hCG, Lupron, Antagon, Cetrotide, Progesterone
chorionic gonadotropin (hCG) Profasi, Pregnyl, Ovidrel
in a non-stimulated cycle, once the egg(s) is/are mature,
the hypothalamus signals the pituitary to release large
amounts of luteinizing hormone which triggers ovulation.
IVF patients usually receive medications (Lupron, Antagon,
and Cetrotide) that prevent the LH surge. This is because
ovulation must not occur before the eggs are mature
and the IVF team is ready for the retrieval.
(the pregnancy hormone) is produced by the placenta
once pregnancy occurs and it is the hormone measured
by most pregnancy tests. The body reacts to hCG in the
same manner as LH. A surge in hCG levels will also trigger
the eggs are mature, hCG is administered by injection
thirty five to thirty-six hours prior to the egg retrieval,
or intrauterine insemination. This signals the final
maturation of the egg and signals the body that ovulation
will soon occur. Production of other hormones, such
as progesterone, increases.
and Pregnyl are "natural products". being
extracted from placental tissue. Ovidrel is a pure hCG
identical to that produced by the body. It is produced
using genetic recombinant production technology and
has no impurities. All of these products have the same
effect of inducing ovulation.
primary use for these medications it to prevent premature
ovulation (before the eggs are mature) in IVF cycles.
They are administered according to patient specific
and Cetrotide are gonadotropin releasing hormone (GnRH)
antagonists while Lupron is a GnRH agonist. GnRH is
the hormone that signals the pituitary to produce follicle
stimulating hormone, which initiates and supports follicular
development, and leutinizing hormone.
blocks GnRH's action by suppressing pituitary and ovarian
function while Antagon and Cetrotide block the production
at the pituitary gland. Therefore, the antagonists cause
a greater suppression of FSH and LH.
is commonly used to treat endometriosis because it indirectly
lowers the levels of estrogen upon which endometrial
cells depend. All of these products produce an "artificial
menopause" with the accompanying symptoms.
is administered to "down regulated" IVF patients
in order to better control and stimulate follicular
development. The physician determines the treatment
protocol for each patient based upon numerous evaluations,
including day three FSH and LH measurements, patient's
age, body mass index, and number of follicles on day
2 or 3 on transvaginal ultrasound. Dosing is modified
during the cycle based upon estradiol and ultrasound
physicians prefer Antagon and Cetrotide because fewer
injections are required and the suppression of LH is
stimulates the endometrium (lining of the uterus) causing
it to thicken and become more vascular. This thickening
is necessary to support the developing embryo.
the egg is ovulated from the follicle, the corpus luteum
forms from the remnants of the follicle (after ovulation
has occurred) and begins to produce progesterone. Once
the embryo is implanted in the endometrium, the placenta
begins to produce progesterone.
is administered in IVF cycles to insure adequate levels
and offset the effects of high estrogen levels produced
by the stimulation. Furthermore, in IVF cycles, since
ovulation did not occur, there is no corpus luteum to
produce the progesterone. Progesterone can be given
by intramuscular injection, vaginally, or by mouth.
ovarian syndrome (PCOS) is a very common cause of infertility.
The symptoms of PCOS include increased levels of male
hormones (androgens), a pear shaped body appearance,
excess body hair, irregular ovulation. And enlarged
ovaries with many cysts.
patients are usually insulin resistant, meaning that
the body is insensitive to the insulin that is being
made so to over compensate by producing excess amounts
of insulin. This is due to increased production of androgens
(and other factors) by the ovaries. Increased androgens
lead to the common symptoms of PCOS including lack of
ovulation, and excess facial, chest, or abdominal hair