Human gonadotrophin preparations May cause allergic reaction

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Abstract
EDITOR, - We were interested in the letter from Aliza Eshkol, of Ares- Serono Group, and Mercia L Page, of Serono Laboratories (UK), regarding extraneous active substances in the old gonadotrophin preparations derived from urine.1 We have noticed that some patients undergoing ovarian stimulation with human menopausal gonadotrophin (Pergonal (Serono)) in our in vitro fertilisation programme develop symptoms that suggest an allergic reaction. The symptoms may be systemic or localised to the injection site, as described by other centres.2 Despite this reaction the patients' ovaries seem to respond normally to stimulation with gonadotrophin, which led us to hypothesise that the non-gonadotrophin proteins (more than 95% of the total protein content3) could be responsible for stimulating an immune response. Two of these patients presented for a subsequent cycle of treatment, for which we used a new highly purified follicle stimulating hormone preparation (Metrodin high purity, Serono). Both patients responded well without any symptoms. During cycles in which human menopausal gonadotrophin had been given in combination with a subcutaneous depot of goserelin …