You’ve had your consultation, finished all your preliminary diagnostic testing as part of your workup, and are ready to get started with fertility treatment.
Based on your results, your fertility doctor has determined the protocol for your IVF cycle will be the “Lupron Down Regulation Protocol”. There are several protocols that can be used to stimulate the ovaries of in vitro fertilization (IVF) patients. With each, the goal is to retrieve the optimal number of eggs required to obtain enough healthy embryos to result in at least one pregnancy.
What is Lupron?
Lupron is an injectable fertility drug that is in the category of GnRH agonists used in an IVF protocol. GnRH agonists shut off your body’s normal process of hormone and egg development. As part of the Down Regulation protocol, it’s used to prevent premature ovulation during the ovarian stimulation process.
The other class of drugs used for Down Regulation are GnRh antagonists, which include Cetrotide and Ganirelix. These alternate medications are used to prevent premature ovulation in what’s known as the “Antagonist Protocol“.
The main difference between GnRh agonists and GnRh antagonists is that the suppressive effects of GnRH agonists (like Lupron) take about a week to take hold. GnRH antagonists act almost immediately. Therefore, the Down Regulation protocol is a longer process than the Antagonist Protocol.
What is the Timeline for Lupron use?
- One week before ovarian stimulation: You’ll start Lupron injections now, usually after natural ovulation has occurred.
- Stimulation phase: You’ll remain on Lupron; the dose is often lowered at this point.
- 36 hours prior to egg retrieval: You’ll stop injections prior to the hCG “trigger shot,” which induces the final maturation of the eggs.
The total amount of time you’ll end up taking Lupron is about 2 weeks.
Lupron and Birth Control Pills
Your fertility doctor may ask you to start taking birth control pills as part of your protocol, since it can help with timing the IVF process and give you scheduling flexibility.
Your doctor may also want you to take birth control prior to IVF to:
- regulate if you have irregular cycles,
- prevent ovarian cysts
- suppress ovaries prior to stimulation with certain protocols.
If you are on birth control pills, usually you’ll start using Lupron a few days prior to stopping the birth control pills.
Your doctor will then tell you when to come back for an ultrasound and blood work (baseline visit) to confirm you are ready to begin the next set of injections to begin stimulation.
Dr. Jeffrey Klein is a board-certified Reproductive Endocrinology and Infertility specialist. Dr. Klein graduated with honors from the University of Michigan. Following his undergraduate education, he received his Doctorate of Medicine from the Albert Einstein College of Medicine and completed residency training in Obstetrics and Gynecology at The George Washington University Medical Center. Dr. Klein has been recognized as a Top Reproductive Endocrinologist and infertility specialist in Westchester Magazine’s Top Doctors every year since 2007. His areas of expertise include treatment infertility, IVF, egg donation, polycystic ovarian syndrome, endometriosis, recurrent pregnancy loss and reproductive surgery. He is a member of the American College of Obstetrics and Gynecology, the American Society for Reproductive Medicine, and the Society for Reproductive Endocrinology and Infertility.