Medication Details
To increase the chance of success with egg donation, we try to obtain multiple eggs for fertilization and conception. You will therefore be taking stimulating medication (Follistim, Menopur, or Gonal F) by injection every day.
Directions for daily monitoring visits
There are two basic medication protocols:
Protocol 1 (short protocol)
Most of you will be using this protocol. It shortens the number of days that you must give yourself injections and may provide an extra margin of safety.
You will start this protocol by taking birth control pills (we will give you the pills) for 3 to 5 weeks. The variation in time allows us to synchronize you to your recipient and also to help you do the monitoring and retrieval at a time that is most convenient for you. You'll take only active pills-ignore or throw away any placebo (sugar) pills that come with your packages.
The last day that you take pills is "day zero". The next day is day 1 and the one after that is day 2, and so on. On day 3 we will ask you to come in between 7:00 AM and 8:30 AM for your first morning monitoring visit. You will have a number of blood tests and a baseline ultrasound.
In the afternoon of day 3, we will call you with instructions for taking your first injectable fertility medication (Follistim). On day 4, we may give you the morning off, but you will still take injectable medication in the evening. Starting with the morning of day 5, you will be coming in daily between 7:00 AM and 8:30 AM for morning monitoring. From day 5 until the day of your retrieval, there are no days off, and no exceptions to this rule.
Usually on day 6 (but sometimes on day 7 or 8), you will be given two additional injections (Antagon and Menopur) in the morning, just after your morning monitoring, by one of our nurses. These additional medications will continue until the day of your retrieval. Do not leave the office on any day after the start of Antagon and Menopur until you have received these injections!
From day 6 on, even though you will be given injections in the morning, you will still be giving yourself an injectable dose of Follistim every evening. We will call you each afternoon or evening to tell you what dose to take that night. This adjustment of dose is very important for your safety as well as for the success of the program.
Sometime between day 9 and day 14, your eggs will be ready for retrieval.
At this point, one last and very important step remains before retrieval. You must give yourself one final, very precisely timed, injection that will trigger ovulation. (Ovulation will occur exactly 36 hours after the trigger injection-we will retrieve the eggs at 35 hours.)
Your ovulation trigger medication will come in a preloaded syringe. It will be either Ovidrel or Lupron. We will decide which of these medications you take based on your ultrasounds and blood tests.
As the eggs mature and you approach the night you will be administering Ovidrel or Lupron, it may be necessary that you return to the office in the evening for an additional ultrasound. Again, it is very important that we are able to reach you.
Always keep track of how much medication you have available. Make sure that you always have an extra night's worth of medicine at home. If you are starting to run low on medicine, please ask for additional medication.
Protocol 2 (long protocol)
In this protocol, you will be taking Lupron daily for about three weeks. Usually you will start the Lupron on day 21 of the cycle previous to stimulation - sometimes while taking birth control pills. After 7 to 10 days on Lupron, usually day 3 of your cycle, you will come into the center for your baseline blood work and ultrasound. It is possible that you will not start your stimulating medications that evening. We will call and tell you when to start. Please stay on the Lupron every night until someone specifically tells you to stop the Lupron.
To increase the chance of success with egg donation, we try to obtain multiple eggs for fertilization and conception. You will therefore be taking stimulating medication (Follistim, Menopur, or Gonal F) by injection every day.
While you are on the stimulating medication, you will need to come in every morning between 7:00 AM and 8:30 AM for a blood test and ultrasound. We will call you each afternoon or evening to tell you what dose to take that night. This adjustment of dose is very important for your safety as well as for the success of the program.
We must be able to reach you or leave you messages while you are taking program medications. Please give us a reliable, private phone number or voice mail/answering machine on which it is OK to leave a detailed message. Make sure that your phone or machine is working properly, that it is turned on and that you check it frequently.
As the eggs mature and you approach the night you will be administering Ovidrel, it may be necessary that you return to the office in the evening for an additional ultrasound. Again, it is very important that we are able to reach you.
During this part of the egg donation cycle, it is normal to feel some tenderness and swelling in the ovaries, some breast tenderness, and to retain fluid. Some donors notice moodiness or PMS like symptoms. These symptoms may continue for two or even three weeks, until your next period. After your next period they will resolve completely.
