What is Lupron and how is it used with IVF?

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Fertility medication for IVF

When your fertility doctor begins making plans for your infertility treatment, they will surely include fertility medications. There are many different types of medications to choose from and when it comes to IVF, Lupron is one of the best known.

Lupron Uses

To understand Lupron, you first need to understand physiology and while it is a bit complicated, it is also super cool.  There is a part of your brain called the hypothalamus and it releases a hormone called GnRH.  GnRH isn’t released all the time, but in pulses, and it is these pulses that stimulate the pituitary, another part of your brain very close by, to release FSH and LH in the blood.  Both FSH and LH stimulate the ovaries to grow an egg, produce estrogen, and to ovulate.  This whole system is called the HPO axis – or the hypothalamic-pituitary-ovarian axis – and it controls female reproduction. 

 Now that we have that out of the way, Lupron is a type of GnRH agonist which means it works like GnRH does.  With a few low dose injections (like a pulse), Lupron stimulates the pituitary to release FSH and LH which stimulates the ovaries to grow eggs and can even cause ovulation.  But if Lupron is given everyday, or if it is given intramuscular so it sticks around for a while, it actually has the opposite effect.  At first it will stimulate FSH and LH but then it will cause the pulses to stop.  When the pulses stop, the pituitary stops making FSH and LH and without that, your ovaries are suppressed.  This suppression of the ovaries causes temporary menopause and can be used to treat a variety of conditions in women including fibroids and endometriosis.  And when it comes to IVF, it can be used in a number of different ways.   

For IVF, Lupron can be started and taken everyday along with birth control pills before ovarian stimulation medications begin.  Remember, by taking it every day, it suppresses the brain’s stimulation of the ovaries.  That is okay during IVF because you are taking other medications that have FSH and/or LH in them to directly stimulate the ovaries to grow eggs.  By starting Lupron early and using it everyday during stimulation, it helps synchronize the eggs and prevent ovulation.  This allows for better control of a woman’s cycle during IVF.  

Lupron can also be started in lower doses at the same time as ovarian stimulation injections are started.  Remember that before Lupron suppresses the ovaries it very briefly increases stimulation to the ovaries.  In this case, if started in lower doses it briefly stimulates the ovaries before it suppresses them and prevents ovulation. 

Finally, Lupron can be used to trigger ovulation.  Taking advantage of the brief stimulation, Lupron given only at the end of IVF stimulation still causes FSH and LH to be released, and because the eggs are now grown, they will respond to the LH surge by ovulating (immature eggs will respond by growing but they aren’t grown up enough to ovulate). 

Lupron Side Effects IVF

One of the downsides of Lupron IVF treatment is the side effects. IVF side effects will vary depending on the treatment, but Lupron side effects can mimic menopause symptoms, which can include hot flashes, headaches, mood swings, nausea, joint pain, dizziness, weight gain, anxiety, and general body aches. Some women will also have decreased libido and vaginal dryness. When taken for longer periods of time with medical conditions like fibroids or endometriosis, Lupron can cause changes in bone density and osteoporosis.  Thankfully, once Lupron is stopped, these side effects often disappear quickly. 

IVF Success and Lupron

IVF success rates depend on a lot of different factors but also include the treatment protocol being used.  At RHWC, a California IVF center, we combine innovative medical  fertility treatments with wellness solutions (acupuncture, yoga, spiritual direction) for the best possible results. Before considering taking Lupron we recommend speaking with a fertility doctor. If you are located in southern California you can book a free fertility consultation with Dr. Marcus Rosencrantz by clicking here.

 

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