IVF Medications

1. Ovarian Stimulation Medications

These stimulate your ovaries to develop multiple mature follicles (eggs) rather than the single egg you’d release in a natural cycle.

Gonadotropins (FSH and/or LH injections)

• Examples: Gonal-F, Follistim, Menopur, Bravelle

• How they work: Contain follicle-stimulating hormone (FSH) and sometimes luteinizing hormone (LH) to directly stimulate the ovaries.

• How they’re taken: Daily subcutaneous injections for 8–14 days, starting early in the cycle.

• Side effects: Bloating, abdominal discomfort, fatigue, mood swings, risk of ovarian hyperstimulation syndrome (OHSS).

2. Medications to Prevent Premature Ovulation

These prevent your body from releasing eggs too soon.

GnRH Antagonists

• Examples: Cetrotide, Ganirelix

• How they work: Block the natural LH surge to prevent early ovulation.

• When taken: Usually mid-stimulation (around days 5–7) until trigger.

• Side effects: Mild injection site reactions, headaches.

GnRH Agonists (less commonly used in modern protocols)

• Example: Lupron

• How they work: Initially stimulate, then suppress natural hormone production.

• When used: Sometimes in “long protocols” or for trigger shots.

3. Trigger Shot

This triggers final maturation of eggs and prepares them for retrieval. Timing is precise here!

hCG Trigger

• Examples: Ovidrel, Pregnyl, Novarel

• How it works: Mimics LH surge to mature eggs.

• Timing: Given ~36 hours before egg retrieval.

Lupron Trigger (GnRH agonist)

• Sometimes used instead of hCG for patients at risk of OHSS.

4. Medications After Egg Retrieval (Luteal Phase Support)

These support the uterine lining and early pregnancy.

Progesterone

• Forms: Vaginal suppositories (Endometrin), gel (Crinone), intramuscular injections (Progesterone in oil)

• How it works: Supports implantation and early pregnancy.

• Duration: Started after retrieval if fresh embryo transfer, continued until pregnancy test (and often through first trimester if pregnant).

Estrogen

• Forms: Pills (Estrace), patches, injections

• Why used: To help build a receptive uterine lining.

5. Additional Medications Sometimes Used

• Birth Control Pills: used at the start to regulate cycle timing before stimulation begins.

• Antibiotics: may be given around retrieval to prevent infection.

• Low-dose Aspirin or Heparin: sometimes used for implantation support, depending on your history.

• Steroids (Prednisone, Medrol): occasionally prescribed to reduce inflammation.

• hCG Micro-doses: used in certain protocols for luteal support.

Typical IVF Medication Timeline

1. Cycle Prep: Birth control pills (1–3 weeks before) to control timing (depending on your treatment protocol)

2. Stimulation (Days 1–14):

• Daily gonadotropin injections (FSH ± LH)

• Midway: Add GnRH antagonist (Cetrotide/Ganirelix) to prevent ovulation

3. Trigger (Day 10–14): hCG or Lupron shot ~36 hours before egg retrieval

4. Egg Retrieval: No injections day of retrieval; anesthesia is used

5. After Retrieval: If transfer is fresh, start progesterone + possibly estrogen for luteal support until pregnancy test

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