So your fertility doctor hass decided for your IVF cycle that they will be placing you on the Lupron Down Regulation. So what is Lupron and what are the common side effects on you body from being placed on this medication? In this article I would like to explain what Lupron is and some of the side effects that are often time concerning for those entering the IVF rhelm. Education and knowledge is the most important part of the IVF process. I feel we all need to be educated about what we are all getting ourselves into.
What is Lupron?
Lupron® is a gonadotropin-releasing hormone agonist. It inhibits the pituitary gland’s ability to control the ovary and, therefore, has been used to reduce the likelihood of unintended ovulation during assisted reproduction treatment cycles. In women with endometriosis, Lupron® provides pain relief and reduction in the size of endometriosis lesions.
Lupron (leuprolide acetate) is often prescribed for endometriosis because it dramatically lowers estrogen levels by regulating the body's production of follicle stimulating hormone (FSH) and luteinizing hormone (LH). The uterine lining is highly dependent upon estrogen for growth.
It is also prescribed in vitro fertilization (IVF) cycles. In IVF treatment, when a patient is on the "luteal Lupron" protocol she usually starts Lupron seven days prior to her next menstrual cycle. Dosages are adjusted based upon each patient's individual response
Lupron is given as a daily injection to tell our body's normal process of hormone and egg development to shut off. As you begin your IVF cycle, you will let your doctor's off know when your period begins (Full flow not just spotting). Some protocols call for patients to begin taking birth control pills. When prescribed, birth control pills should be given for a minimum of 10 days to prepare your body for the IVF process by controlling your ovarian hormones and preventing ovarian cysts. They are also beneficial in the timing of the process. When instructed by your doctor to begin the Lupron injections, there will be some medication overlap as you take birth control pills for several more days before stopping them. You will take the Lupron for 10-12 days on average.
Once you stop the birth control pills, your body will begin another period due to the effects of the Lupron. Your doctor’s office will instruct you on when to return to the office for an ultrasound and blood work (baseline visit) to confirm you are ready to begin the next set of injections (to begin stimulation). You will remain on the Lupron during your stimulation phase and the dose may change at that point. Lupron will also keep you from ovulating prematurely during the stimulation phase.
How does Lupron Work?
Lupron essentially "shuts down" the body's reproductive hormone system.
While shut down, IVF patients use a follicle stimulating hormone (FSH) drug like Gonal-F or Follistim, to cause the recruitment and development of follicles. Dosages of FSH are adjusted based upon each patient's response and it is continued until the follicles are mature.
When Lupron is first administered there is a characteristic initial increase in FSH for several days followed by suppression. Lupron is administered on day 2 on the menstrual cycle and FSH is added to take advantage of this initial surge in FSH.
Ovulation cannot occur naturally while on Lupron because Lutenizing Hormone (LH), which triggers ovulation, is suppressed. This prevents a premature surge of the LH before the retrieval, which could cause loss of the cycle. Once the eggs are mature, an injection of Human chorionic gonadotropin (hCG) or LH is given to stimulate ovulation. Egg retrieval is scheduled 35 hours later
Common side effects include;
- gastrointestinal issues such as constipation or nausea
- redness/burning/stinging/pain/bruising at the injection site
- hot flashes (flushing),
- increased sweating,
- night sweats,
- upset stomach,
- stomach pain,
- breast swelling or tenderness,
- joint/muscle aches or pain, this pain has been know to last for months to years after IVF, and has not found a cure to the pain.
- trouble sleeping (insomnia)
I suggest reading this article from the National Women's Health Network to educate yourself some more if you are concerned with the long lasting effects of this medication. https://www.nwhn.org/lupron-what-does-it-do-to-womens-health/