Medications Used For IVF | Dr. Hakan Özörnek

Medications Used For IVF

Owing to advances in pharmaceutical technology, there are many new and effective drugs are available today in the field of infertility therapies. The aim of using these drugs is to ensure the development of an adequate number of follicles with sufficient size in ovaries so that the rate of becoming pregnant is increased. Especially in assisted reproductive techniques (IVF, ICSI), obtaining more than one follicle is one of the most important factors for success. For the stimulation of the ovaries; two hormones, called FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are used, which are responsible for the generation of eggs.


Clomiphene is one of the first drugs to be used in infertility treatment and it increases FSH release. Clomiphene is available in the form of tablets and is usually used in the period between the 5th and 9th days of the menstrual cycle. The use of clomiphene can result in the development of more than one follicle in ovaries.

Human Menopausal Gonadotropins (HMG)

HMG is obtained via the purification of urine obtained from post-menopausal women and contains both FSH and LH hormones. HMG is applied to stimulate the ovaries and obtain more than one follicle for the IVF and ICSI procedures. HMG is administered via a daily subcutaneous injection.

Urinary FSH

This medication, which is obtained by purification of the urine of postmenopausal women, contains only the hormone FSH and is used as a daily subcutaneous injection for the stimulation of ovaries to obtain more than one follicle for the IVF and ICSI procedures.

Recombinant FSH

Recombinant FSH preparations are 100% pure and produced under laboratory conditions via genetic engineering. The aim of using recombinant FSH is to stimulate the ovaries via FSH to achieve multiple follicle development and to obtain more than one egg for IVF and ICSI. Recombinant FSH is administered by subcutaneous injections. Currently, this medication is available in devices in the form of a pen, which allows automatic dose adjustments.

Gonadotropin Releasing Hormone Agonists (GnRHa)

GnRHa is a synthetic form of the gonadotropin releasing hormone synthesized in the hypothalamus in the brain. GnRHa induces the release of FSH and LH hormones from the pituitary gland. The available forms of GnRHa include injectable forms and nasal sprays.

Early elevations of LH (luteinizing hormone) levels account for a major problem in treatment processes using assisted reproductive techniques. The early surge in LH levels cause ovarian follicles to pass through prematurely, resulting in reduced chances to obtain follicles in adequate numbers and quality. The administration of GnRH agonists minimize the risk of obtaining low-quality and low number of eggs during the hormonal stimulation of ovaries by preventing the premature surge of the LH hormone secreted by the body. GnRH agonists are no longer used in our clinic.

GnRH Antagonists

Although GnRH antagonists act similarly to GnRH agonists, their shorter onset of action and shorter time of use reduce the number of days of patient visits in our center reducing the cost of treatment. Another advantage of GnRH antagonists is the low number of injections to be performed during the treatment. A daily dose of 0.25 mg is started on the 6th day of the stimulation and the daily doses are continued until the egg development is completed.

Human Chorionic Gonadotropin (injection for ovulation)

Human Chorionic Gonadotropin (HCG) is injected approximately 35-36 hours before the egg retrieval procedure. Approximately 36-38 hours after this injection; follicles pass through, that is eggs are released (ovulation occurs). The effect of HCG is to mature the eggs in growing follicles, prepare them for fertilization, and induce progesterone secretion. These medications are similar to the natural LH hormone and cause ovulation in women. Because the timing of HCG injection is very important, it must be applied at the specified time.


Because progesterone is necessary for the healthy growth and development of the endometrial layer lining the uterine cavity; where the fertilized egg is implanted, the implantation of the embryo into the endometrium will be impossible when the progesterone level is inadequate. Therefore, this hormone is supplied as a medication to support the endometrial development in IVF and ICSI processes. Progesterone is available in various forms including tablets for oral administration, a vaginal ovule form, and an injectable form for subcutaneous injection for use in the treatment called as luteal phase support. In our clinic, the vaginal ovule is started as one ovule to be administered three times a day on the day of egg retrieval. This regimen continues until the pregnancy test. The administration of progesterone vaginal ovules can be stopped if the pregnancy test result is positive. Because the progesterone preparations administered in our clinic are natural, they are associated with no untoward effects on pregnancy.


This medication is used in patients, whose egg development will be difficult. Letrazole is started to the patients in the period from the second to fourth days of the menstrual cycle to be taken twice a day for five days. In case no egg development occurs, letrazole can be administered for 3-4 consecutive menstrual cycles.

Other medications

 Folic acid (Folbiol or Centrum): It is a vitamin given daily starting from the beginning of the treatment to avoid congenital abnormalities in infants.

Dostinex Tablet: This medication is given to patients with high prolactin hormone levels to be taken twice a week.

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