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Lupron (leuprolide acetate)- GnRH
Agonist
Ovulation induction for assisted reproductive
technologies, such as IVF, involves the administration
of several fertility drugs. Follicle stimulating hormone
(FSH), is given by injections to stimulate the recruitment
and development of ovarian follicles, each of which
contains one egg.
Once the follicles mature, an injection
of hCG (Pregnyl, Ovidrel) is administered and egg
retrieval is scheduled. The physician must insure
that ovulation does not occur before the eggs are
retrieved. Otherwise the cycle would be "lost".
GnRH, or gonadotropin releasing hormone,
is the hormone that stimulates the production of FSH,
LH, and other hormones by the pituitary. When Lupron
is given it produces a state known as "down regulation"
and since Lupron inhibits the production of GnRH,
injections of gonadotropins are necessary to cause
follicular development.
In a normal
menstrual cycle, a surge of LH occurs once the follicles
mature, thus simulating ovulation. Lupron allows the
physician to precisely time ovulation since ovulation
cannot occur until an injection of hCG (the body responds
to hCG in the same manner as LH) is given. Follicular
development is monitored via vaginal ultrasound and
measurements of estrogen levels.
Lupron is administered by injection
according to patient specific protocols and the dose
is adjusted during the stimulation cycle. Sometimes
it is started in the cycle prior to ovulation induction.
Since Lupron chemically induces a "menopausal
state," its side effects can include hot flashes,
mood swings, and others normally associated with the
menopause.
Antagon (ganirelix) Cetrotide (cetrorelix
acetate)
GnRH Antagonists
This class of drugs is known as GnRH
antagonists. They produce the same "down regulated"
state as Lupron albeit by a different mechanism. While
Lupron inhibits GnRH production, Antagon and Cetrotide
block its production at the pituitary. These products
cause much quicker and "stronger" blockage
of FSH and LH. Because of this, they can be given
in smaller doses and for a shorter period of time.
Since the body's production is virtually stopped,
higher dosages of FSH may sometimes be required.
Many reproductive endocrinologists
favor Antagon and Cetrotide because of patient convenience
and greater control of FSH and LH production.
Please
Review the Patient Injection Instructions
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