If other options, such as ovulation stimulation medication or intrauterine insemination (IUI), don’t work, Dr. Douglas may recommend in-vitro fertilization (IVF). During this process, your eggs and your partner’s sperms are combined in a lab to create embryos and transferred back to your uterus. With IVF, Dr. Douglas will select the protocol that he feels will produce the best results.
Reproductive endocrinologists make their decisions based on which protocols they feel will provide adequate stimulation, have few effects on the eggs, allow for good retrieval, and produce quality embryos. Dr. Douglas will explain your specific protocol and provide detailed instructions.
A typical IVF protocol may involve:
Birth Control Pills
Often, doctors use birth control pills the first month of an IVF cycle to regulate the ovaries so that they can control ovulation going forward. With birth control pills, you will start the medication on day 3 for 12 to 28 days.
Leuprolide acetate, or Lupron, suppresses the release follicle stimulating hormone (FSH) and leutinizing hormone (LH), which means that your ovaries will not produce eggs or release them without the help of gonadotropins. Using Lupron allows Dr. Douglas to identify a sufficient number of follicles containing eggs without risking a spontaneous LH surge that would cause ovulation before egg retrieval.
Drugs like Ganirelix, Acetate and Cetrotide will immediately suppress the pituitary from releasing LH and FSH. GnRH Antagonists are started at the stimulation phase of the IVF cycle, during gonadotropin stimulation but before there is a risk of an LH surge.
To develop numerous follicles containing eggs, Dr. Douglas will select either an FSH product like Gonal-F, Follistim or Bravelle or an FSH product in combination with a product that also contains LH, such as Luveris, Repronex and Menopur. Often, patients take gonadotropins for three to five days and then have a blood test and sonogram to check their responses. Stimulation may take 10 to 13 days, continuing until you have several adequate follicles and a high enough estradiol level for egg retrieval.
Approximately 32 to 34 hours before egg retrieval, you will receive a single injection of an HCG product like Ovidrel, Novarel, Pregnyl or generic HCG. This medication will cause the eggs to mature so that Dr. Douglas can retrieve them from your ovaries.
Given orally, vaginally or as an IM injection, progesterone is often prescribed the day of or the day after egg retrieval until your pregnancy test. This hormone helps thicken the uterine lining so that it offers the embryo a supportive environment.
For more information, please visit www.ivfplano.com.