Determination of the drugs used in the treatment of in vitro fertilization, which is an assisted reproductive method, is related to the age of the woman, the egg reserve in the ovaries and the hormone levels. As a result of the examinations performed to the woman, the dosage and use of the drugs to be used in the treatment are determined. The drugs used in this treatment include different applications for each patient. In some, on the second or third day of menstruation, the beginning of the use of medication, while in others, drugs can be started on the first day of menstruation. Medication dose is very important in treatment. When overdose is used, the over excitation of ovaries called OHSS may occur. The aim of the drugs is the growth of the ovaries and follicle development and increases the chances of becoming pregnant. During treatment drugs are used in the stage of stimulation and collection of eggs.
Drugs used to suppress egg production and physiology
GnRH Analogs (Lucrin and Decapeptyl): These drugs are used to prevent premature cracking of eggs and suppress normal physiology. The hormone released from the hypothalamus in the brain is the synthetic one. Nasal spray or needle is given to the patient.
Stimulating needles (Menogon, Puregon, Merional, Menopur, Fostimon, Gonal-F): Women normally produce only one egg per period. In order to be successful in IVF treatment, many eggs are needed. After suppression of physiology, a large number of eggs are obtained with stimulating needles. The efficacy and safety of these drugs are close to each other. Stimulant needles can be applied under the skin or into the muscle. However, it is mostly preferred to be made under the skin. When injected intramuscularly, the upper external side of the hip, subcutaneous injection of the arm, thigh front and anterior abdominal wall are preferred.
These drugs should be stored at +4 degrees in the refrigerator. It can be stored for a long time in medications kept at room temperature. In order not to decrease the effectiveness of drugs, it should not be kept at room temperature during the summer period. For drug therapy, ultrasound and blood estrogen levels are measured on day 2 and day 4 of menstruation. The stimulating needles applied to the patient are performed at the same time every day. Since patients are prescribed daily doses, these must be observed.
What are the side effects of drugs used to stimulate the ovaries?
The drugs used to stimulate the ovaries in treatment have no serious side effects. The most important side effect of medication is ovarian hyperstimulation syndrome OHSS due to overexcitation of ovaries in ovarian women. In this case, weight gain occurs due to excessive water retention in the body. The development of OHSS occurs after embryo transfer. The patient should inform his doctor immediately if the following effects occur.
A little swelling, pain and tension in the abdomen is considered normal. However, physicians should be advised of excessive effects.
Weight loss in a sudden and rapid manner during the day
In case of increase or decrease in urine output
Ingestion and severe nausea
Shortness of breath
Drugs used for egg maturation and cracking
GnRH Antagonists (Cetrotide, Orgalutran): They are used to prevent the early cracking of eggs.
Egg Cracking Needle – HCG (Pregnyl, Ovitrelle): In the treatment, the eggs reach the required maturity and require a diameter of more than 15 mm. In the treatment, HCG is preferably administered when 3 or more eggs mature above 17 mm, or when E2 level exceeds 500 pg / ml. The purpose of the cracking needles is not to allow the eggs to crack. These needles are applied to ensure that only the final maturity of the egg cells is reached. Eggs should be collected before cracking. Eggs are collected 36 hours after HCG administration. Attention should be paid to this period.
Pregnyl: This drug consists of 5000 units of dust and solvent water. There are 1 dust and 1 water in the box. Usually 2 doses of powder and 1 dose of water are administered intramuscularly and intramuscularly. Ovitrelle 250 grams of 1 dose of powder and 1 dose of water are mixed and applied under the skin. These drugs can be stored at room temperature for a certain period of time. However, in order to maintain their full efficiency, they should be preserved at +4 degrees in the refrigerator during the summer.
Drugs used in the preparation of the uterine wall
Medications used to sensitize the ovaries
Progesterone (Crinone, Proluton): Progesterone hormone is released from the ovaries and the uterine wall is ready for the embryos to cling. Progesterone hormone should be supplemented externally. This hormone is started the day after egg collection. With the acquisition of the pregnancy, hormone supplements are made until the tenth week of pregnancy.
Femara: These drugs are often used in patients who are expected to have very weak cases of ovarian disease. These medications are preferred to make the ovaries more sensitive.