QuestionDear Dr.Ramirez
Thank you so much for letting us ask you questions,I also enjoyed your website and whatever you are doing to help women get pregnant.
I am an ob/Gyn interested in IVF protocols and am from Iran.
I wanted to ask you a question,would be more than happy to have your opinion on the matter:
What do you think of administration of Superfact on the 5 th day of the E.T (embro Transfer) as a single dose?
Would it help the success rates? if so, how?
Thanking you in anticipation and hope to hear from you soon,
P.Karian
AnswerHello Peggy from Iran,
Suprefact (Buserellin) is a GnRH agonist (gonadotropin releasing hormone agonist). In low doses, it induces the release of FSH and LH from the pituitary, but in high doses, through the negative feedback loop, it blocks the release of fSH/LH. Similar to Lupron (Luprolide acetate), it can be used in the long protocol for IVF. Basically, its purpose in this protocol is to suppress the ovary so that natural ovulation induction does not occur and ovulation does not occur prematurely. The ovary then responds exclusively to the administered FSH and LH, then HCG. I know of no protocols that use this medication after embryo transfer and can think of no reason to do so. GnRH agonists can also be used in place of HCG to stimulate ovulation, if an antagonist protocol is used (not the long protocol). In fact, I use antagonists exclusively for my IVF cycles so in patients that have an exaggerated response and have the risk of ovarian hyperstimulation syndrome, I trigger with Lupron instead of HCG. This has been shown to reduce the incidence of OHSS. If used at the time of embryo transfer for whatever reason, I do not think that it will help with implantation or success rates.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV
