MEDICATION

Treatments / Medication

Drug treatment is administered in our Center and it is charged separately from the IVF/ICSI cost and includes:

? establishing the stimulation protocol

? monitoring the ultrasound treatment

? administering the drugs

? establishing the right moment for triggering the ovulation.

In our center we use several drugs types:

1. Drugs for ovarian stimulation include:

a. Gonal-F, Puregon, Menopur, Bravelle and others.

The purpose of the controlled ovarian stimulation is to determine the ovaries to produce more than one oocyte like it is happening in the natural cycle.

There are prepared substances which contain FSH combinations ( follicle-stimulating hormone) and LH (Luteinizing hormone) or only FSH and which, administered on a daily basis, induce the recruitment and development of ovarian follicles (fluid-filled sacs within ovaries which contain the oocytes).

Side effects that may appear when using large doses of hormones are: headaches, indisposition, abdominal discomfort, lack of appetite, fatigue, and discomfort at the injection location. Usually, they disappear after the oocytes are harvested.

The main risk of hormone treatment is ovarian hyperstimulation. This can be prevented by establishing the adequate dose. Nevertheless, if the response to treatment is exaggerated there are methods to avoid hyperstimulation from decreasing the doses to interrupting the treatment completely.

Read more about using Gonal-F in our treatments

b. Elonva

It is one of the most recent prepared substances appeared on Romania?s market and it is used to stimulation treatment also in our clinic. This prepared substance offers the possibility of a single ovarian stimulation injection for a 7 days period, without being necessary to daily supplement the stimulation dose. Elonva?s biodisponibility is gradual on the entire 7 days period. From day 5 Antagonist is being added.

It is contraindicated in Agonist protocols, being safe to use only in the Antagonist ones. It is not recommended to women diagnosticated with Polycystic ovary syndrome.

c. Pergoveris - the newest prepared substance on Romania?s market!!!

It is now in our Center too, especially for patients over 35 years. Until its appearance, we had to prepare ?cocktails? and to administer FSH and LH based prepared substances. Now, the number of injections is half reduced and the quality of oocytes and embryos on women over 35 years will improve significantly, thus the chances of success for IVF/ICSI procedures being also increased.

It is a perfect combination of FSH and recombined LH.

2. GnRH Antagonists (Cetrotide, Orgalutran and others.)

They are being used in the most modern protocols, named short protocols. Antagonists prevent the natural LH peak, thus allowing the growth of more follicles until the desired size. It is used in combination with stimulation prepared substances (Gonal-F, Puregon, Elonva, Bravelle). They facilitate the decrease of the period of treatment.

Antagonists decrease the complications ratio resulted from ovarian hyperstimulation.

3. GnRH Analogues (Diphereline, Gonapeptil)

They are analogues to gonadotropin-releasing hormone. They enhance the recruitment of ovarian follicles, which will grow under stimulation, and prevent premature evolution. In essence, the purpose for using these prepared substances is to have a better control over the ovarian stimulation.

Side effects are short-term ones. Transitory, hot flushes may also appear; they disappear when the proper stimulation begins. Occasionally, headaches have been recorded.

There are two main versions of treatment:

a. Long protocol,, in which a single intramuscular dose is administered or daily subcutaneous doses beginning from day 21-23 of the previous cycle. After 14 days estradiol from blood is dosed, in accordance with which the proper stimulation begins.

b. Short portocol, in which a subcutaneous injection is daily administered, at the same hour, beginning with the first day of the menstruation until the ovulation is triggered.

4. Human chorionic gonadotropin, hCG (Pregnyl, Brevactid, Ovitrelle)

It is a hormonal prepared substance similar to LH, which naturally induces the ovulation.

It is administered when the ovarian follicles have reached certain dimensions in order to influence the oocytes? maturation and the follicular changes shortly before ovulation. After 36 hours from its administration, the ovulation occurs. Harvesting the oocytes must be previously done, otherwise the follicles will be emptied. HCG is also useful for keeping the pregnancy and will be produced by secretion by a placenta, once this is formed.

5. Treatment for hormonal sustainability

In the first 8-10 weeks of pregnancy, an estro-progestive treatment is recommended to support the implantation and subsequently keeping the pregnancy. Medication that is used has two forms:

a. Progesteron (Arefam, Ultrogestan), administered vaginally or orally.

b. Estrogeni (Climen, Estrofem Progynova) especially used in artificial cycles, in ovules donation projects or embryos cryopreservation.

6. Treatment for spermatogenesis sustainability

Vitamine ? Spermotrend is the perfect combination between different compounds so necessary for the normal functioning of the male reproductive system. It contains antioxidants which protect the spermatozoa from external aggression factors (stress, toxins, smoking, alcohol, etc). Vitamins and excipients of this prepared substance are in an ideal proportion in order to ensure a normal development of spermatozoa.