Before leuprolide acetate (Lupron) is administered, the initial stages of the IVF treatment cycle typically begins at the onset of a menstrual period with a regimen of either Progesterone/Provera or birth control. The woman’s next menstrual cycle is then followed by mall daily intramuscular injections of Lupron for about three to four weeks. Lupron can either be administered by the woman herself, or her partner. Alternative methods include an intranasal spray; however, the intramuscular route is preferred because it insures more even absorption. Lupron is key to the IVF treatment cycle because it suppresses the woman’s hormones for a short time in order to control the menstrual cycle in a process known as controlled ovarian hyperstimulation (COH). Secondly, Lupron also prevent “early LH surge,” which is the premature release of eggs from the ovaries before the time of retrieval.
How Lupron Works
Lupron is able to achieve this because its structure is very similar to Gonadotropin Releasing Hormones (GnRH), a natural peptide (a molecule consisting of a chain of amino acids) produced by the hypothalamus. Lupron’s initial effect (for about 2-4 days or so) is to stimulate the pituitary gland to produce both follicle stimulating hormones (FSH) and luteinizing hormones (LH). It does, however, operates in a dual function when administered in multiple doses. In this way, it stimulates the release of gonadotropins, causing the pituitary glands to switch off so that it no longer produces any gonadotropins. This process is referred to as “pituitary down-regulation” and the effect continues for as long as Lupron therapy is maintained uninterrupted. There are many other kinds of GnRH analogues available that act similarly, including Lupride, Buserelin, Triptorelin (Decapeptyl).
About a week after taking Lupron, the woman’s period will begin, “freezing” her hormonally and allowing normal egg production to be put on hold. Ultimately, preventing the release of eggs will allow doctors to collect them later in the process. Lupron is used for at least two weeks before the patient is scheduled for a baseline appointment. Most women will start taking one stimulating medication (Gonal F, Follistim, Bravelle, Repronex, Menopur), otherwise known as HMG injections (Lupron Protocol – IVF Guide, n.d.). As you continue to take Lupron, these additional medications will help stimulate the development and maturation of multiple eggs in the ovaries. The objective of this medication protocol is to produce as many eggs as possible in a given cycle, and “tell” the ovaries to hold them until they are collected. On average, about 6 to 12 eggs develop.
References
Detailed Explanation of IVF. (n.d.). Retrieved from CYN Fertility Center: http://cnyfertility.com/fertility-treatments/in-vitro-fertilization/detailed-explanation-of-ivf/
Lupron Protocol – IVF Guide. (n.d.). Retrieved from Women and Infants: http://www.womenandinfants.org/fertilityandpregnancy/ivfguide/lupron-protocol.cfm
Lupron Therapy and IVF. (n.d.). Retrieved from Sher Fertility: http://haveababy.com/fertility-information/ivf-authority/lupron-therapy-and-ivf
