As not all fertilized eggs develop to the blastocyst stage – the stage at which implantation occurs – and not all blastocysts are genetically normal and able to implant, if a woman can develop more eggs than just the usual 1 per cycle she will have more chances of having a normal embryo that can implant and result in a healthy pregnancy.
At our New Jersey fertility center, North Hudson IVF, injectable medications called gonadotropins are the preferred option for ovarian stimulation. Although “injectable” may sound intimidating, the medications are administered subcutaneously with tiny needles that cause little, if any, discomfort. Our staff meets individually with all patients to walk them through the preparation and injecting processes. We are always available as well, by phone or page to answer any “med questions” should they arise.
Gonadotropins are hormones: the same ones that our bodies make – just more of them. Using them according to certain protocols allows women to develop more than one egg per cycle. This results in more “targets” for the same number of sperm – regardless of how egg and sperm get together (intercourse, IUI or IVF). FSH (follicle stimulating hormone) and LH (leutinizing hormone) are the hormones required for follicle recruitment, growth and maturation and the fertility medications contain these hormones in specific proportions. The usual course of treatment consists of 9 – 11 days of nightly injections. An additional medication (ganirelix acetate or leuprolide) is often used in combination with the gonadptropins. These medications are used to prevent a woman from ovulating too early and on her own before the timed IUI or IVF egg retrieval.
The final injectable medication in a fertility treatment cycle is the “trigger shot” of HCG. This mimicks the body’s “LH surge” which prepares the eggs to be able to fertilize with sperm. This is a timed injection: 36 hours before IVF egg retrieval or 39 hours before IUI. HCG can be self – administered, just like the other medications, subcutaneously or intramuscularly.
Side effects of fertility medications include transient, mild bloating, abdominal “fullness” and breast tenderness. As our aim is to “hyperstimulate” the ovaries to develop more than 1 egg, a rare complication of fertility treatment is the “hyperstimulation syndrome” – an exaggeration of the bloating which results in temporary ovarian enlargement, blood clotting and fluid problems. The patients who are at higher risk for this “OHSS” are younger (20s – early 30s) and those with a diagnosis of PCOS. Eating a diet high in protein and drinking 8 – 10 8 oz glasses of water a day during the treatment cycle can help reduce a woman’s chance of developing this self-limiting but significant condition.