Assess couple's infertility as appropriate & evaluate putative CI for pregnancy before starting treatment. Evaluate patients for hypothyroidism, adrenocortical deficiency, hyperprolactinemia & give appropriate specific treatment. Regularly monitor ovarian response w/ ultrasound, alone or in combination w/ serum oestradiol level measurement. Closely monitor patients w/ existing or family history of porphyria. W/hold hCG & advise patient to refrain from coitus or to use barrier contraceptive methods for at least 4 days if signs of ovarian hyperstimulation syndrome (OHSS) occur. Consider treatment discontinuation when risk of OHSS & multiple pregnancies is assumed. Possible ovarian torsion. Incidence of pregnancy loss by miscarriage or abortion is higher in patients undergoing follicular growth stimulation for ovulation induction. Risk of ectopic pregnancy in women w/ history of tubal disease. Possible ovarian & other reproductive system neoplasms in women who have undergone multiple regimens for infertility treatment. Possible congenital malformations. May increase risk in women w/ recent or ongoing thromboembolic disease or w/ generally recognized risk factors for thromboembolic events [eg, personal or family history, thrombophilia or severe obesity (BMI >30 kg/m
2). Contains Na <1 mmol. Renal & hepatic impairment. Not indicated for use during pregnancy & breast-feeding. No relevant use in paed population. Elderly.
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