What are the drugs used in a stim cycle? What are they called and what does each one do?
ok - i'll list the ones i know - and how they work (as far as my understanding goes) - anyone else that wants to correct me, go for it!

OCP/Pill - as mentioned before, it helps to get AF to visit when you need her to, and is the first step in a fully down regulated cycle. i get the feeling this tends to apply more to people that have something of a cycle of their own (however irregular), as they have natural production of hormones that the clinic don't want them to produce. the clinic likes to have full control over hormones being introduced to the body so as they can expect (well, hope for!) a specific response. it's also an additional step to ensure that no early, undetected pregnancy, is trying to take hold when other drugs, far more detrimental to a developing fetus, are introduced

Synarel (nasal spray) or Lucrin (injections) - these are the drugs that basically shut your ovaries down before starting a stim cycle - as it was explained to me, the drugs basically put your ovaries into a drug-induced menopausal state. the clinic want your hormones (estrogen and progesterone) at non-existent levels (as they would be day 1 of AF) naturally, so that they can introduce the synthetic hormones in a controlled manner. These continue along until very close to egg pick-up or insemination as they also prevent the bodies ability to have a surge ot luteinising hormone (LH) - which is the hormone that naturally causes ovulation. for those of us that can't use these meds (or some that do, but need extra help to stop OHSS developing etc, they may use antagonist meds which i'll explain below)

for some people, this step is excluded - this is what happens with me. i have relatively flat-lined hormones all the time - and when my body is forced into the menopausal state, my ovaries refuse to wake up again!

Puregon or Gonal-F (injections) - for a lot of the drugs, there are two main manufacturers - so a lot of them have two names, but essentially the same action! these are an injection of follicle stimulating - basically it's used to encourage the development of a uterine lining, and, more importantly, the follicles on your ovaries. the hope is that each follicle would contain a nice little egg that is maturing nicely - unfortunately, that's not always the case - sometimes, a follicle will develop that contains only fluid - others will not mature enough to be a viable egg. the injections are administered daily, and the follicular development monitored. the aim is to get a number of dominant follicles that are large enough to include a mature egg.

for some people, they have a nice number of healthy mature follicles that give them nice mature eggs - for others, particularly those of us unfortunate enough to have PCOS - this can be a very difficult tight rope to walk - need enough meds to encourage follicular development, but not so much as to overstimulate the ovaries and develop OHSS.

Cetrotide/Orgalutron (injections) - these are the antagonist meds i mentioned earlier. for those of us who don't have the synarel or lucrin, these meds are injected after about a week of the stim drugs. basically, they're used to prevent the LH surge. you have them every 24 hours to stop the body naturally trying to ovulate. it helps to give the follicles the extra few days to develop nicely , the eggs to mature, and to stop ovulation occuring before the doctors want it to happen! for IVF in particular, the timing of ovulation is really important - without that level of control, ovulation may occur too early, or too late, and everything you've been through would be a waste of time!

Pregnyl/Ovidril (injection) - this is the shot that "triggers" ovulation. it forces the LH surge, finalises the maturation of the egg, and, in IUI, it will allow the release of the egg. In IVF, it is used to force the maturation of the eggs, but before the eggs are released, they're collected (egg pick-up or EPU). in some cases, pregnyl (in particular, haven't heard of it with ovidrel) is used as a "booster" during the luteal phase. basically it's there to help you maintain the luteal phase long enough for the embryo to take hold before the progesterone levels drop off and AF arrives. as BW explained before, progesterone support is important as you don't have a corpus luteum after EPU to help keep the levels high enough to sustain a pregnancy

Crinone or progesterone pessaries have been explained before...


when you move onto FET's and the like, there are more options again. for some people, they ovulate naturally, so may need no additional meds - this happens more often when there is male-factor or unexplained infertility. some natural cycles the clinic will automatically use the progesterone support (crinone/pessaries/pregnyl). for others, drugs such as clomid are used to induce ovulation. for others again (like me) the drugs don't work to force ovulation, so i go into a fully medicated FET. Hormone Replacement Therapy (HRT) is often used by post-menopausal women to ensure they're hormone levels aren't too low - it can often be used to help treat the nasty side effects of menopause (hot flushes etc) - for IVF purposes, it's used to artificially create a uterine lining. basically HRT is an estrogen supplement, so it will help to develop a lining. after a certain amount of time, the thickness of the lining is checked to make sure it's dense enough to support an embryo. progesterone support is started on what the clinic will label as ovulation day (even though no O occurs) - then depending on the age of your embryo's (day 3, day 5 etc) - they'll be transferred when appropriate.


hmmm, i think i've waffled enough - hope that helps!! anyone that wants to add to, or correct, anything i've said - feel free

BG