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Why do you use a nasal spray to trigger ovulation, instead of an hCG injection?

1 answer

Due to the fact that natural LH (lutenizing hormone that triggers ovulation) is short-lived and very expensive to produce synthetically, conventional IVF uses a hormone from the human placenta called human chorionic gonadotropin (hCG), or Ovidrel (synthetic hCG), as alternatives in order to induce final egg maturation, or the “triggering” of ovulation prior to egg retrieval or IUI. The problem with hCG is that due to its long half-life, it lasts much longer in the human body than natural LH and is more potent. Furthermore, in order to properly induce final oocyte maturation, a large amount of hCG (typically 10,000 IUs) is required, which is roughly the equivalent to double the amount of total gonadotropins a patient typically receives in a conventional daily injection protocol. HCG not only induces ovulation, but also stimulates small follicles which might then be recycled only to become cysts in the following cycle. It is common to find cysts in patients after cycles using hCG injections. On the other hand, using a GnRH agonist called Synarel (synthetic Lupron) in a diluted form taken as a nasal spray, serves to stimulate the pituitary to produce a surge of LH, resulting in timed ovulation. It is high enough to induce ovulation in larger follicles, but too short-lived to stimulate small follicles. This allows the body to cultivate those smaller follicles for upcoming cycles rather than stimulating them prematurely and causing them to become cysts. This increases the likelihood of the production of healthy eggs and also allows women to cycle repeatedly without taking breaks. This is especially advantageous for older patients and those with limited ovarian reserve.


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