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About your Medications
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Your
body normally produces one egg that is released for
fertilization each month. To increase the chances for
successful fertilization, you will be taking certain
medications to help your body produce more than one
egg without depletion of your egg pool.
It
is important for you to carefully follow the instructions
we give you about your medication, to take them at the
current time,
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| in
the correct dosage and to ask questions, if you are uncertain
of any part. We will teach you and your partner (or another
person) how to administer your injections. |
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| You will
be taking some of the following medications: |
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| Antibiotic
Prophylaxis may be given to some patients and their partners
to be taken orally during their cycle. |
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| Human
Chorionic Gonadotropin (hCG; Profasi, Pregnyl) is an IM injection that like a woman's
natural LH, hCG hormone causes the dominant follicle to release
its egg. hCG, which is produced by the placenta during pregnancy
is extracted from the urine of pregnant women, and is similar
in chemical structure to LH. The physician may also use ultrasound
or blood tests to determine the precise day to administer hCG.
Do not take hCG until you have been given specific instructions
to do so. hCG does need to be refrigerated, if it has been premixed.
After hCG is mixed it must be used within 30 days or discarded. |
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| Metrodin
(Follicle Stimulating Hormone; FSH) is an IM (intamuscular)
injection and contains 75 units of FSH and less than 1 unit
of LH per ampule. It is really hMG with almost all the LH removed.
FSH bypasses the hypothalamus and pituitary to directly stimulate
follicle growth. It is also used to cause multiple follicles
to grow for use in IVF. Pregnancy rates after hMG-induced ovulations
are similar to those of normally ovulating women and may be
even higher. Most doctors start FSH treatment on day 2, 3, 4,
or 5 of your cycle. The injections are given over a period of
days, usually 7-12 days, but this may be extended if the ovary
is slow to respond. The follicle size is monitored by ultrasound
and the estrogen level is measured through blood tests. Ovulation
is triggered by an injection of hCG or reduces the amount of
hCG given. If the doctor sees that too many follicles are developing,
he may decide to withhold the hCG injection. Despite intense
monitoring, multiple gestations occur in approximately 15% -25%
of the hMG cycles. Of the multiple gestations, about 2/3 are
twins and 1/3 are triplets or more. |
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| Side effects
include breast tenderness, swelling or rash at the injection
site, abdominal bloating, mood swings or slight twinges of abdominal
pain. |
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| Fertinex
(Follicle Stimulating Hormone; FSH) is an SQ (subcutaneous)
injection and contains 75 units of FSH and less than 1 unit
of LH per ampule. It is really hMG with almost all the LH removed.
FSH bypasses the hypothalamus and pituitary to directly stimulate
follicle growth. It is also used to cause multiple follicles
to grow for use in IVF. Pregnancy rates after hMG-induced ovulations
are similar to those of normally ovulating women and may be
even higher. Most doctors start FSH treatment on day 2, 3, 4,
or 5 of your cycle. The injections are given over a period of
days, usually 7-12 days, but this may be extended if the ovary
is slow to respond. The follicle size is monitored by ultrasound
and the estrogen level is measured through blood tests. Ovulation
is triggered by an injection of hCG or reduces the amount of
hCG given. If the doctor sees that too many follicles are developing,
he may decide to withhold the hCG injection. Despite intense
monitoring, multiple gestations occur in approximately 15% -25%
of the hMG cycles. Of the multiple gestations, about 2/3 are
twins and 1/3 are triplets or more. |
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| Side effects
include breast tenderness, swelling or rash at the injection
site, abdominal bloating, mood swings or slight twinges of abdominal
pain. |
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| Human
Menopausal Gondatrophin (hMG, Pergonal; Humegon) is an IM
(intramuscular injection and contains equal parts of the pituitary
hormones FSH and LH, which are derived from the urine of postmenopausal
women. The FSH and LH have direct impact on the ovaries, stimulating
them to produce several eggs in one cycle. It is also used to
cause multiple follicles to grow for use in IVF. Pregnancy rates
after hMG-induced ovulation are similar to those of normally
ovulating women and may be even higher. Most doctors start FSH
treatment on day 2, 3, 4, or 5 of your cycle. The injections
are given over a period of days, usually 7-12 days, but this
may be extended if the ovary is slow to respond. The follicle
size is monitored by ultrasound and the estrogen level is measured
through blood tests. Ovulation is triggered by an injection
of hCG or reduces the amount of hCG given. If the doctor sees
that too many follicles are developing, he may decide to withhold
the hCG injection. Despite intense monitoring, multiple gestations
occur in approximately 15% -25% of the hMG cycles. Of the multiple
gestations, about 2/3 are twins and 1/3 are triplets or more. |
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| Side effects
include breast tenderness, swelling or rash at the injection
site, abdominal bloating, mood swings or slight twinges of abdominal
pain. |
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| Leuprolide
Acetate (Lupron) is a synthetic hormone that stimulates
the pituitary gland to secrete LH and FSH production. However,
when a woman starts to take Lupron, her pituitary gland is exposed
to a constant level and the effect is just the opposite. After
an initial acceleration in LH and FSH production, the pituitary
stops producing these hormones. Ovulation is prevented and estrogen
levels drop. As a result the patient often has symptoms of menopause,
including hot flashes, headaches and mood swings. Other side
effects include insomnia, night sweats and decreased libido.
Lupron is given as a daily SQ injection taken up to the time
of hCG. Lupron has been used extensively in the United States
and elsewhere and has been found to increase the number of mature
follicles and decrease the chance of having to cancel a cycle.
Lupron has been approved by the FDA and has been used successfully
in the treatment of endometriosis over a number of years. While
yet to be approved specifically for the use during controlled
ovarian hyperstimulation, Lupron continues to be used safely
and extensively for this purpose. |
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