It's all about supression

Well, here we are in the throws of IVF cycle#2. My last dose of Aygestin was Saturday evening. I was taking Aygestin for my endometriosis and to help ease into this cycle. I can't take birth control because I get migraines with aura's, so, this is how we start. Aygestin has been good to me since our last IVF cycle. I was in a good amount of pain from my period/miscarriage, and after I started taking the Aygestin the pain has been minimal to none. Being pain free is something unknown to me since my entire endo journey has begun. So, pain-free is a wonderful state!

Lupron is taken for a number of reasons. Being in the field of Oncology professionally, my first run in with Lupron was for the treatment of prostate cancer. Never had I thought of it in another manner until it was prescribed to me by my OBGYN after my first surgery and diagnosis of stage IV endometriosis. My opinion on it for the treatment of endometriosis isn't very high, but, that could be for a number of reasons. First, I didn't take it for it's full course (started having ocular migraines and decided to stop). Second, my endometriosis "came back" rather quickly once I was off. In my case, my second surgery was to remove an endometrioma that resurfaced only a few months off treatment. So, really, it was only a temporary "fix". The Dr.'s make you feel like the "fix" will be longer, so, I was pretty disappointed when I was back in surgery just months later after stopping. (NOTE, it is NOT a cure for endometriosis-don't let ANYONE tell you otherwise!)

So, when I heard of Lupron again for IVF, I was a little reluctant. It's in a MUCH smaller dose than in treatment, and it's side effects were minimal during my use for IVF. I'm still not 100% thrilled with having to take it because of everything that I experienced when using it to "treat" endometriosis, but, it seemed to work well the last cycle.

So, what does Lupron do in IVF?

Lupron Depot (leuprolide acetate for depot suspension) is a GnRH agonist - a hormone that works in two distinct phases. Phase one stimulates the ovaries causing them to produce more of the most potent of the three estrogens produced by women - estradiol. In phase two the messenger hormones that tell the ovaries to produce estrogen decline dramatically. This causes a significant reduction in estrogen levels, and results in the "pituitary suppression" phase.

Because of the initial surge in estrogen, it is usually given for a few weeks before starting the other fertility medications. This allows patients to “get past” the stimulation phase and into the suppression phase.

Pituitary suppression is important for recruitment of multiple follicles. By desensitizing the pituitary to signals from the brain, Lupron blocks the natural tendency of the brain to allow only one dominant follicle to grow in each cycle.

Tonight will be my 6th injection of Lupron this cycle. Seems today I have signs of spotting. This happened last cycle after I stopped the Aygestin as well, and, is considered "normal". I didn't have any particular side effects last cycle. This time I am having some local irritation at the injection site for about 30 minutes after injections. I've also noticed I'm bruising this time. So interesting how things differ from cycle to cycle. Hopefully the rest of the regimen will go well.

Sorry I've been MIA. It's been super busy in "normal everyday life" around here. I've been so pleased to go through some of my blogroll to find some of my fellow endo sufferers and infertility bloggers have found themselves with recent positive pregnancy tests and new adventures. Very exciting. It also seems I have new followers. I need to catch up!

My next apt is on Thursday and I am eager to see how things are going. Last time I had an endometrioma by my first ultrasound (it was luckily drained during my egg retrieval). I'm wondering if that right ovary will have another or, if it doesn't, will it be productive this time? So many unknowns ahead. Here we go!!!!