Ovarian Suppression - Downregulation - GnRH Agonist

In order to optimize pregnancy rates, medications are given to increase the number of eggs produced in an IVF cycle. To prevent premature egg release (ovulation) and control the timing of retrieving mature eggs a GnRH agonist is given. These medications cause a temporary state of menopause and are administered as either an intranasal spray, or subcutaneous (needle under the skin) injection. In some circumstance the birth control pill may be used in combination with these medications. Your physician will determine which protocol is used based on your individual medical history. The nursing staff will start your medications on set days of your menstrual cycle. Once a patient is on the IVF waiting list she will phone in her last menstrual period on the first day of full flow. If there is a slot available the IVF set-up nurse will phone back and offer treatment in that cycle. If the couple accepts the IVF treatment, it will commence in this cycle. If this month is not convenient they will likely be offered treatment in the subsequent cycle.

Suppression Check - Pelvic Ultrasound

After a patient has had approximately 2 weeks of GnRH agonist, or just prior to completing a package of birth control pills, a pelvic ultrasound is performed. This ultrasound is necessary to confirm ovarian suppression and to ensure that no new findings (such as an ovarian cyst) have developed that may interfere with treatment. The transvaginal ultrasound is usually done at the clinic; however, for patients who live a long distance away, alternate arrangements may be made.

Medications/Side Effects

GnRH agonists are commonly known as Suprefact® or Lupron®. These medications may cause nausea, vomiting, hot flashes, night sweats, and headache. You should notify your doctor if you develop rapid heartbeat, chest pain, breathing difficulties, fever, chills, severe headache, or visual changes.