Patient Medication Information

ANTAGONIST

Drugs Actions Actions Continued Side Effects Storage
Synarel (Nasal Spray)
or
Lucrin
(subcutaneous injection)
(Agonists)
or
Decapeptyl
(Subcutaneous injection)
• Acts on the pituitary gland to desensitise (down-regulate) prior to commencing a stimulation cycle.
• Can also be used to Trigger for the final maturation of oocytes prior to egg collection.
• Treatment may begin in the early follicular phase (Day 2 of cycle) or the mid-luteal phase (usually Day 21 of the preceding cycle) or to trigger final maturation (end of stimulation).
• Causes an initial and transient increase in the pituitary hormones (LH and FSH) – leading to a temporary increase in ovarian hormone production.
  • Repeated dosing
leads to a decrease in the secretion of LH and FSH from the pituitary gland – resulting in a reduction in ovarian hormone production. This provides a more controlled situation for stimulating follicle production.
• Down-regulation of the pituitary can prevent the LH surge –thereby preventing premature ovulation.
• Headaches
• Hot flushes
• Mood swings
• Vaginal dryness
• Changed in libido
• Acne
Synarel:
store below 25ºC and away from light
Lucrin: refrigerate (2-8 degrees) Do not freeze
Decapeptyl: refrigerate (2-8 degrees) Do not freeze.

FOLLICLE STIMULATING HORMONE (FSH) (Subcutaneous injections)

Drugs Actions Actions Continued Side Effects Storage
Gonal F
or
Puregon
or
Menopur
or
Bemfola
or
Rekovelle
and
Elonva
• Acts directly on the ovaries to stimulate follicular development and hormone production within the ovaries with the aim of collecting multiple mature eggs at egg collection. • Headaches
• Dizziness
• Pelvic pain
• Pelvic discomfort
• Nausea
• Fatigue
• Tender breasts
• Mood swings
• Fluid retention
• Ovarian Hyperstimulation Syndrome (OHSS)
Refrigerate (2-8 degrees). Do not freeze.

RECOMBINANT HUMAN LUTEINISING HORMONE (R-HLH) (Subcutaneous injections)

Drugs Actions Actions Continued Side Effects Storage
Luveris
• Used in conjunction with Follicle Stimulating Hormone (FSH) injections for patients with low levels of luteinising hormone (LH). Helps to increase follicular oestradiol secretion and induce follicular development. May occasionally be used in patients who have had a previous poor response. •  Headaches
• Pelvic pain
• Pelvic discomfort
• Nausea
• Soreness and redness at injection site
• Mild or moderate OHSS
Store below 25 degrees. Protect from light.

RECOMBINANT HUMAN FOLLICLE STIMULATING HORMONE (R-HFSH) AND RECOMBINANT HUMAN LUTEINISING HORMONE (R-HLH) (Subcutaneous injections)

Drugs Actions Actions Continued Side Effects Storage
Pergoveris
• A combination of FSH and LH into 1 injection. Stimulates follicular development and hormone production within the ovaries with the aim of recruiting multiple mature eggs at egg collection.
• Used for patients with low levels of luteinising hormone (LH). Helps to increase follicular oestradiol secretion and induce follicular development.
• May occasionally be used in patients who have had a previous poor response.
• Headaches
• Abdominal tenderness and swelling
• Breast tenderness
• Nausea
• Mood swings
• Dizziness
• Fluid retention
• Tender ovaries
• OHSS
Store below 25 degrees. Protect from light.

ANTAGONISTS (Subcutaneous injections)

Drugs Actions Actions Continued Side Effects Storage
Cetrotide
or
Orgalutran
• Used to prevent premature ovulation by inhibiting pituitary LH and FSH secretion.
• Must be taken at the same time every day.
• Headaches
• Nausea
• Itchiness
• Soreness and redness over the injection site.
Cetrotide: store below 30 degrees.
Orgalutran: Store below 30 degrees.

TRIGGERS

Drugs Actions Actions Continued Side Effects Storage
Ovidrel
or
Pregnyl
or
GnRH Agonist
• Induces the final maturation process of eggs within follicles just prior to ovulation. Also used to support the lining of the uterus after embryo transfer. Commonly known as a “trigger” injection. • Headaches
• Nausea
• Itchiness
• Soreness and redness over the injection site.
Ovidrel: refrigerate (2-8 degrees). Do not freeze.
Pregnyl: Refrigerate (2-8 degrees). Do not freeze.

LUTEAL MEDICATIONS

Drugs Actions Actions Continued Side Effects Storage
Crinone
or
Oripro
or
Endometrinor
or
Utrogestan
• All contain progesterone to support the lining of the uterus after an embryo transfer in Assisted Reproduction Treatment (e.g. IVF and Frozen Embryo Transfer cycles) • Uterine cramps
• Headaches
• Sleepiness
• Dizziness
• Nausea
• Abdominal pain
• Constipation
• Difficulty passing urine
• Thrush-like symptoms
Crinone: store below 25 degrees in a cool dry place.
Oripro: Store below 25 degrees in a coo; dry place.
•  Endomitrin: store below 25 degrees in a cool dry place.
Utrogestan: store below 30 degrees in a cool dry place.
Drugs Actions Actions Continued Side Effects Storage
Clomid/Serophene
or
Femara Letrozole
or
Progynova (oral tablet)
• Blocks estrogen receptors to increase the release of pituitary hormones to help induce ovulation. •“Off Label” use for ovulation induction. Reduces the amount of oestrogen circulating in the bloodstream – thereby reducing oestrogen and increasing FSH and LH secretion. • Progynova is a synthetic hormone replacement for estrogen. It is used to build up the lining of the uterus in preparation for embryo transfer during a frozen cycle for women who do not ovulate regularly.    • Breast tenderness
• Bloating
• Mood changes
• Nausea
• Headaches
Store at room temperature.
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