Key Points

• During an in vitro fertilization (IVF) protocol, your doctor may use leuprolide (Lupron) injection as part of an ovarian stimulation regimen.
• Leuprolide is a gonadotrophin-releasing hormone (GnRH) agonist. It reduces the amount of hormone that stimulates ovulation.
• This helps to control your ovulatory cycle and prevent premature ovulation, so that your doctor can have predictable access to your eggs for IVF.

The brand name product Lupron is no longer available commercially in the U.S., but the generic option is available through several manufacturers.

You will be taught to administer leuprolide injections at home. It is often given as a daily subcutaneous dose (injected under the skin) for two weeks. The GnRH agonist may be continued to prevent an early surge in luteinizing hormone (LH) secretion. You may receive other medicines, like oral contraceptives, while you are using leuprolide.

The infertility protocol selected by your doctor may differ and you may not use leuprolide. Your doctor can give you the timelines and specifics of your protocol. IVF is expensive and time-consuming, so be sure to discuss the costs and your insurance coverage with your healthcare team.

Leuprolide is used "off-label" in IVF protocols, but it's use is widely accepted by doctors. Unapproved, or "off-label" uses of leuprolide are uses that have not been approved by the FDA and are not found in the package labeling.

What are GnRH agonists?

Natural gonadotropin releasing hormones (GnRH) are produced endogenously (in the body) in the hypothalamus, found in the brain near the pituitary gland. GnRH controls the secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary.

GnRH agonists produce an initial surge in the hormones follicle stimulating hormone (FSH) and leutinizing hormone (LH) and then they block this process to produce a negative feedback. This lowers the amount of natural hormone your body produces and helps to control your ovulation.

Leuprolide is also approved to treat conditions such as central precocious puberty (CPP), endometriosis, prostate cancer and uterine fibroids.

Related: List of Gonadotropin Releasing Hormones

What is IVF?

In vitro fertilization (IVF) is a form of assisted reproductive technology (ART) to overcome infertility and to result in a viable pregnancy. IVF requires treatment with hormones before the surgical implantation of the embryo.

IVF may be used for:

• fallopian tube abnormalities that cannot be treated with surgery
• infertility due to endometriosis
• primary ovarian insufficiency
• certain male infertility issues (i.e., abnormal sperm production, low sperm count, or anatomical problems).
• other causes of infertility

In protocols for in vitro fertilization (IVF), ovaries in a woman are stimulated to release mature eggs that are then collected surgically. The eggs are then fertilized with a man’s sperm and grown in the laboratory to produce embryos. One or more embryos are then inserted into the woman’s uterus.

An IVF cycle takes several weeks, requires repeated blood tests and daily hormone injections. IVF does not guarantee pregnancy and more than one cycle may be needed. If more than one embryo implants in the uterus, twins or higher-order pregnancies can result.

Protocols for IVF vary by the doctor’s preference and the regimen used at the treatment center. Follow only your doctor's instructions for IVF.

The steps of a typical IVF cycle might include:

• Producing multiple eggs by using GnRH analogues and other hormones like LH and FSH to stimulate ovulation and control your cycle.
• When your eggs are ready, your doctor will retrieve them in a surgical procedure that lasts 15 to 30 minutes. A vaginal ultrasound probe and a needle are used to withdraw the mature eggs from the ovaries. You will be given a light anesthesia (conscious sedation) during surgery and should not drive or return to work for 24 hours.
• After the eggs are retrieved, they are combined with the sperm to be fertilized. About two-thirds of the eggs eventually are fertilized.
• About 2 to 5 days after fertilization, one or more fertilized eggs (embryo) are placed in the uterus using a thin catheter. Anesthesia for this procedure is not usually required.
• Embryos that are not used may be stored for future use for an unlimited period of time. Frozen embryos have the same pregnancy success rate as fresh embryos.
• About 2 weeks after the embryo transfer, you will have a blood or urine pregnancy test to measure human chorionic gonadotropin (hCG), a hormone associated with pregnancy. You may need a repeat test.

This is not all the information you need to know about leuprolide (Lupron) for safe and effective use. Review the full leuprolide information here, and discuss this information and any questions you have with your doctor or other health care provider.