Follistim AQ (follitropin beta) — United Healthcare
Male hypogonadotropic hypogonadism
Initial criteria
- ALL of the following:
- • ONE of the following: Diagnosis of male primary hypogonadotropic hypogonadism OR Diagnosis of male secondary hypogonadotropic hypogonadism
- AND • For induction of spermatogenesis
- AND • Infertility is not due to primary testicular failure
Approval duration
2 months