congenital malformations. Moderate/severe renal or hepatic impairment. Not indicated during pregnancy & breastfeeding.