Injected Hormones

How are They Used? These are typically shots, the dose depends on use, and previous responses. You can get injections in the stomach, upper arm, upper thigh or buttocks. Depending on the hormone being administered, some you start injecting on the second or third day in your cycle, for 7-12 days, then given another shot to cause ovulation, others are given throughout the pregnancy. Sometimes hormonal injections are combined with clomid.

Side effects and risks:  tenderness, swelling, or bruising at the injection site. Also a risk of  ovarian hyperstimulation, which is when your ovaries respond too much to the medication, and swell. This can lead to fluid leaking into the  body, which can result in hospitalization and bed rest.

What do They do? These medications are used to control the menstrual cycle, to optimize egg retrieval and embryo transfers.  These medications often contain FSH alone, or FSH and LH together. These hormones are important for egg maturation and ovulation. 

Why is it Used? If clomid was unsuccessful or if you are preparing for ART procedure (like IVF or IUI), your doctor may prescribe gonadotropins.

Ovarian Stimulation

Follicle Stimulating Hormone – FSH:

Brand Names: Gonal-F, Follistim, Bravelle, and Fertinex

What does it do? Stimulate the ovaries directly to produce multiple eggs with an increase in naturally occurring hormone FSH.

How are They Used? Administered by subcutaneous injection (videos on how to admisiter in hyperlinks above). Prescribed for IVF as well as in more aggressive protocols for IUI.

Human menopausal gonadotropin (hMG): 

Brand Names: Menopur, Metrodin, humegon, and Pergonalm Repronex

What does it do? A combination of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) stimulate the gonads in the ovaries for follicle development.

How are They Used? Administered by subcutaneous injection. Prescribed for IVF.

Ovulation Suppression 

Gonadotropin-releasing hormone antagonist (GnRH antagonist): 

Brand Names: Ganirelix, Cetrotide, Antagon and Orgalutran

What does it do? Prevents early ovulation before egg retrieval. It blocks the pituitary gland from producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) causing the ovaries to stop producing estrogen and progesterone to prevent premature.

How are They Used? Administered by subcutaneous injection. Typically used in conjunction with FSH and HCG. Prescribed for IVF.

Gonadotropin-releasing hormone agonist (GnRH agonist): 

What does it do?prevents early ovulation before egg retrieval.

AKA: Lupron, Synarel , Suprecur, Zoladex

Ovulation Stimulation

Synthetic Human Chorionic Gonadotropin – HCG

Brand Names: Ovidrel, Pregnyl, Novarel and Profasi

What does it do? Similar in structure to luteinizing hormone (LH), hCG  triggers the mature follicle to fully mature and be released by stimulating LH surge, inducing ovulation.

How are They Used? Administered by injection intramuscularly. Prescribed for IVF and in some IUI cycles.

Uterine Lining

Progesterone

What does it do? Prepares the uterine lining for implantation. Taken before embryo transfer and frequently continued afterward to support the uterine lining and maintain the pregnancy.

Progesterone in oil (PIO)

Brand Name: Generic- Progesterone Injection USP, 50 mg/mL

How are They Used? Administered by intramuscular injection.

Progesterone suppositories

Brand Name: Endometrin

How are They Used? Administered by vaginal suppository 

Estrogen

Brand Name: Estrace or Estradiol 

What does it do? Grows the endometrium of the uterus to prepare for pregnancy.

How are They Used? Administered orally or by suppository. Generally prescribed prior to an embryo transfer and continued after the transfer to support the uterine lining and maintain the pregnancy.