The Paradox of Choice

That is actually the title of a book I read a few years ago. And here I am, faced with the decision of what brand name to choose for my FSH: Gonal-F, Follistim or Bravelle.

I like the name Bravelle. It sounds like a brave woman. And I really need my courage, since these days I am thinking of chickening out of this. It's not the injections that worry me, I don't mind needles at all. I just find myself thinking constantly of the many ways this can go wrong. More than anything else, I fear another miscarriage. But my train of negative thoughts is also quite creative at bringing all sorts of birth defects into mind. I am, after all, 41 years old, and my chances of having a healthy child are not as good as that of a 22 year old woman.

Anyway, Bravelle is a simple method: There's the solvent, there's the powder, you mix them together and you inject them. Straightforward and familiar. Although if I need large doses, I will end up mixing the contents of several vials. Sounds cumbersome, but the volume to be injected stays the same at all times.

Then there's the Gonal-f, which according to their website is preferred by two out of three patients. It also says that "The Gonal-f^® RFF Pen has a visual confirmation scale that lets you know the precise dose you set is ready to inject, reducing the chance of dosing errors." If I am reading it correctly, several doses are provided in one Pen. I prefer throwing away syringes after using them. Also, If I am mixing the doses myself, I don't think I have to worry about dosing errors. Still, there must be a reason why people prefer this method.

Finally, there's Follistim, which comes in vials, which can be used with syringes,  or in cartridges that hold more than one dose and can be used with a Pen. As the cartridge empties, you may be left with an incomplete dose and need two injections for one dose. Not a big deal. Can this happen with Gonal-f too? I see less potential for mistake with this type of pen compared to the Gonal-f pen, where there's the potential to pull the plunger and then realize that you have entered the wrong dose.

Well, there they are, my three choices. I am inclined to choose the Bravelle, simply because I like the name and the injection method is familiar. Follistim could also be injected with regular syringes, but larger doses probably mean larger volumes. Plus, refrigeration is a must with Follistim and Gonal-f. Not that I should worry about that, but I did grow up in a third world country where power outages were not that rare.

What would you choose? If you have used any of these drugs, do you have any comments to share?