ART Medications Overview
A woman’s body normally produces only one egg that is released for fertilization each month. To increase the chances for successful pregnancy, female patients are given certain medications that induce the ovaries to develop several mature eggs rather than the single egg. In addition to fertility medications, additional medications are used to schedule ART cycles, particularly for synchronizing patient cycles with egg donors or surrogates, induce ovulation at the appropriate time and enhance uterine receptivity and embryo implantation. Injectable medications commonly used in ART treatment include:
- Gonadotropins: Hormone medications containing follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) that stimulate the ovary to produce multiple follicles (see Table 1).
- Human Chorionic Gonadotropin (hCG): A hormone medication with a similar chemical structure to LH, which is used to trigger ovulation at the appropriate time when the follicles are ready (see Table 1).
- Gonadotropin releasing hormone (GnRH) analogs: Medications used to prevent the body’s own release of LH and FSH from the pituitary gland (see Table 2). Note: The GnRH agonists (Lupron) can also be used to induce a flare-up or LH “surge.”
- Sex Steroids: The natural hormones estrogen and progesterone that are made in the ovary and by the placenta (see Table 3).
- Growth Hormone: Used as an adjunct for ovulation induction for low responders.
Other medications can be administered by alternative routes (oral, vaginal or nasal sprays).The following is a list (in alphabetical order) of medications and hormonal preparations you may be prescribed:
may be stored at room temperature.
deficiency. The hypothalamus therefore orders the pituitary to secrete more FSH and LH.
you have been given specific instructions to do so. Side effects may include abdominal bloating and fluid retention. HCG does not need to be refrigerated.
follicular development, since all endogenous LH and FSH production is suppressed. Lupron should be kept in the refrigerator. At high doses, and in a non-down-regulated IVF cycle, Lupron can also be used instead of HCG to trigger ovulation (for lowering the chance of ovarian hyperstimulation syndrome).
Ovidrel is a recombinant human chorionic gonadotropin which is available in a ready-to-inject prefilled syringe. It is used in fertility treatment cycles to help follicles mature. Ovidrel is taken only once as a single dose, on a specific day and at a specific time as instructed by your physician or nurse coordinator
Are used for 5 days prior to stimulation start (at night for 12–14 hours) to enhance ovarian response.
Disposal of Needles and Syringes
Please Dispose of used needles and syringes carefully in a closed, puncture-proof container. Examples are: coffee can with lid, 2-liter soda bottle with cap or any other non-breakable closed container. Some pharmacies will provide a container designated for the disposal of needles and syringes. You should return this container to the pharmacy that provided it. If the pharmacy from which you purchased your medications does not provide a needle return and disposal service, you may return the sealed container to RSMC.
Possible Side Effects and Complications of Ovulation Induction Medications
Most of the side effects of these drugs are minor, involving discomfort, but not usually requiring continuing or unusual medical intervention. Serious complications of these medications, with the exception of multiple gestations, are rare. Please discuss any concerns you have regarding a specific medication with the IVF nurse. For further information regarding risks and complications of ovarian stimulation, including ovarian hyperstimulation syndrome (OHSS) see Chapter 16: Risks and Side Effects of ART Treatment.
Possible Skin/subcutaneous Reactions to Intramuscular Injections
A red area may appear around the injection site and/or the injection site might itch and/or bruising may occur. These are all excepted reactions and will disappear over time. Due to the viscous nature of steroids in oil solutions, moderate induration (hardening or thickening) of the subcutaneous tissue may occur. This is normal and is of no cause for concern. If the indurated area becomes very tender and/or warm to touch or if redness/bruising around the injection site appear to be enlarging or spreading, please notify us immediately.
Possible Skin Reactions to Subcutaneous Injections
A red area may appear around the injection site and/or the injection site might itch and/or bruising may occur. These are all excepted reactions and will disappear over time. Please notify us if redness/bruising around the injection site appear to be enlarging or spreading.