15 Dec When Do We Use Injectable Fertility Medications?
Fertility medications are used to hyper-stimulate the ovaries so they produce more mature eggs than they usually would. There are two different types of fertility medications: oral and injectable. Oral meds are a weaker version of the two. So, while they still cause side effects worth knowing about, women taking oral fertility meds typically release one, two, or three eggs, and we use them to support timed intercourse at home or IUI.
If we need to retrieve multiple eggs, we use more powerful, injectable fertility medication options.
What’s Different About Injectable Fertility Meds?
Injectable fertility medications introduce hormones, called gonadotropins, into your system. Gonadotropins include a range of hormones that stimulate follicular development in the ovaries. These are Gonal-F, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).
These hormones are usually produced by the pituitary gland and released in different quantities throughout your menstrual cycle. If, however, you have an infertility factor such as PCOS, are under/overweight, or some other condition blocking ovulation, your body may need more help.
They are more potent than oral meds
Depending on your ovarian reserves, women using injectable fertility medications produce as many as 20 or more eggs at one time. This is very different from the two or three eggs we want to mature using oral medications. Therefore, we only use injectable drugs for specific circumstances.
All of the following medications are injected subcutaneously, which means just into the skin’s fatty tissue without going all the way into the muscle tissue. Administering injections is something we’ll teach you to do for yourself, but it’s easier and much less painful than you’d think.
Read, Tips for Making Injections Less Painful to put your mind at ease.
The most common injectable fertility drugs are:
- Human menopausal gonadatropin (hMG). This is a combo-med that combines FSH and LH. It is administered fo the first seven to 12 days of your menstrual cycle via a subcutaneous injection. The most common brand names are Pergonal, Repronex, and Metrodin.
- FSH (follicle-stimulating hormone). FSH is another follicle-stimulating hormone that is used in place of hMG. Your doctor will help you determine which one is best for you. The most common prescriptions of FSH are Fertinex, Gonal-F, Follistim, Bravelle, and Menopur.
- Human chorionic gonadatropin (hCG). Once the ovarian follicles are mature), you’ll administer the “trigger shot.” The trigger shot contains hCG, which “triggers” the follicles to release their precious eggs. You are closely monitored during ovarian stimulation, and we use a combination of blood tests and ultrasound imaging to determine when the follicles are ready. Common trigger shot meds include Pregnyl, Novarel, Ovidrel, and Profasi.
- Gonadotropin-Releasing Hormone Agonists (GnRH agonists). These are often prescribed during the week or so preceding the menstrual cycle we plan to retrieve eggs. GnRH agonists shut down the production of ovarian hormones, but it does so by stimulating hormone production and then shutting it off when the body realizes it has produced “too much.” Using GnRH agonists is a way to create a “clean slate” so the follicle-stimulating doses used during your cycle are as accurately controlled as possible. Trigger shot options include Lupron, Zoladex, and Synarel.
- Gonadotropin-Releasing Hormone Antagonist (GnRH antagonists). These work similarly to GnRH agonists. However, instead of triggering hormone production and then shutting it down, GnRH antagonists immediately block the body’s natural follicle-stimulation hormone production cycle. As a result, fewer injections are required. Common prescription names are Antagon, Ganirelix, and Cetrotide).
You May Be Prescribed Injectable Fertility Medications When…
You’re pursuing IVF
If you’ll be using IVF, your fertility specialist will prescribe injectable fertility medications to retrieve as many eggs as we can. Then, we’ll fertilize those eggs using your partner’s or a donor’s sperm. The fertilized eggs can be frozen and stored for as long as you want until you’re ready to begin an IVF cycle.
Read 5 Things Women Should Know about IVF to learn more about what you can expect during the injectable med, ovarian stimulation, and egg retrieval process.
You’d like to freeze eggs (fertility preservation)
If you’re pursuing egg freezing to delay family building or as a means of fertility preservation as the result of a medical condition/treatment, we use injectable fertility medications to retrieve at least 15 to 20 eggs or so. These eggs are frozen and stored for you until you use them for IVF or decide to thaw and discard them (or donate them to an individual or couple in need!).
You’re donating eggs
Whether you’re donating eggs for a family member or friend, or you’re donating eggs to a bank, you’ll go through the same primary steps as a woman pursuing IVF.
NEVER use injectable medications if…
Injectable fertility medications have more serious side effects and require consistent daily monitoring. If they aren’t used correctly, you are at risk – as is your pregnancy and your babies if you become pregnant with a high-order multiples pregnancy (quadruplets and beyond…).
You should never use injectable medications if you:
- Are timing intercourse at home
- Have decided to pursue IUI
- You haven’t had a consultation or fertility testing with an experienced fertility specialist
Are you interested in learning more about injectable fertility medications and whether it’s time to consider them? Schedule an appointment at the Fertility Center of Dallas.