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Ovidrel, Pregnyl (hCG)
Human chorionic
gonadotropin (hCG) is produced by the placenta in pregnancy
and sets up the cascade of events that causes production
of progesterone by the corpus luteum. hCG levels are
measured to confirm pregnancy.
In addition, hCG can be used to
trigger ovulation in women undergoing
stimulated IUI and assisted reproductive technology
cycles, IVF
. In a normal ovulatory cycle, a surge of LH triggers
ovulation and release of the egg (s). The body responds
to hCG in the same manner as it does LH, therefore a
surge of hCG also initiates ovulation. In 98% of cases,
patients receiving Lupron
or Ganirelix Acetate can only ovulate when they are given
an injection of hCG or LH. Therefore the insemination
or egg retrieval can be precisely timed for 36 hours
after the hCG injection. Profasi
and Pregnyl are human derived and Ovidrel is a recombinant
product with a higher percentage of hCG per unit mass.
Parlodel (bromocriptine)
Hyperprolactinemia
is a condition in which the levels of the hormone
prolactin are abnormally elevated which leads to abnormal ovulation and infertility. Prolactin levels
normally rise in pregnancy to stimulate the production
of breast milk. High prolactin levels in the absence
of pregnancy can cause anovulation and are often due
to a small tumor at the base of the pituitary gland.
Treatment sometimes involves removal of the tumor by
a neurosurgeon or the drug Parlodel (bromocriptine)
is prescribed to normalize levels.
Antibiotics
The physician rules out infections
that could cause infertility in the male and female in the initial fertility
evaluation. Infections of the reproductive tract
can be very serious causing pelvic inflammatory disease
which can scar and damage internal organs including
the uterus
and
tubes or in the male
the testicles, vas deferens, and other structures.
Common infectious agents causing infertility include
gonorrhea, Chlamydia, and mycoplasma. Fortunately, there
are a wide variety of antibiotics effective in treating
these infections. The key is early diagnosis and treatment
before the organisms can cause damage
Birth Control Pills
Obviously, birth control pills
are used to prevent conception; however, they are sometimes
used in assisted
reproductive technology cycles, IVF. Birth control
pills may be administered in the cycle prior to the IVF
cycle. They contain progesterone and estrogen, which suppresses
the production of FSH.
Since FSH is suppressed it is highly unlikely that any
dominant follicle will be produced in the cycle where
birth control pills are administered. Since the follicle
is not produced, the next IVF cycle starts with no residual
dominant follicles.
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