So many questions come in from our readers as to what a “trigger shot” is. As a follow-up to our second video series, Dr. David Tourgeman explains what “the Trigger shot” is.
Listen and watch along with us as Dr. David Tourgeman, Reproductive Endocrinologist at HRC Fertility, explains what a trigger shot is and how you can avoid OHSS during your cycle.
Hi everyone! I’ve been asked to give a quick primer about the trigger shot.
So, as you probably are becoming more familiar with these terms, what you should know is that when a patient or an egg donor has stimulated her ovaries, which usually takes somewhere between nine and eleven days to prepare, and the follicles that contain the eggs are ready, the patient will then be ready for the “trigger shot.” The trigger shot is simply something that prepares the eggs to be extracted from the follicles and completes the last bit of genetic preparation so that they can be fertilized.
The traditional way of doing the trigger shot was to administer HCG, usually at a dose of five thousand or ten thousand international units. And, by the way this is absolutely a fine way of triggering the eggs for preparation, however, what we have found is that using a larger dose of HCG can also predispose people to ovarian hyper-stimulation syndrome.
There have been multiple, different studies that have evaluated how best to avoid hyper-stimulation, because we know that the active ingredient, HCG, in the trigger shot, is what worsens ovarian hyper-stimulation. So, it turns out we can lower that dose—that’s an option—in some cases we can go down to 2500 units of HCG. What we have also used is something called the Lupron trigger.
The Lupron trigger causes the brain to release a hormone called luteinizing hormone, which is what the the body usually utilizes to cause ovulation. This is usually given in combination with a small amount of HCG, usually on the order of a thousand to 2500 units of HCG, so that it can minimize the effects of HCG causing hyper-stimulation especially in at-risk populations like an egg donor, and yet it is effective at causing the release of the egg or affecting the release of the egg.
So just a quick review HCG is the standard currently in people that are at risk for ovarian hyper-stimulation, like egg donors, we will typically give a much smaller dose along with what’s called a lupron trigger.
Hope that helps. Thanks!
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