Ovitrelle/Ovidrelle are hormones called chorionic gonadotropins (HCG) which we use in assisted reproduction treatment to trigger ovulation.
What is Ovitrelle/Ovidrelle based on?
The menstrual cycle, follicle development and ovulation are all regulated by the production of different hormones (FSH and LH) in the pituitary gland.
Changes in the production of these hormones are what cause the different stages of the menstrual cycle: the proliferative phase, ovulation, the secretory phase, and finally menstruation.
At the same time, the ovary produces oestrogen and progesterone in varying amounts depending on what stage of the menstrual cycle the female is currently in.
As a dominant follicle develops (this is the follicle selected by the ovary thanks to the hormones produced in the pituitary gland), it releases oestrogen; then, once the amount of oestrogen reaches a certain level, production of the hormone LH is stimulated in the pituitary gland.
A rapid surge in LH levels triggers final maturation of the egg, rupture of the follicle and then ovulation.
After ovulation, the female enters into the secretory or luteal phase which is characterised by the production of progesterone by the corpus luteum in the ovary. Oestrogen production continues as well, but in smaller amounts.
While all of the above is taking place, the production of oestrogen and progesterone in the ovaries prepares the endometrium to become receptive so that a future embryo could potentially implant.
Why do we use Ovitrelle/Ovidrelle in assisted reproduction?
With certain assisted reproduction techniques such as artificial insemination and in vitro fertilisation, we need to simulate the different phases of an ovulating female’s menstrual cycle.
In order to do so, we generally stimulate the development of one or more follicles in the ovaries via the administration of external FSH; then, when we need to trigger ovulation, we should simulate the natural LH surge.
The amount of the hormone LH needed to simulate this surge is very high, and it’s also very costly.
To simulate the surge, we use a hormone called hCG that is very similar to the hormone LH which is naturally present in the female body.
Administering hCG allows us to have control over the moment when final maturation of the developed follicles will occur, and in turn allows us to schedule the exact day of the egg retrieval in IVF/ICSI treatment, or the day of the intrauterine artificial insemination procedure.
We also often use hCG to trigger ovulation in scheduled sexual intercourse treatment cycles, as well as in preparation cycles for frozen embryo transfers (natural cycle embryo transfers).
How and when are Ovitrelle/Ovidrelle administered?
Ovitrelle and Ovidrelle are subcutaneous injections that can be self-administered by patients themselves.
It’s very important to administer this medication on the correct day and time, as its timing directly impacts the beginning of a trigger effect which will result in the final maturation of the developing follicles and the egg inside each one.
Moreover, for example, with in vitro fertilisation it would be very unlikely to successfully collect any eggs during an egg retrieval if this medication is not administered correctly or not administered at all.
The hormone hCG should be administered approximately 36 hours before the egg retrieval procedure is to take place.
Once hCG has triggered ovulation, this hormone will also sustain and stimulate the activity of the corpus luteum -the name given to an ovarian follicle after ovulation has occurred-, so that it produces the right levels of progesterone which are necessary for correct development of the endometrial lining and for good endometrial receptivity for embryo implantation.
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