("Switching off" your own reproductive hormone production.)
A woman’s reproductive (menstrual) cycle is controlled by the pituitary gland. This tiny gland can be found on the base of the brain, somewhere behind your eyes. The pituitary gland releases hormones (chemical messengers) that control the actions of your ovaries. Hormones from the pituitary gland tell the eggs in the ovaries when to grow and when to be released.
Your pituitary gland needs to be “switched off” before you can receive drugs to stimulate egg production. These drugs stimulate the production of a “follicle.” A follicle is an immature egg, surrounded by a bubble of fluid, in the ovary. These immature eggs need to grow and develop inside their bubbles of fluid before they can be collected.
If the pituitary gland is not “switched off” it may release a hormone that causes the bubbles (follicles) to burst (doctors call this “spontaneous ovulation”). When the follicles burst they release the immature eggs into your body and the doctors are not able to collect them. The immature eggs have to remain in their bubbles of fluid if they are to be collected for use in your IVF cycle.
Turning off your reproductive hormone cycle in this way allows the doctors to have better control over the actions of your ovaries.
The drugs used to switch off your reproductive cycle are called gonadotrophin-releasing hormone analogues, or GnRH analogues for short. They may include buserelin (also called Suprecur) and goserelin (also called Zoladex). You will need to take these drugs every day. They are given by injection and staff at the Unit will teach you how to do this yourself.
Having your reproductive cycle turned off tricks your body into thinking it is going through the menopause. Because of this, you may experience symptoms similar to those of the menopause, such as hot flushes, headaches, mood swings, dizziness, lack of concentration, dry mouth and vaginal soreness. Don’t worry – this artificial menopause is only temporary and will stop once your stop taking the drugs.
There is an alternative drug that may be prescribed called cetrorelix (also called Cetrotide). This drug also prevents your developing follicles from bursting. You would take this drug instead of taking buserelin or goserelin. It is given at the same time as you take your follicle-stimulating drugs (see step 2). Because this drug is given later than the other drugs, you would avoid the menopause-like symptoms that are common with buserelin and goserelin. However, like all drugs, Cetrorelix has drawbacks and is not suitable for everyone. Your doctor at the Unit will be able to recommend the best drug for you to take, taking into account your preferences.
The private treatment room in which your mock embryo transfer will take place
A mock embryo transfer will be carried out before your treatment begins. It is normally carried out when you come for your first downregulation appointment (see step 1) or when you come for your first monitoring scan.
The mock embryo transfer is a practice for when you have your embryos put into your womb (see step 6). It allows the nurse to take measurements of your womb and to spot any potential problems early, so that we can be prepared when you have your embryos put back for real.
The mock embryo transfer will be carried out in a private treatment room. A small plastic tube will be inserted into your womb via the natural opening in your cervix. It is normally painless and takes only a few minutes.