Fertility Belgium

Medication

The medication administered during IVF treatment can be generally classified into two subgroups:

  1. Stimulation medication
  2. Medication to support implantation

The composition of the medication can always be adjusted or extended, of course, to include specific products based on the individual situation.

1. Stimulation medication

In an initial phase of an IVF treatment, we carry out what is called ‘ovarian hyperstimulation'. This means that the woman is given medication to make her ovaries produce several eggs. After all, dozens of immature egg cells grow inside a woman every month. In a natural cycle, one (or maximum two) eggs are selected and all the rest die off. In IVF treatment, however, we try to bring more than just that one egg (e.g. eight to ten eggs) to maturity by means of hyperstimulation. This stimulation medication works the same way as the natural follicle-stimulating hormone (FSH).

The stimulation medication is administered in the form of injections. Until recently, this was only possible by means of intra-muscular injections that had to be administered by a nurse or doctor, but ‘pen needles' have become available in the last few years that are very user-friendly. To use one, the dose is set on the pen and the injection can be made under the skin of the abdomen wall. These injections are almost painless and can easily be administered by patients themselves. There are several varieties of stimulation medication. For example, some medication works like FSH alone, but it can also be combined with the luteinising hormone (LH). The exact dose and composition of the medication is determined on the basis of the patient's history (for example, ovarian reactions and egg quality in any previous cycles) and the patient's age.

As well as this, medication is also used to prevent ovulation from occurring spontaneously. This is because it is important to time the oocyte retrieval to the exact moment when as many eggs as possible are mature, without the body itself disrupting this process. This medication has a significant effect on the hypothalamic-pituitary axis.

Finally, a last injection is given during hyperstimulation, which is called ‘triggering'. This ‘triggers' the final maturation of the egg. This occurs exactly 36 hours after the injection.

2. Medication to support implantation

After the retrieval and fertilisation of the egg cells, a final round of medication is administered to support the implantation phase and calm the womb. The main focus is on natural mechanisms stimulated by administering progesterone. Progesterone is a natural hormone produced by the ovaries after ovulation with the aim of calming the womb and making the uterus lining (endometrium) receptive. However, after a hyperstimulation cycle, it may be that insufficient natural progesterone is produced, which clearly means that extra needs to be provided. This is done in the form of vaginal tablets. If necessary, the woman's own progesterone production is reactivated by means of injections.

Finally, a low dose of muscle relaxant and/or a child's dose of aspirin is administered in some cases to improve blood flow in the endometrium and calm the uterus.