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Infertility Treatments > Medical > Lupron IntroductionGnRH is a hormone released from the hypothalamus, one of the brain centers that control reproductive function. GnRH controls the release of the LH and FSH from the pituitary gland, and these hormones in turn are responsible for stimulating the production of hormones, and the development of eggs in the ovary. In other words, GnRH controls the functioning of the ovaries. In normal menstrual cycles, GnRH is absolutely necessary. However, when FSH preparations such as Follistim, Gonal-F, or Bravelle are used to induce ovulation, GnRH may actually interfere with our efforts. It can do so by causing premature ovulation or by inhibiting the development of multiple eggs. Before the routine use of Lupron for ovulation induction in ART procedures, premature ovulation was the most common reason these cycles were cancelled prior to the retrieval of eggs. It has been clearly shown that the use of Lupron enhances our ability to retrieve multiple eggs that are all of similar maturity. Lupron is one of a group of synthetic hormones known as GnRH agonists. When given over a seven to ten day period of time, they effectively inhibit the production of LH and FSH. By "turning off" LH and FSH, we can, in essence, turn off the ovaries until such time as we begin to provide direct stimulation to the ovaries in the form of one of the FSH preparations. GnRH agonists have been used for many years in many European countries. Lupron has been available in this country since 1989, and is considered a standard part of ovulation induction for ART procedures by most programs in this country. Lupron is approved by the FDA. Administration Lupron must be administered by subcutaneous injection once, or sometimes twice, daily. A very small volume and very small needle are used, and the injections are virtually painless. Injections are usually begun on "day 21" of the menstrual cycle proceeding the month during which we intend to administer FSH. When your period starts, call and notify the office. An ultrasound and blood test (estradiol) will be scheduled to be sure your ovaries are suppressed and ready to undergo stimulation. FSH injections will then be initiated. Although circumstances vary from individual to individual, the injections of Lupron are often continued on a daily until mature follicles have been developed within the ovaries. Risks and side effects Lupron use is associated with minimal side effects. The most significant of these is hot flashes, but even this side effect is rare and very temporary. Many other side effects have been reported, but these are all tolerable, transient, and rare. No long-term adverse effects have been noted. Lupron very specifically inhibits the production of FSH and LH and is not known to have significant effects on any other system within the body. The drug has a very short "half-life". That is, it is very rapidly cleared from the circulation, and therefore has no adverse effects should you become pregnant. During the month in which you anticipate starting Lupron on "day 21", we advise that you should avoid pregnancy. There is no way to be certain that you are not pregnant before starting Lupron on day 21. While this has occurred in a significant number of instances and no adverse effects have been demonstrated, we would still advise you to avoid conception. "Day 21 Lupron Instructions" Use a barrier form of contraception
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