Egg Donor Medications

We often begin the process of egg donation by starting the egg donor on the birth control pills. The hormones (synthetic progesterone and estrogen) in the birth control pills suppress the ovaries and keep the resting egg follicles quiet (inactive). The very low dose of hormones in the pills lowers the hypothalamus’ (the part in the brain that is responsible for, among others, releasing hormones) production of GnRH or gonadotropin-releasing hormone.

The pituitary (near the hypothalamus) depends on GnRH to release FSH/LH, the gonadotropins that tell the ovary to recruit and release an egg. Thanks to the birth control pills we can start the ovarian stimulation process with a ‘clean slate’ and wake up the follicles with medication when ready for the cycle.

Another role that birth control pills play in egg donor medications protocols is synchronizing the cycles of egg donors and recipients (intended mothers) for fresh egg donation cycle; the timing of the menses can be changed to coincide with the specific week and to match the donor and recipient. The side effects of birth control pills are usually minimal.

Follicle Stimulating Hormone (Gonadotropins: Gonal F, Follistim, Menopur) is a hormone that the pituitary gland produces in order to mature eggs in the natural menstrual cycle. As an egg donor medication, its use is to grow more follicles that in turn will yield more mature eggs ready for egg retrieval. Similar to the other egg donation medications we will review, this medicine is self-administered by an injection. In a number of brands of this medication we use for our egg donors, the FSH is administered via a pen with a tiny needle, making it a much more comfortable experience when injecting. FSH injections are taken once a day for around 10 days, but – as with all other medications used in egg donation process – the protocol is individually prescribed and will vary from person to person.

Ovarian hyperstimulation syndrome (OHSS) is extremely rare and happens in approximately 1% of IVF treatments. OHSS happens when the body over-responds to the medication; this causes swelling as fluid leaks out of the ovaries and collects in the abdomen. The condition can cause pain and bloating. In rare cases, individuals may need to go to the hospital to receive treatment. You will need to call your doctor immediately if you are experiencing any of the possible symptoms of OHSS as this condition can be life-threatening. If you or someone you know is exhibiting symptoms – go straight to the ER or call 911.

Gonadotropin-releasing hormone antagonist (Ganirelix Acetate, Cetrotide) is a synthetic drug similar to GnRH, which blocks its activity. It is used to treat women undergoing fertility treatment. It is also an important part of the egg donors medication protocol because it prevents an early release of luteinizing hormone (LH) and premature ovulation (egg release) in women taking follicle-stimulating hormone (FSH) when preparing for in-vitro fertilization or egg donation. FSH stimulates the ovary to select a follicle that houses the egg whereas LH causes egg release from the ovary.

This egg donation medication is self-administered by injection and your assigned nurse will explain your protocol and teach you how to inject into the fatty tissue of your abdomen. You may experience some common, mild side effects associated with hormonal therapy.

hCG (‘trigger shot’: Ovidrel, Lupron hCG) – this hormone is produced in the placenta and elevated levels of this hormone may indicate pregnancy. In egg donation, as well as IVF, this hormone is used as a ‘trigger shot’ to mature eggs so they can be retrieved. The timing of the hCG injection is closely managed and is given when the follicles reach the desired size. The egg retrieval will take place 36 hours after the trigger shot administration and must be accurately timed – if the eggs are not retrieved in time, they will be lost with the onset of menses. The side effects of this medication used in the egg donation process are mainly mild and short term.