Question for ghost or anyone else

[jandc33]

I had a question re: ganirelix verus lupron. I have done 2 previous cycles with lupron and am switching clinics and my new doc is considering switchin it to ganirelix. I'm curious what your thoughts are.

Also, from what I am seeing is the ganirelix substantially more expensive than lupron. We have no prescription coverage so I am curious is there is a major difference between these 2 drugs.

THANKS!!!

[katie99]

Jand -- I have also been completely out of pocket for 2 IVF cycles
I'm sorry but yes theres a big difference in price. Lupron -1 vial
ran about 100 dollars, but thats enough for a cycle. Ganirelix
cost me 108 dollars per injection! It comes in a pre filled
syringe. It really sucks when you have ins. that won't cover IVF
or the meds. Hope that helps.....Best of luck to you

[Ghost]

I had a question re: ganirelix verus lupron. I have done 2 previous cycles with lupron and am switching clinics and my new doc is considering switchin it to ganirelix. I'm curious what your thoughts are.

Also, from what I am seeing is the ganirelix substantially more expensive than lupron. We have no prescription coverage so I am curious is there is a major difference between these 2 drugs.

THANKS!!!

They do the same thing in completely opposite ways.

Lupron stimulates the pituitary. But continued use over several days keeps the pituitary from being able to store up for an LH surge. So you must start Lupron days before the stim cycle (in the usual "long Lupron cycle", flare cycles are different).

Ganirelix shuts down the pituitary directly by binding the receptors, but without activating an LH surge. With the receptors bound, GnRH from the hypothalamus cannot trigger an LH surge.

Which is better? There's no clear answer.

One costs more, the other requires more injections.

Pregnancy rates are allegedly a little higher with Lupron, or so I have read from time to time, but some think this is because some clinics are not yet very experienced with ganirelix. Most clinics use Lupron almost all the time, but a few use ganirelix almost all the time, and some mix it up a bit.

If you happen to be a very high responder, using ganirelix for your pituitary suppression will allow the Lupron to be used as the trigger instead of hCG. This causes an LH surge to mature the eggs, then the LH fades away quickly (*much* faster than hCG), pretty much ending the chance of OHSS.

If you're not a high responder, then that benefit is probably of no value.

How did your two previous cycles fail? No embryos? Or no implantation?

[jandc33]

Thanks for your reply ghost. Actually neither. Both cycles I produced alot of eggs (19-1st, 25-2nd). The 2nd cycle produced ectopic. My RE & I were speaking and he was thinking of switching to Ganirelix. However, if I am running into an issue with the expenses and there isn't much of a difference, I would like to consider staying with the lupron in that case.

Thanks!