Answer from: Raúl Olivares, MD
There are different types of hormones, and they play a different role in the different phases of the IVF. The first group of hormones that we use is those hormones that are going to stimulate the ovaries, mainly FSH or hMG. This kind of drugs are going to work on the ovaries, and they are going to grow more than the single follicle that the woman produces in the natural cycle. These drugs are usually taken as subcutaneous injections.
We are also going to have hormones that are going to block the natural ovulation of the woman. These kinds of drugs are two different types, the GnRH agonist or the GnRH antagonist. The drugs are taken subcutaneously as well, and they are designed to block the natural ovulation and let us decide when we want to trigger the ovulation. Usually, these two drugs, the gonadotrophins that are going to stimulate the ovaries and the antagonists or agonists are going to be taken together for a few days.
Whenever the patient is ready for the egg collection, we are going to use a third type of drug called hCG, which is going to be used to trigger the ovulation.
Then after the egg collection, we are going to use the fourth type of drug, which is progesterone, and the main role of the progesterone is to open the implantation window and lead to the necessary changes in the endometrium that will allow the embryo implantation. Progesterone can be taken either in vaginal pessaries, oral pills, subcutaneous injections, or intramuscular injections. Mainly, we work with vaginal pessaries because they are quite easy to take, and the effects are more than enough, but in some cases in which the levels of progesterone are not good, we may recommend taking subcutaneous injections of progesterone or simply add them to the vaginal pressures that the patients are already taking.
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