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You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
You have selected a link to a third-party Web site. This link is provided solely as a convenience to you and not as an endorsement by EMD Serono, Inc. of such third-party Web site. EMD Serono is not responsible for and does not make any representations regarding the accuracy of materials on such third-party site.
Gonal-f® Cares and EMD Serono are committed to increasing access to fertility medication through the Compassionate Care patient assistance program.
Compassionate Care is available to eligible patients who may not otherwise be able to afford fertility medication. The program offers certain EMD Serono fertility medications free of charge, including Gonal-f® RFF Pen (follitropin alfa injection) to patients who meet the following eligibility criteria:
Qualifying income is assessed according to a standard set of parameters including the Federal poverty guidelines, which take into account the number of persons in household and state of residence.
Patients should complete the Compassionate Care Patient Application and fax or mail it to:
12 Kent Way
Byfield, MA 01922
Attn: Compassionate Care Program
1-866-LETS-TRY
Fax: 1-866-882-2900
Monday-Friday: 9 am–5:30 pm EST
Applications will be confidentially evaluated on an individual basis and will not be reviewed until all supporting income information is received, including most recent 1040 tax return, last two pay stubs, and a copy of the front and back of the patient’s insurance card. If eligibility criteria are met, a product request form will be sent to the physician as listed on the enclosed patient application. Once the physician returns the form and the patient’s application is approved, the request will be processed and product will be shipped directly to the physician’s office.
To download the materials below, please sign in or register for access.
Compassionate Care Patient Application
Fertility LifeLines™ helps patients learn about payment options and saving on Gonal-f® treatment.
Learn about patients' payment options
Indication:
For women, Gonal-f® (follitropin alfa for injection), Gonal-f® RFF (follitropin alfa for injection), and Gonal-f® RFF Pen (follitropin alfa injection) are indicated for (1) the induction of ovulation and pregnancy in the anovulatory infertile patient in whom the cause of infertility is functional and not due to primary ovarian failure and (2) for the development of multiple follicles in the ovulatory patient participating in an ART program.
Gonal-f® is also indicated for the induction of spermatogenesis in men with primary and secondary hypogonadotropic hypogonadism in whom the cause of infertility is not due to primary testicular failure.
Important Risk Information:
These products should be prescribed only by physicians specializing in fertility or reproductive health. Use of Gonal-f®, Gonal-f® RFF, or Gonal-f® RFF Pen by women can result in multiple births.
Gonal-f®, Gonal-f® RFF, and Gonal-f® RFF Pen are potent gonadotropins capable of causing mild to severe adverse reactions, including Ovarian Hyperstimulation Syndrome (OHSS) in women with or without pulmonary or vascular complications. Gonal-f®, Gonal-f® RFF, and Gonal-f® RFF Pen are contraindicated in women and men who exhibit prior hypersensitivity to recombinant FSH preparations or one of their excipients, high levels of FSH indicating primary gonadal failure, uncontrolled thyroid or adrenal dysfunction, sex hormone-dependent tumors of the reproductive tract and accessory organs, and an organic intracranial lesion such as a pituitary tumor. Additionally, Gonal-f®, Gonal-f® RFF, or Gonal-f® Pen should not be given to women with abnormal uterine bleeding, presence or enlargement of an ovarian cyst of undetermined origin or to women who are pregnant or nursing.
The most common side effects reported in women using Gonal-f®, Gonal-f® RFF, or Gonal-f® RFF Pen include headache, abdominal pain, enlarged abdomen, ovarian cysts, nausea, and upper respiratory infections. Men using Gonal-f® have commonly reported acne, breast pain and growth, and fatigue. Injection site reactions have been reported.
Please see accompanying prescribing information below for full disclosure.
RFF: Revised Formulation Female
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Thank you for your interest. The information provided on this site is intended for US healthcare professionals only. To help you get more information and educational resources about fertility, we are automatically directing you to FertilityLifeLines.com.
Gonal-f® Cares helps healthcare professionals care for patients by providing valuable information and educational resources. This site is intended for US healthcare professionals only.
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