What You Should Know About Injectable Medications (Bravelle, Follistim, Gonal F)

Bravelle, Follistim, and Gonal F are injectable fertility drugs that assist your body in growing at least one egg each month, sometimes even two or three. If you are currently unable to grow one mature egg each month, the drugs would be used with a goal of growing one egg. If you are currently able to grow and ovulate one egg each month, then the drugs would be used with the goal of growing two to three eggs each month. More targets , or more mature eggs, for the sperm create more opportunities to get pregnant.

Directions for Injectable Medications

Day 1:  (First day of bright red bleeding from your vagina) Call the office at 824-0075 to schedule an appointment for a day 3 ultrasound and blood test.
Day 3:  Ultrasound and blood test. We will call you once we have the results of the blood test and tell you what dose of injectable drug to use and when your next appointment will be.

Over a period of two weeks, ultrasounds and blood tests will be conducted every few days to help us to make sure you are growing enough eggs, but not too many. Because we will have a target number of mature eggs that we are aiming for, we will adjust the dose of the drug during your cycle to reach the goal.

What to Expect

You and/or your partner will be taught how to administer the shot. The drug will be injected with a small needle just under the skin. During this time, you will feel a pinch and experience brief discomfort. Although the procedure can be a bit scary the at first, it will get easier.

Risks

1.  There is a rare but slight risk of blood clots:

  • Reasons to Call Immediately:
    • Pain or swelling of legs or arms
    • Shortness of breath

2.  Ovarian Hyperstimulation Syndrome:

  •  When your body grows a lot of eggs, you can be at risk for blood clots and dehydration. This is called ovarian hyperstimulation syndrome. Although this can be life threatening, we do everything we can to prevent and treat this problem. If you begin growing too many eggs or your estrogen level starts getting too high, we will lower the dose of the injectable drug or even cancel your cycle in order to keep you safe.
     
  • If you do get ovarian hyperstimulation syndrome, we will admit you to the hospital. You will be given intraveneous (I.V.) fluids to treat the dehydration. You will also be given a mild blood thinner to keep you safe from blood clots.

3. Multiple Births

  • There is a risk of twins, triplets, quadruplets, or an even higher number of pregnancies. Multiple births depend on how many eggs you grow during your cycle. You and the doctors, together, will be deciding this number as you experience your treatment. The more eggs you grow, the higher your chance of having multiple babies.

Drug Failure

An ovarian reserve test will be administered before you start any of the drugs. This test should show how well you will respond to the injectable drugs. However, sometimes, even when we use the injectable drugs, your ovaries will not respond as we would hope. The injectable drugs are the strongest drugs there are to grow eggs. The highest dose given is usually 450 units. If your body does not respond to this dose, then we will discuss alternatives to help you build your family.