Before starting the patient of gonadotropins an HCG injections, the basic fertility test to be carried out to rule out hormonal imbalance, PCOD, to look at the anti-mullerian hormone to know the ovarian reserve. Uterine anomalies like cynicae, adhesions should be ruled out by doing 3D scan. Tubal patency should be done by a hysterosalpingography. If the natural ovulation is happening or not, it needs to be checked out. Male factor has also to be looked into. The combinations of medicines along with gonadotropins and injections certainly increases the chances of conception if the above problem is ruled out. Maximum of 6 – 7 cycles can be tried out as there is risk of OHSS, multiple pregnancy and there is a risk of ovarian cancer in long run. Cost factor depends on the type of gonadotropins used. There can be menopausal type, highly purified type and recombinant type. Coming to the HCG injections, almost all the brands of injections have the similar rates.
