Leuprolide is a synthetic analog of naturally occurring gonadotropin-releasing hormone (GnRH). Leuprolide is generally indicated as a palliative treatment of advanced prostatic cancer.
It has also been known for years that Lupron (or other GnRH agonist medications) can stimulate an effective LH surge, which results in mature eggs release [8]
Micro dose protocol is used to “jump start” ovarian response to stimulation in poor responders, in women of advanced reproductive age, and in women with low ovarian reserve.
This regimen uses the same medications as the “Lupron overlap” protocol. The major difference is that, by cutting the dose of Lupron down, and by giving it twice daily, the Lupron turns the pituitary gland “on” rather than “off”, producing major release of FSH.
Side Effects and Precautions
Common side effects include:
- Local discomfort
- Bruising and soreness at the injection site
- Ovarian hyperstimulation syndrome (OHSS) (excessive fluid retention and severe abdominal discomfort)
- Vaginal bleeding, pelvic pain, breast tenderness, hot flashes, vaginal dryness, constipation, headache, weakness, and dizziness.
- There is potential for serious pulmonary conditions and thromboembolic events (difficulty breathing or chest tightness).
Warnings and Precautions
Contact the Physician immediately If the patient experiences:
- Allergic reaction (difficulty breathing, closing of the throat, swelling of the lips, tongue or face, or hives)
- Difficulty urinating
- Bone pain, numbness, tingling or weakness in the legs or arms.
- Symptoms of ovarian hyperstimulation syndrome (OHSS) (excessive fluid retention and severe abdominal discomfort) or symptoms of pulmonary conditions and thromboembolic events (difficulty breathing or chest tightness).
Missed Dose
It is crucial that this dose be given EXACTLY at the date and time instructed by your physician. If you miss your scheduled dose you must immediately contact your physician for instructions.
Contraindications:
- Hypersensitivity to GnRH, GnRH agonist or any of the excipients in LUPRON DEPOT.
- Pregnancy
Pregnancy
Category X -may cause fetal harm when administered to a pregnant woman.
Storage
Store in a refrigerator, protect from light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.
References
Castillo, J. C., Humaidan, P., & Bernabéu, R. (2014). Pharmaceutical options for triggering of final oocyte maturation in ART. BioMed research international, 2014, 580171.
Demirol A, Gurgan T. Comparison of microdose flare-up and antagonist multiple-dose protocols for poor-responder patients: a randomized study. Fertil Steril. 2009 Aug;92(2):481-5. doi: 10.1016/j.fertnstert.2008.07.006. Epub 2008 Nov 5. PMID: 18990368.
