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Follitropin Alfa

Follitropin alfa is a recombinant human follicle-stimulating hormone used to stimulate ovarian follicle development in women with infertility and to stimulate spermatogenesis in men with hypogonadotropic hypogonadism.

Brief glance

The primary outcome is Sexual Health, but it's also used for Metabolic. This compound is considered a Hormone. It is not currently indicated as compoundable in 503A pharmacies. It is not listed under a DEA schedule.

Overview

Follitropin alfa is a recombinant form of human follicle-stimulating hormone (FSH), a gonadotropin that promotes follicular development by binding to FSH receptors and activating intracellular signaling pathways such as PI3K-Akt. It is indicated for inducing ovulation in women with anovulation unresponsive to clomiphene citrate, including those with polycystic ovarian syndrome, and for multifollicular stimulation in assisted reproductive technologies like IVF. In men with hypogonadotropic hypogonadism, it stimulates spermatogenesis when used with human chorionic gonadotropin.

Benefits

Follitropin alfa is a recombinant form of follicle-stimulating hormone (FSH) used to treat infertility in both females and males by stimulating the growth and development of reproductive cells1,2. In females, it promotes ovarian follicular development and helps induce ovulation in those with absent or irregular ovulation, and is commonly used during assisted reproductive technologies such as in vitro fertilization (IVF) to develop multiple follicles for egg retrieval2,3. In males, follitropin alfa increases sperm production in those with hypogonadotropic hypogonadism or related fertility conditions2,3. The medication works by signaling the body to prepare and mature eggs or sperm, increasing the likelihood of successful conception when used as part of a structured fertility treatment program1,3. Clinical efficacy has been demonstrated across multiple indications, with randomized trials showing live birth rates of 17% to 20% in women with certain types of anovulation, and case series documenting successful follicular growth in 94% of ovulation induction cycles when combined with luteinizing hormone in severely deficient patients4.

Side effects

Common side effects of Follitropin Alfa include injection site reactions such as redness, swelling, or bruising, headache, nausea, abdominal or pelvic pain, ovarian cysts, acne, tiredness, and breast tenderness.1,2,5 Serious adverse effects encompass severe allergic reactions with hives, difficulty breathing, or facial swelling; ovarian hyperstimulation syndrome (OHSS) manifesting as severe abdominal pain, bloating, rapid weight gain, reduced urination, and breathing difficulties; and risks of blood clots, stroke, or heart attack indicated by chest pain, sudden weakness, vision changes, or leg swelling.1,2,5,6 Key safety considerations involve immediate discontinuation and medical attention for OHSS symptoms or thromboembolic events, close monitoring during fertility treatment to mitigate multiple pregnancy risks, and reporting all side effects to healthcare providers or regulatory authorities like the FDA.1,5,7 Use is contraindicated in conditions like uncontrolled thyroid disease, pituitary tumors, or ovarian cysts unrelated to polycystic ovary syndrome.8

Mechanisms of action

Follitropin alfa, a recombinant form of human follicle-stimulating hormone (FSH), binds to the follicle-stimulating hormone receptor (FSHR), a G protein-coupled transmembrane receptor on granulosa cells in the ovaries and Sertoli cells in the testes.9,10 This binding activates the stimulatory Gαs protein subunit, stimulating adenylyl cyclases to produce cyclic AMP (cAMP), which in turn activates protein kinase A (PKA) to promote steroidogenesis and gamete maturation.9,10 FSH receptor activation also triggers downstream signaling through the PI3K-Akt pathway for cell survival, growth, and differentiation, as well as ERK1/2 MAPK pathways that regulate proliferation in a context-dependent manner.9,10 These molecular events collectively drive follicular development in females and spermatogenesis support in males.9,10

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