I know that for most of us IF'ers out there, we're more than familiar with all the different medications used prior to, during and after an IVF cycle. I know that when we started our first cycle, I had so many questions that needed answering. I was scared, nervous and excited all at the same time!
For those newcomer's out there, I thought it might be beneficial to do a post explaining what the "typical" IVF meds are. So, without further ado, here's a little more information as to what each one is used for during a "typical" IVF cycle. Please keep in mind that everyone is different, and your protocol may/may not include all these. I've also included some other meds that come into play as well throughout the cycle...
- I couldn't find a really good definition of this, other than that it's used to treat conditions due to menopause (eg, hot flashes; vaginal itching, burning, or dryness), treating vulval or vaginal atrophy, and preventing osteoporosis (brittle bones). It is also used for estrogen replacement therapy after failure of the ovaries and to relieve the symptoms of breast cancer. Not sure what it's exactly used for in conjunction with IVF. Hmmm, anybody?
- Microdose Lupron (subcutaneous inj)
- initially accelerates the pituitary gland and then stops it from producing LH and FSH the two hormones responsible for egg development and ovulation), allowing for a controlled stimulation cycle prior to IVF. The low-dose preparation has the ability to stimulate rather than suppress the ovaries. This is used for "poor responders." Usually, five, ten or twenty units is given daily as prescribed during the cycle. It may be overlapped with birth control pills for 3-7 days.
- Low-dose hCG (subcutaneous inj)
- used as a replacement for LH to help supplement the stimulation during ART cycles. When administered as an injection to a non-pregnant woman, hCG acts the same way that luteinizing hormone (LH) does. The advantage is that hCG lasts a lot longer in the body than LH does and therefore has a more reliable, consistent effect. Because of these features, hCG is much more potent than LH.
- Follistim (subcutaneous inj)
- used to induce or enhance ovulation, or, to super-stimulate the ovaries. Follistim contains follicle stimulating hormone (FSH), a naturally occurring hormone. FSH is important in the development of follicles (eggs) produced by the ovaries. Generally started on the second, third, fourth or fifth day of the cycle, and continued for 7 to 12 days or longer if the ovary responds slowly. Gonal-F, Bravelle, Pergonal and Repronex can also be put in this category.
- Ganirelix (subcutaneous inj)
- GnRH antagonist that immediately suppress luteinizing hormone (LH). This medication is initiated during the later part of the stimulation cycle when the follicles begin to increase in size. Cetrotide can also be used.
- hCG ("trigger shot")(subcutaneous inj)
- causes the eggs to complete the maturation process. This is taken only once in the cycle. Release of the eggs should occur about 36-46 hours after the shot. Timing this shot is vital! If it's given too early, the eggs will not have matured enough. If given too late, the eggs may be “too old” and won't fertilize properly. The daily ultrasounds at the end of your stims are meant to time this trigger shot just right. Usually, the hCG injection is given when four or more follicles have grown to be 18 to 20mm in size and your estradiol levels are greater than 2,000pg/ML. Brand names for this include Ovidrel, Novarel and Pregnyl.
- prescribed to each partner during an IVF cycle, to control bacteria that may affect implantation in the female and sperm quality in the male. This ensures that uterus is free of bacteria before embryo transfer. In most cases your partner will start this on your CD3, taking it twice a day for a minimum of five days prior to partner’s retrieval, and you will start it the night of your retrieval.
- a light steroid that is used to prevent 'inflammation' of the uterine lining that can cause it to reject the embryo. Usually, one pill daily beginning the day of retrieval and ending the day of, or after, embryo transfer.
- Progesterone (intramuscular inj)
- these are the big boys!! Administered to support the uterine lining during early pregnancy. Used daily starting the day of IVF retrieval and continuing until the pregnancy test, and an additional four to six weeks if the pregnancy test is positive. I use the Progestero.ne in Ethyl Oleate which is a much thinner consistency. Because of this, you can use a smaller gauge needle, which in turn, makes it that much easier to administer. Do yourself (and your hiney!) a favor and ask your Dr. for this one!!!
So, that about sums it up!
