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Q. My friend and I are both trying to get pregnant through in vitro fertilization (IVF). We have different doctors…and we’re taking different prescription drugs. Why are we getting different medications, and how do we know which is better?

A. There are really three basic drug protocols for IVF. One drug protocol tends to be used in younger patients, or those with PCOS (polycystic ovarian syndrome). In this case patients are administered the drug Lupron daily, and then given egg stimulation drugs afterwards (also called gonadotropins, there are many of these drugs, including Bravelle, Follistim, Gonal-F, and Repronex). A second protocol uses very low doses of Lupron, and then starts the egg-stimulating drugs after two days. Finally, there is a protocol in which you begin with the egg-stimulating drugs, and after five or six days you start the patient on a GnRH analogue medication (such as Cetrotide or Antagon) in place of Lupron.

Some programs just take a cookie-cutter approach and give everyone the same protocol, while other programs use all three, depending on the patient. It’s really a decision physicians should make based on the patient’s age, her response to previous drugs, and the results of screening tests she’s been given.

Your friend’s medications may be different than yours because her medical circumstances are different. Or, in fact, your friend may be on the same protocol as you but the names of your medications are different. There really is no dramatic difference in outcome using different brands of the same medicine. They’re basically equally effective, and it comes down to physician preference.

 

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