Ovulation Induction Success is increased in the IVF procedure if more than one embryo is replaced in the uterus. We would ideally like to replace three or four embryos to provide the best chance to become pregnant with one baby. The number of eggs we get from the egg donor will influence the success rate for the recipient couple. The excess embryos that are not transferred can be frozen (cryopreserved) so that if the recipient does not get pregnant the first time, she will have the opportunity to get pregnant without having to get a donor to donate eggs again. In order to obtain more than one egg from the donor, and to accurately control the time of ovulation, it will be necessary to use medications to stimulate the ovaries to produce more than one egg in the first half of the menstrual cycle. To the best of our knowledge, there are no permanent changes from these medications and they should not affect your future ability to get pregnant. You will not go through menopause at an earlier age because we have used a number of eggs. Medications typically used for ovulation induction: Birth control pill Lupron Follicle Stimulating Hormone (FSH) hCG (Profasi) The birth control pill is the first drug that is taken. It is used to suppress ovulation and synchronize donor and recipient cycles. The birth control pill is generally taken for three weeks. Lupron is the next medication taken, and it is taken daily during the last week you are on the birth control pill. This drug is an injection given underneath the surface of the skin. Lupron is not a fertility medication, but is used to prevent the pituitary gland from releasing the necessary hormones to stimulate the production and growth of the egg in your natural cycle. It temporarily "turns off" your own system. Lupron is taken for approximately 10 to 12 days before the fertility medications are given and for about 10 days during the fertility medication. FSH is the fertility medication used to stimulate the ovaries to produce eggs. It contains pure hormones identical to those you make on your own. FSH is given by intramuscular injections and will be taken for approximately 10 days. We will retrieve the eggs before you would have ovulated them naturally. Major side effects of the medications are rare. Lupron's most common side effect is hot flashes. These occur rarely, as you are on the Lupron for only a short time before starting FSH. A side effect of FSH is hyperstimulation of the ovaries (when many eggs are produced). This can cause some abdominal discomfort and bloating, but less than 1% of women will have a severe case of hyperstimulation. We will monitor you closely so those potential side effects can be avoided. You will be monitored to confirm egg development by ultrasound examination and blood tests. The development of follicles (fluid-filled sacs) can be measured by ultrasound. Blood tests will give a measurement of how well the eggs are developing. When conditions are optimal, hCG (human chorionic gonadotropin) will be given for final egg maturation. Your eggs will be retrieved approximately 34 to 36 hours later.