Sara H and Margie D

Sara H and Margie D

Mrs. A
Mrs. A

June 23rd, 2011, 3:38 pm #1

I tried to follow a thread from yesterday but am speedreading these days on the board. I think you are asking what is the purpose of doing an HCG booster in the luteal phase, above and beyond its use as a trigger? The shortcut answer is that the extra HCG booster tricks the body into producing more of the luteal hormones P4/E2. I have done HCG boosters in the past, even after doing a trigger.
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MargieD
MargieD

June 23rd, 2011, 3:53 pm #2

So how do you (actually THEY) know when someone needs a HCG booster??

I did the HCG shot this month and only 2 out of 3 of the mature follicles released. Wondered why they didn't have me do the boost? They said "not all follicles release." They were even happy with it and told me that I would be doing the HCG again next month, if needed.

So I was surprised when they had Sara H do the boost.
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Mrs. A
Mrs. A

June 23rd, 2011, 4:05 pm #3

because she's using Lupron as well. So I really can't speak to her scenario. When is she being instructed to take the HCG?

But want to make sure that we are clear - there's HCG trigger and HCG booster. Both use HCG (whetehr it's Novarel, Pregnyl, Ovidrel, whatever HCG). Triggers are used to release the egg and boosters are used in the luteal phase to help women with poor luteal function. A woman can be "prescribed" only a HCG trigger, only an HCG booster or both an HCG trigger and an HCG booster.

So how do "THEY" know when to give you a booster? It's basically a decision based on learnings of your luteal function from prior luteal phases. Using regular P4 support should be enough but for some women it's not.
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Cee
Cee

June 23rd, 2011, 4:07 pm #4

So how do you (actually THEY) know when someone needs a HCG booster??

I did the HCG shot this month and only 2 out of 3 of the mature follicles released. Wondered why they didn't have me do the boost? They said "not all follicles release." They were even happy with it and told me that I would be doing the HCG again next month, if needed.

So I was surprised when they had Sara H do the boost.
Margie, sounds like you used the hCG as a trigger, correct? They had Sara H do the hCG booster because she triggered with Lupron. The nurse at Cooper told me the point in doing this is because the Lupron collapses the follicle and forces the egg out and that the hCG booster "triggers" the corpus luteum to develop and start producing the necessary luteal phase hormones. If not all your follicles releases with an hCG trigger they might have you try Lupron or something a little stronger to get you to release. That's why Sara H and I both use Lupron as a trigger - because hCG didn't cause us to release.
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MargieD
MargieD

June 23rd, 2011, 4:36 pm #5

I should wait for Sara H to post, but my understanding is that they wanted her to do the HCG shot about 12 hours after the Lupron shot, but only 5,000 units.

Hey, Sara, clarify this for us.

And, Cee, we asked about using Lupron this month and they said that no - the HCG shot did what it was supposed to do and "not all follicles release." Was surprised....
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Sara H
Sara H

June 23rd, 2011, 5:08 pm #6

Yip, you are all dead on!

Did two Lupron to cause a "pseudo" trigger, if you will (in that it causes the egg to go but does not supply the hormones that are supposed to be there if it was a natural release, as I understand it now.) Those shots were 12 hours apart. I waited 36 hours and went for ultrasound to confirm release. Then, that night, did another 5,000 of Noverlle/HCG, supplying the hormones I needed for stuff to start going on it's own. (
Only, not sure it really has since I have had only a very slight rise in temperature.)

So, everyone was exactly right about my cycle!

You guys amaze me!

Thank you for the answers, very helpful!
Hugs to all!
Sara H.

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MargieD
MargieD

June 23rd, 2011, 6:31 pm #7

If anyone triggers with Lupron, they also need to boost with a HCG shot as well? So - that person would actually be injecting herself three times in 36 hours?

Ouch!!
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Cee
Cee

June 23rd, 2011, 6:55 pm #8

Two in the belly (Lupron) and one in the butt (hCG)!

I do IUI so they have me trigger usually around 7pm, then 7am the next morning, then 40 hours after the first trigger I have my IUI. Then, at the time of the IUI or sometime later that day I do my hCG shot.

I found this good description:

Human chorionic gonadotropin signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick lining (endometrium) of the uterus and providing an area rich in blood vessels in which the zygote(s) can develop. From this point on, the corpus luteum is called the corpus luteum graviditatis.
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MargieD
MargieD

June 23rd, 2011, 7:33 pm #9

Wow.... this is making sense... thanks for explaining!!! :-) n/t
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