At the Center for Fertility and Gynecology in Los Angeles, CA we perform hundreds of IVF cycles every year. From long protocols to short protocols, natural, mini and low stimulation cycles, we are practiced and experienced in all forms of IVF.
One thing that all of the different varieties of IVF have in common is the requirement that the egg is retrieved prior to ovulation. In some situations like natural IVF, this is accomplished through close monitoring and early retrieval. In stimulated cycles however, medication is used to prevent ovulation.
Luprolide acetate (brand name Lupron or Eligard) is a GnRH agonist which prevents ovulation during flare and long protocol IVF. This blog post will discuss luprolide and its’ role in IVF.
What is Luprolide?
To discuss luprolide requires some background knowledge of how the brain and ovary interact to promote egg growth and ovulation. This process begins with the beginning of each menstrual cycle when the brain sends a message to the ovary asking it to select a group of potential eggs for ovulation. This group of eggs can range in number from 0 to over 20 depending on age and ovarian reserve. Importantly, the egg is microscopic so it cannot be seen by the eye or ultrasound, however each egg grows in side a structure called a follicle, which is a spherical sac of fluid that can be seen by ultrasound.
Over the subsequent 14 days, the brain selects one follicle from the group to develop faster than the others. Once this follicle reaches a specific size, the brain recognizes it as the dominant follicle and sends a signal for it to ovulate. That signal is sent via a hormone called luteinizing hormone or LH. When an ovulation prediction kit becomes positive, it is due to this hormone.
Lupron’s role in this process is simply to interrupt the communication between the brain and ovary. This accomplishes two things;
First, it prevents the brain from selecting just one egg from the available group of eggs at the beginning of the cycle. This is important because one of the main strategies of fertility treatment is to get more than 1 egg to grow at one time.
Second, it prevents the brain from sending the ovulation signal to the follicles. This allows fertility doctors to time ovulation with a fair amount of accuracy rather than trying to catch when the brain is sending the signal.
Lupron is just one of the many tools we use in modern fertility treatment. There are several ways to achieve the same result, but understanding the principles and applying them to each patient as an individual is the secret to finding the right treatment. If you have questions about fertility medications or fertility treatment in general, feel free to contact us, we are happy to chat with you.