A woman has her lifetime supply of eggs (about 7 million) in her ovaries before she is even born and each month loses some, so by the time she is born the number has dwindled down to approximately 1 million. This steady decline continues so that approximately 300,000 remain as a woman enters puberty and the supply of eggs is depleted by the time a woman enters menopause.

Eggs grow in fluid filled sacs in the ovary called follicles which contain cells that support the growth and development of the eggs as well as secreting the hormones necessary for ovulation. There is a huge discrepancy between the number of available eggs in the ovaries and the numbers that actually develops to maturity and are released during ovulation.

Typically a woman will ovulate around 400 times during her reproductive life span. The failure to have any ovulatory cycles is called anovulation and only having irregular ovulatory cycles is called oligo-ovulation. These are among the most common causes of infertility. These types of ovulatory disorders have many causes and can include problems with the central nervous system or the pituitary gland, problems with the developing follicles or ovary, or both.

Most of the approaches to treatment focus on raising the levels of Follicle Stimulating Hormone normally secreted in sufficient amounts by the pituitary gland, to the point where follicular growth and development resumes, ultimately resulting in the release of a healthy mature egg (ovulation). This process is called ovulation induction and can be achieved by using medications such as clomiphene citrate or gonadotropins such as Follistim® AQ Cartride (follitropin beta injection). This is a safe and effective means of restoring fertility in many women who do not ovulate and can also be used to stimulate the development and release of multiple eggs in ovulatory women undergoing various fertility treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF). This form of treatment does require careful monitoring with blood tests and transvaginal ultrasounds and results in pregnancy rates.

Safety Information:

• Follistim® AQ Cartridge administered with Follistim Pen® delivers on average an 18% higher amount of follitropin beta compared to lyophilized preparations administered with a conventional syringe. A lower dose should be considered when using Follistim® AQ Cartridge.
  
• Follistim® AQ Cartridge, like all gonadotropins, is a potent substance capable of causing mild to severe side effects including ovarian hyperstimulation syndrome (OHSS), with or without pulmonary or vascular complications.
  
• Follistim® AQ Cartridge should be used only by physicians who are experienced in infertility treatment and should advise their patients of treatment risks, including OHSS and multiple births.

Please see accompanying Full Prescribing Information.

REFERENCE: Organon patient booklet: Ovulation Induction