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Hormone treatments to help make eggs before IVF or GIFT

BMJ Group Medical Reference

If you're having IVF ( in vitro fertilisation) or GIFT (gamete intrafallopian transfer), you are given hormones to increase the number of eggs your ovaries make. The hormones you're treated with are very similar to the hormones that your body makes normally. There are three main groups of hormones used for fertility treatment.

Gonadotrophins. These come as injections and they increase the number of eggs your ovaries make. Some gonadotropins (and their brand names) are:

  • follitropin alfa (Gonal-F, Puregon)

  • menotrophin (Menopur)

  • chorionic gonadotrophin (Choragon, Pregnyl).

GnRH agonists. These come as injections or sprays. They are used before treatment with gonadotrophins to stop you ovulating. Some GnRH agonists are:

  • goserelin (Zoladex)

  • nafarelin (Synarel)

  • buserelin (Suprecur).

GnRH antagonists. These injections are given after treatment with gonadotrophins to stop you ovulating. Some GnRH antagonists are:

  • ganirelix (Orgalutran)

  • cetrorelix (Cetrotide).

You may have the following combinations of hormone treatments when you have IVF or GIFT:

  • Gonadotrophins

  • GnRH agonists plus gonadotrophins

  • Gonadotrophins plus GnRH antagonists.

Another option is called priming. This has been used in women with polycystic ovary syndrome (PCOS), who may be very sensitive to hormone injections. In this case doctors do IVF by taking out young eggs from the ovary and fertilising them in the laboratory by injecting sperm straight into the egg (a procedure called intracytoplasmic sperm injection or ICSI for short). Before taking out the young eggs, the woman will have some hormone injections. [43] [44] [45]

Taking a GnRH agonist before IVF may work better than taking a GnRH antagonist. [46] If you take a GnRH antagonist, your chance of pregnancy may be about one-fifth less.

It's not clear what type and amount of hormones are best for priming. [43] [44] [45]

Are there any side effects?

One side effect is called ovarian hyperstimulation syndrome (OHSS). It happens to about 1 in 10 women who have hormone treatments. [47] One review of the evidence found that taking gonadotropins was more likely to cause OHSS than using other hormone treatments. [48]

OHSS can be mild or severe.

Symptoms of mild OHSS include:

  • Feeling swollen or puffy

  • Putting on weight

  • Feeling bloated

  • Feeling sick.

These symptoms normally last only a week and you may feel better if you drink more fluid.

You may also have more serious side effects such as:

  • Vomiting

  • Pain in your abdomen

  • Feeling out of breath.

About 1 in 50 women who have IVF have serious problems that can affect their heart and circulation, lungs, liver, or kidneys. If this happens, you may need to go to hospital.

If you have polycystic ovary syndrome (PCOS), you have a higher chance of getting OHSS if you take a GnRH agonist together with gonadotropins, rather than gonadotropins alone. [49]

Glossary

kidney

Your kidneys are organs that filter your blood to make urine. You have two kidneys, on either side of your body. They are underneath your ribcage, near your back.

liver

Your liver is on the right side of your body, just below your ribcage. Your liver does several things in your body, including processing and storing nutrients from food, and breaking down chemicals, such as alcohol.

For more terms related to Fertility problems

Citations

For references related to Fertility problems click here.
Last Updated: October 23, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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