Injectable medications for IVF sound alike, look alike, and can be very confusing! We are here to help at every step of the process.
You will have a full discussion of the medications with Dr. Moomjy, and you will have a full teaching session with her nurse, Diana. Additionally, there are medication teaching videos via the link on this website. And finally, should you have any question about a medication that you need to take, you are encouraged to call the office, even if it is after hours, to have a clarification so that you may do your injection with perfection!
Here we list the medications used for priming, followed by the IVF medications used for the 10 to 15 days of ovarian stimulation to prepare a group of eggs for the actual egg retrieval day.
Medication Protocol
Priming medications prior to the start of IVF/Egg Freeze Cycle:
1. Minivelle 0.1mg (Estrogen Patch)
- This patch is started typically after a midcycle ultrasound or bloodwork confirms ovulation. It helps prime the ovaries to be more responsive to the injectable hormones used at the start of the IVF/Egg Freeze cycle. The patch is then discontinued once you come in for your baseline appointment and Dr. Moomjy has advised you to remove the patch, or on the start of your menses.
2. Endometrin 100mg (Progesterone Capsule Inserts)
- These inserts are done vaginally also after a midcycle ultrasound or bloodwork confirms ovulation. It is typically done once or twice a day vaginally as per Dr. Moomjy’s recommendation, based on your protocol. Endometrin start and stop dates are instructed by MD/RN.
3. Ganirelix/Cetrotide 250mcg (Subcutaneous Injection)
- This Injection is done for 3 days consecutively; 8, 9 and 10 days after confirmed ovulation. It is important that this injection is administered every 24 hours on the days Dr. Moomjy has advised. The purpose is to quiet your own hormones for better synchronization in the actual cycle.
After you have successfully primed your ovaries with the medications stated above, you will then be scheduled for a baseline appointment; typically right before the start of menses or on Day 1 or 2 of menses. This appointment consists of an ultrasound and bloodwork that will confirm the start of the IVF/Egg freeze cycle. If criteria of the ultrasound and bloodwork are met, you will start the injectables the day of your baseline appointment. IF your baseline is day 2 of menses, bring your Menopur with you to the visit.
Injections for the IVF/Egg Freeze Cycle:
1. Menopur 75 IU (SubQ Injection)
- This medication comes in a powder form and in a vial/ampule. The powder would need to be diluted in 1cc of saline prior to injection.
2. Follistim/ Gonal F 900unit (SubQ Injection)
- This Injection comes in the form of a pen. Whether you use Follistim of Gonal F, is based on insurance preference. Both are interchangeable. This medication must be refrigerated.
3. Ganirelix/ Cetrotide 250mg (SubQ Injection)
- As you may notice, this medication was done during the priming portion of your cycle. It is also done again once Dr. Moomjy sees a lead follicle of 12-14mm on your ultrasound. Ganirelix is prepared in a pre-filled syringe and Cetrotide comes in a powder form which needs to be diluted with the prefilled saline syringe. Cetrotide needs to be refrigerated. Cetrotide or Ganrielex needs to be given at the same time each day (Set an alert on your phone). This medication is critical to timing the egg retrieval.
4. Ovidrel 250mcg (SubQ Injection)
- This trigger shot is done when Dr. Moomjy sees your lining and follicles are ready for retrieval. Ovidrel must be refrigerated in a baggie so it does not get confused with any other medications and only given once instructed. There is an exact time for ovidrel. Set 2 alarms to inject at that exact time.
Author
Maureen O'Brien Moomjy, MD, FACOG
