What You Need to Know About Medications Used in IVF

Medically, infertility is defined as a condition where a couple of reproductive age cannot conceive after at least one year of unprotected intercourse. IVF treatment, which has been one of the most successful methods for many years, helps couples unable to conceive naturally. As a form of assisted reproductive technology, IVF treatment is used to overcome unexplained infertility, blocked fallopian tubes in women, low sperm count, or poor sperm quality in men, allowing many couples to have children. Couples considering IVF treatment often have numerous questions about the process. Among the most commonly researched topics is the use of medications in IVF. 

Medications used in IVF are one of the most crucial aspects of the treatment process. These medications are not used as a cure but rather as a part of the treatment process. For the treatment to be successful, it is essential to ensure that the female reproductive system functions properly. IVF medications aim to achieve this by promoting the development of the follicles, obtaining a high number of eggs to facilitate pregnancy, regulating hormone levels, and supporting the embryo’s implantation in the uterus after transfer. Additionally, the type and dosage of medications required by the mother-to-be may vary. Therefore, the IVF doctor determines which medications to use, their dosages, and the duration. 

What Medications Are Used in IVF?

Different medications are used in IVF treatment for various purposes. Some stimulate egg development, others induce ovulation, and some help increase hormone levels after embryo transfer. While some of these medications are taken orally, others are administered as subcutaneous injections. Thus, medications in IVF can be categorized into tablets and injections. A brief overview of oral medications used in IVF is as follows:

1. Medications to Stimulate the Ovaries

The IVF process begins with a preliminary consultation, necessary tests, and examinations, followed by the stimulation of the ovaries on the 2nd or 3rd day of menstruation. Medications used to stimulate and grow the eggs include:

• Letrozole: Rarely used in IVF, it is preferred for patients with issues in egg development. It increases estrogen secretion in the body, promoting ovarian growth. It is also frequently used in treating endometriosis.
• Clomiphene Citrate: The first medication introduced for use in IVF, it stimulates the pituitary gland in the brain to secrete Follicle Stimulating Hormone (FSH), promoting egg growth. FSH is a hormone couples should be familiar with in both infertility and IVF treatment.

2. Medications to Prepare the Uterus for the Embryo

These medications aim to prepare the uterine lining to facilitate embryo implantation. Typically used after embryo transfer, these progesterone-based medications not only aid in implantation but are also crucial for development. Additionally, the mother-to-be must take folic acid to prepare the uterus for the embryo. 

What Injections Are Used in IVF?

In addition to oral tablets, IVF treatment involves injections known as IVF shots, administered subcutaneously. These injections aim to promote egg development, prevent premature ovulation, and induce ovulation. Here is a brief overview of the injections used in IVF:

• Human Menopausal Gonadotropins (HMG): Derived from purified urine of postmenopausal women, HMG contains FSH and LH hormones. These hormones stimulate the ovaries and help obtain multiple eggs. 
• Urinary FSH: Similar to HMG but contains only FSH. It is also derived from postmenopausal women’s urine.
• Recombinant FSH: Produced in laboratories through genetic engineering, recombinant FSH is a pure medication widely used in IVF to stimulate the ovaries and obtain multiple eggs. 
• Gonadotropin-Releasing Hormone Agonists (GnRHa): Used to suppress the LH hormone, preventing premature ovulation and allowing better egg quality and quantity.
• GnRH Antagonists: Similar to GnRHa in function but shorter in duration and faster in action.
• Human Chorionic Gonadotropin (HCG): Known as the “trigger shot,” it is administered 35-36 hours before egg retrieval to induce ovulation.

The injections used in IVF treatment are crucial for the success of the process. Therefore, they must be administered as prescribed by the doctor. 

When Are Injections Started in IVF Treatment?

One of the most common questions is when injections begin in the IVF process. The treatment starts with a consultation, necessary tests, and examinations, followed by hormonal injections beginning on the 2nd or 3rd day of menstruation. The mother-to-be continues these injections for 8-10 days while attending regular check-ups. As eggs reach 18-20 mm in size, injections to prevent premature ovulation are introduced. Once the eggs are ready, the “trigger shot” is given, leading to the egg retrieval stage. 

Side Effects of Medications in IVF

Like any medication, IVF medications and injections may have side effects due to their hormonal nature. Common side effects include:

• Redness, bruising, or swelling at the injection site,
• Headaches,
• Breast tenderness,
• Mood swings,
• Fatigue,
• Water retention,
• Hot flashes,
• Nausea and vomiting,
• Diarrhea.

Despite these side effects, the mother-to-be should remember that they are temporary and continue with the treatment. 

How Long Are Medications Used in IVF?

The duration of medication use varies according to the stages of IVF. Hormonal injections begin on the 2nd or 3rd day of menstruation and typically last 8-10 days. Depending on the response, this period may extend by 2-4 days. After egg retrieval, medications like progesterone continue to support embryo implantation and may be used until the 12th week of pregnancy.

As the Kalem Bebek team, we have aimed to provide detailed answers to the most commonly asked questions about “medications used in IVF.” Click here to visit our website for more detailed information on IVF treatment and medications used in IVF.