To be able to acquire adequate amounts of eggs and follicles for the in vitro fertilization or IVF process, you will need to be stimulated with injectable medications to easily cultivate multiple follicles or eggs that contain structures. The injections are usually given by you or your male partner and the technique for this process is easy to learn and understand.
Generally, there are two types of injectable medications utilized during the IVF drug stimulation protocols: one of the medicines is given to suppress ovulation from occurring before the eggs are removed, while the other medication is used for stimulating the development of multiple eggs.
Types of IVF Medication Protocols
Listed below are the different kinds of IVF medication protocols that are utilized during the procedure:
Long Lupron IVF Medication Protocol
This is the most commonly prescribed protocol in the USA that makes use of BCPs, Lupron or Leuprolide Acetate to prevent you from ovulating; gonadotropins like FSH / follicle stimulating hormones or even hMGs / human menopausal gonadotropin causes eggs to mature better while progesterone supports the lining. For this specific regimen, you will take the BCPs for about three to four weeks, and then five days before your last BCP, you will begin with the Lupron. A couple of days after you stop using the BCPs, you will have your period and this is when you will begin taking the hMG or FSH on a daily basis until your largest follicles reach maturity.
This process usually takes about eight to twelve days; during the period, the stimulation process will also be monitored by making use of a blood estrogen level and vaginal ultrasound for about two to three days. Once the biggest follicles reach around eighteen to twenty millimeters, the eggs will be ready to go through the final step of the maturation process; here, a single infusion of hCG will be given to you. If there are no other procedures done, you will ovulate at around thirty-six to forty-two hours after your hCG injection; so to be able to take the eggs even before you spontaneously ovulate, you will be brought to the operating room where the eggs will be removed non-surgically.
After two days from the egg retrieval, you will be supplied adequately with progesterone regardless of when the embryo transfer had occurred, and this will continue until you reach the time of the pregnancy test.
Around fifteen years ago, a distinct kind of GnRH analog was created and was called the GnRH antagonists. These specific types of medicines function differently compared to Lupron, a GnRH antagonist. Lupron slowly suppresses the pituitary over four to five days but the newer medicines such as the Ganirelix Acetate and Cetrotide suppresses the pituitary in just a few hours.
Low Dose Lupron or Microdose Flare (Poor Responder Protocol)
The poor responder protocol or low dose Lupron is necessary when patients do not react well to the provided stimulation medicines because she has a curtailed ovarian reserve, she is much older, or if she had previously undergone an ovarian surgery; additionally, the regimen is also called the microdose flare, the low dose Lupron protocol, or simply the flare.
The biggest difference of this IVF medication is that by diminishing the dose of Lupron and by supplying you with it two times a day, the Lupron will turn on the pituitary glands instead of turning this off. Doing so will adequately produce great amounts of FSH which will work directly on your ovaries before it gets reinforced with extremely high doses of injectable FSH, making your ovaries react positively as much as they can.
Since the poor responder protocol or low dose Lupron is considered as one of the most challenging, and since there are no instant bullet-type regimens available to stimulate patients adequately, a plethora of alternative protocols to the flare have actually been proposed. Some of these associate the use of oral medicines like Femara or Clomid in addition to the present gonadotropins.
To summarize, the ovarian stimulation process can be very complex which is why a variety of stimulation regimens have been created, as well as evaluated for the whole procedure. This is why it is extremely important for you to discuss the options with your doctor, so he or she can give you a detailed explanation regarding the IVF medication.