A biosimilar medicine is a biological medicine that is highly similar and clinically equivalent (in terms of quality, safety, and efficacy) to an existing biological medicine however they cannot be considered generic equivalents of the originator biological medicine. Follitropin alfa is available as Gonal-F® and the biosimilar product Bemfola®. Pregnyl ® injection with solvent 1500 units, 5000 units.Ovitrelle ® prefilled syringe 6500 unit/0.5ml (250 micrograms/0.5ml).Patients who present in primary care who, after initial assessment by the GP, qualify for further investigation of fertility problems should be referred to and managed within specialist teams. Safety concerns around risks of Ovarian Hyper Stimulation Syndrome (OHSS) mean that drugs used in the IVF treatment option are not considered appropriate for routine prescribing in the primary care setting. Plasma cortisol should be measured immediately before the injection, after exactly 30 minutes and then at 1, 2, 3, 4 and 5 hours. Tetracosactide test – measure plasma cortisol immediately before and at exactly 30 and 60 minutes after an IM/IV dose of 250 micrograms.Injection 250 micrograms in 1ml, 1mg in 1ml (depot).Injection 100 micrograms (unlicensed preparation).It is envisaged that certain aspects of fertility treatment, once initiated and stabilised by a specialist, may be appropriate for on-going maintenance within primary care e.g.Clomifene is only indicated for patients in whom ovulatory dysfunction has been demonstrated and other causes of infertility have been excluded or adequately treated.The use of all preparations in this section requires detailed prior investigation and should be reserved for specialist centres.