Injectable Fertility Medications contain follicle stimulating hormone or FSH.
Medications such as Follistim®, Gonal-F®, Menopur®, Repronex®, and Bravelle® contain follicle stimulating hormone (FSH) and/’or luteinizing hormone (LH). FSH, which naturally occurs in a woman’s body, causes the follicles in the ovary to begin to make oocytes every month. Follicles are fluid-filled sacs located on the ovaries; the immature egg (oocyte) is attached to the inner wall of the follicle. As the egg becomes more mature, the follicle becomes larger. In a normal month, when the woman’s body regulates the cycle, secreted hormones will cause several follicles to grow, but only one follicle will mature to ovulation.
In IVF cycles, Dr Douglas controls the growth of the follicles, causing multiple follicles to grow and produce many mature eggs. For different types of cycles, He will change the amount of medication given. Usually, the higher the dose given, the larger the number of mature follicles we will see, resulting in a higher number of eggs retrieved. For patients going through an insemination cycle, we prescribe much lower doses of the injectable medicines so that two to three eggs will mature at the appropriate time. If you are going to go through an in vitro fertilization cycle, we would like to have 8 to 15 eggs and the doses of gonadotropins will be higher to increase the stimulation of your ovary for an IVF cycle.
Injectable gonadotropins require daily subcutaneous injections to maintain adequate blood levels so that the follicles continue to grow. Dr. Douglas will monitor your blood work (estrogen, LH, and progesterone) as well as perform transvaginal ultrasound examinations every two to three days to monitor the size of the growing follicles. The ultrasound will give Dr. Douglas a clear picture of how the follicles are growing and when the retrieval step can occur. The gonadotropin stimulation usually takes8 to 12 days, but each case may differ slightly.
Once the follicles reach maturity, as determined by their size as well as their estradiol production, you will receive a dose of HCG, human chorionic gonadotropin, also called a “trigger shot”. We plan this injection 36 hours before the scheduled retrieval to allow for maturation, which prepares the eggs for fertilization and readies the ovary to release the eggs.