Today we will talk about the rules for the use of hormonal ovulation stimulation drugs. Hormonal drugs are drugs obtained synthetically. They act like natural hormones produced in the body.
Types of hormonal drugs for women
In the treatment of female infertility, hormonal drugs are always used, as a rule. Women can be prescribed combined oral contraceptives, tablet or transdermal (through the skin) drugs containing estrogens, progesterone preparations, as well as the well-known clomid.
During ovulation and superovulation stimulation (IVF protocols), antiestrogens (Clostylbegit), recombinant (purified), urinary preparations containing FSH and/or LH are used.
In IVF protocols, Gnrh agonists (Diferelin, Decapeptil), Gnrh antagonists (Orgalutran, Cetrotide) are prescribed. The trigger of follicle maturation is the hormone – chorionic gonadotropin.
Thyroid preparations (synthroid) or medications that reduce prolactin production, as well as many others, can be used for treatment.
Hormonal ovulation stimulation: side effects
For the safe and effective use of the necessary hormonal drugs, the doctor first needs to examine patients, collect anamnesis and additional examinations (ultrasound, blood tests for hormones).
There are practically no medications without side effects at all. But it is necessary to distinguish side effects that do not require withdrawal of the drug. For example, breast swelling when taking contraceptive hormones is considered a normal phenomenon.
Headache, dizziness, fluctuations in weight (plus or minus 2 kg) — all this is possible and, as a rule, passes quickly.
Most medications containing hormones have a large list of contraindications. The main ones are: malignant neoplasms or suspicion of their presence, hereditary or acquired risks of thromboembolic complications (changes in blood test parameters, identified genetic mutations of hemostasis that previously occurred in patients with thromboembolism, smoking, etc.).
! It is very important to inform at the reception of all the transferred diseases, the results of the examination and follow all the recommendations of the attending physician.
Rules for the use of hormonal drugs in IVF protocols:
Regularity and dosage. Hormonal drugs should be taken at the appointed time, with a clear regularity. If you miss an appointment or have doubts about the need to continue treatment, be sure to consult your doctor. Self-cancellation or dose change can lead to negative consequences.
The frequency of appearance for follicle growth monitoring is determined individually for each patient and depends on the follicle growth rate, the specifics of the stimulation protocol.
If the patient could not get to the appointment due to unforeseen circumstances, then it is necessary to coordinate further actions by phone with the attending physician. Ovulation stimulation is carried out with daily doses of hormones, missed days can affect the result achieved.
The dosage of hormonal drugs is prescribed by the doctor individually and must be strictly observed. Any deviation in the direction of increasing or decreasing the dosage can completely disrupt the entire treatment process.
Introduction of a trigger (hCG). As soon as the ultrasound picture shows that the ovulation stimulation process is completed successfully, i.e. the follicles are ripe enough for puncture, the patient is prescribed a single injection of hCG. This drug is administered 35-36 hours before the puncture.
Ovulation may occur after 37 hours. If less than 34 hours pass after hCG administration and puncture, the oocytes will not have time to mature. In such situations, the follicles will be empty during puncture.
That is why it is so important to inject hCG at exactly the appointed time. In those situations when the patient accidentally changed the time of the trigger injection, he should immediately inform the attending physician in order to coordinate a possible change in the time of the operation.
During intrauterine insemination, the principle of the introduction of a trigger (hCG), as a rule, changes. After the introduction of the final ovulation drug, insemination is prescribed a day later, and a repeat procedure is performed 1-2 days after the first one. So it is planned to carry out insemination before and after ovulation.