For every patient, superovulation stimulation requires three types of injections:
• Gonadotropins are what causes follicles to grow;
• Gonadotropin-releasing hormone agonists are what does not let the growing follicles ovulate prematurely;
• An ovulation trigger is what allows us to obtain an oocyte during puncture.
The first group may include the following drugs: Gonal F (available for purchase in the form of 300, 450 or 900 IU injection pens), Puregon (available for purchase in 300 and 600 IU), Menopur (available for purchase in 75 IU vials, the multidose being 1200 IU), ELONVA (available for purchase in 100 и 150 µg), Pergoveris (available for purchase in 225 IU vials), Luveris (75 IE vials). Naturally, the medication and the dosage are determined by the doctor, but on the average, one stimulation takes 1500 to 2500 IU of any of these drugs, the only exception being Luveris. It is never used in a single-agent regimen; instead, it is added to therapy with recombinant agents (Gonal F or Puregon). At the same time, a standard stimulation takes 10 days. If you google the cost per a unit of medication and calculate how many of those you need judging by the total dose per course, you will get the overall cost of the required gonadotropins.
For example, the doctor prescribed you 225 IU of Gonal F per day and you know that the stimulation will take up about 10 days, hence, you need 225Х10 = 2250 IU. In other words, you will need 2 x 900 IU and 1 x 450 IU pen of Gonal F. This is, of course, only an estimate, yet a very close one.
Now, to the agonists. In Russia there are two agonists available – Cetrotid 0,25 and Orgalutran 0,25. Now this is simpler. You will need 3 to 5 vials for the whole cycle.
Ovulation triggers. We have Pregnyl 5000 IU, Choragon 5000 IU, HCG 5000 IU, Ovitrel 250 mg and Difereline 0,1 on hand. In the cycle, you will need either one Ovitrel or 2 vials of any of the other drugs.
This is it, in fact, as far as the financial burden put on you by the drugs is concerned. But whatever you do, do not buy medication in advance and do not store it up. The principal rule is as follows: drugs are to be bought at the beginning of the protocol and only so that they will suffice until the next visit. The reason behind this is that it often happens so that during stimulation we sometimes have to change the dosage, the drugs themselves or the initial plan, and all your unclaimed supply can end up lying around in the fridge…