Ovarian follicles are tiny structures which contain female’s eggs. In a natural menstrual cycle free from fertility medications, a number of follicles start to enlarge around the time one is experiencing her menses. Interestingly, after a few weeks, only one follicle develops to maturity. It then ruptures and releases the egg in a process known as ovulation. The rest of the follicles which were developing stops growing and dissolves or degenerates, thus only a minimal percentage of eggs available in the ovaries are released in one’s reproductive life span. There are some women who are infertile due to immature eggs in the ovaries and they rarely experience ovulation.
What are the Causes of Immature Eggs in the Ovaries?
- Hormonal imbalance – hormones play a vital role in a female reproduction system and if inadequate, the follicles in your ovaries aren’t produced, thus the eggs remain immature and chances of ovulation taking place are minimal. This can occur in women with polycystic ovarian syndrome. Women with the disorder have minimal production of FSH and increased production of LH, estrogen, and testosterone.
- If the hypothalamus is at fault – hypothalamus is located in the brain and signals the pituitary gland to produce FSH and LH to cause the ovaries to produce eggs. However, this may be interrupted if you have a tumor or any other condition affecting the hypothalamus gland and may result in immature eggs in the ovary.
- Fault on the pituitary gland brought by an injury or a growth which interferes with the production of crucial hormones (FSH and LH), hence ovulation won’t occur.
- Injured ovaries.
- Failure of the ovarian follicles to rupture, therefore the egg(s) aren’t released.
- Onset of menopause at a young age, so the eggs don’t mature in these females, it commonly occurs in athletic females and those who engage in strenuous physical activity .
However thanks to fertility shots for example follicle stimulating hormone (FSH) which aids in “rescuing” your follicles, the eggs which would have dissolved and assisted the immature eggs in the ovaries to grow and develop. The FSH shot given resembles the natural FSH released by the pituitary gland. With an increase of man-made FSH, several follicles may grow, leading to maturity of more than one egg. But remember, in a controlled ovarian stimulation cycle, the natural hormones may trigger premature ovulation, hence fertility doctors may prescribe Cetrotide, however, expect to encounter Cetrotide side effects.
What is Cetrotide?
Cetrotide is a fertility medication that falls in the class medicines known as a gonadotropin-releasing hormone (GnRH) antagonist. Cetrorelix is the active ingredient and the drug comes in the form of a powder and a solvent used to make a solution for a shot. It is used to prevent premature ovulation in a woman going through ovarian stimulation. What is ovarian stimulation? It’s a fertility treatment in which a woman’s ovaries are stimulated to release more than one egg. It does this by blocking the effects of the natural GnRH. GnRH controls the production of Luteinizing hormone (LH) which is a hormone responsible for causing ovulation during a woman’s menstrual cycle. It’s important to note that one can only purchase the medication with a doctor’s prescription.
Treatment with this drug must be carried out by a physician with experience in fertility treatment. Cetrotide is administered through an injection under the skin especially the lower abdomen. The starting dose is 0.25 mg injected after every 24 hours, either in the evening or in the morning. Cetrotide treatment begins on the 5th or 6th day of ovarian stimulation and continued for the entire period of stimulation. The injections are stopped in the morning before or the evening (depending if the shots are given in the morning or in the evening) of the day when the release of eggs is planned.
Because of Cetrotide side effects such as severe allergic reactions, the first shot is given and supervised by a physician and the woman is closely monitored for at least 30 minutes. The patient will be trained to self-administer further injections if she understands the injection procedure and she is aware of the symptoms of allergic reactions, for example:
- Difficulty breathing
- Swelling of the lips, tongue or face
If you come across the above-listed side effects, contact the medical practitioner. Remember to self-inject the medicine at different spots on the abdomen once daily. Cetrotide injection is mainly used during assisted reproductive technology such as in vitro fertilization (IVF). In IVF, daily injections like FSH and Cetrotide are given. FSH is used to artificially induce the production of ovarian follicles and eggs in the ovaries as well as to prevent premature ovulation. On the other hand, Cetrotide is administered to block the actions of the natural gonadotropin-releasing hormone, which then inhibit a premature surge of LH, thus the follicles develop fully. Ultrasounds and blood test will be carried out to confirm if the follicles are mature for ovulation to be triggered. If the fertility expert is satisfied with the progress (enough follicles have matured), human chorionic gonadotropin is given to induce ovulation and the eggs are then harvested 36 hours later; however, if the results of the blood tests and ultrasounds showed signs of OHSS (ovarian hyperstimulation syndrome), the HCG shot is postponed and one is advised to avoid sexual intercourse.
Some undesired effects may be triggered by Cetrorelix which is the active ingredient. In the event that the unwanted effects happen, they may need doctor’s intervention, whereas others may not. The common negative effects clear once the patient becomes used to the drug; although it’s advisable to seek a physician opinion if the usual effects become irritating and interfere with the daily activities of the patient. The following are some possible side effects one may come across:
- Stomach pain
- Severe nausea and vomiting
- Severe diarrhea
- Decreased amount of urine
- Bloating which can be severe or moderate
- Weight gain within a short period of time
- Bruising, itching, swelling or redness on the injection spot
- Swelling of the lower legs
Individuals react differently to the drug, so one may experience a few of the listed unwanted effects but others may not experience any at all. There are other Cetrotide side effects not mentioned in the article, you can contact the medical care provider for more information and the actions to take if they occur.