What is Diferelin 0.1 after embryo transfer? Diferelin for IVF: a drug for the desired pregnancy. Interaction with other drugs

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The drug Diferelin is prescribed to many women for IVF and helps increase the likelihood of pregnancy. The effectiveness and action of the product depend on the dosage and methods of use. Find out the indications for use and treatment regimens.

The active substance of the drug is triptorelin, which belongs to the category of gonadotropin-releasing hormone analogues. The component affects the functioning of the pituitary gland and suppresses the production of follicle-stimulating (FG) and luteinizing (LH) hormones involved in the processes of egg maturation, the formation of a dominant follicle and its rupture.

Normalizing the level of LH and FH allows you to put the general hormonal levels in order, establish and stabilize the functioning of the reproductive system, speed up recovery from certain diseases, stop pathological processes and increase the chances of successful conception.

Diferelin is prescribed not only to girls and women, but also to teenage girls and even men. The drug is recommended in the following cases:

• uterine fibroids and fibroids;
• endometriosis;
• prostate cancer in males (with complex treatment of cancer);
• premature puberty in girls;
• the use of assisted reproductive techniques - in vitro fertilization.

For your information! The drug is available in different dosages, and the concentration of the active substance is 0.1 mg, 3.75 or 11.25. For IVF, a dosage of 0.1 milligrams is usually prescribed, but in some cases 3.75 is used. "Diferelin", containing 11.25 mg of triptorelin, is used for serious pathologies.

Why is Diferelin prescribed for IVF?

Diferelin is prescribed to prepare for in vitro fertilization and performs a number of functions:

• increased ovarian activity;
• stimulating the functioning of the pituitary gland;
• a decrease in the level of androgens and estrogens synthesized in the female body (they interfere with conception and implantation of the fertilized egg);
• blocking the production of follicle-stimulating and luteinizing hormones;
• stimulation of the onset of ovulation - the maturation of the egg and its release from the follicle (this is necessary for the collection of a woman’s own oocytes);
• implantation of the embryo after its transfer.

The use of Diferelin in IVF

The drug "Diferelin" can be included in short and long IVF protocols.

Short or long IVF protocol?

Features of use with a short protocol:

1. The minimum dosage of the drug prescribed is 0.1 mg.
2. Injections are given from the second day of the menstrual cycle.
3. One course includes 10-12 injections, injections are usually given daily.
4. Together with the drug, hCG - human chorionic gonadotropin - is prescribed. This hormone is administered a day longer, that is, another injection is necessary after discontinuation of Diferelin.

Treatment regimen for a long protocol:

1. A dose of 0.1 is administered on the 21st day of the menstrual cycle, then one injection is given daily.
2. At the same time, estrogen levels are monitored: after it decreases to 50 pg/ml or less, the use of gonadotropin begins. The first injection usually occurs on the third, fourth or fifth day of a new menstrual cycle.
3. Diferelin is stopped administered the day before gonadotropin is discontinued. But the dominant follicle must reach a diameter of 17 to 19 millimeters, and its size is determined using ultrasound.
4. After therapy, eggs are collected through ovarian puncture.

Another acceptable option for a long protocol is to prescribe an average concentration of the active substance - 3.75 mg. The dosage allows you to create a so-called depot in a woman’s body: the component is released gradually, penetrating into the blood and performing its functions for three weeks. Ovulation is stimulated in the same way as with a long IVF protocol, which involves daily administration of minimal doses of Diferelin.

When the embryos are transferred, after 2-3 days Diferelin is administered once to block the activity of the ovaries and increase the chances of implantation of the fertilized egg. In this case, a depot dose (3.75 mg) is prescribed.

The use of Diferelin during IVF if endometriosis is diagnosed

If IVF is planned for endometriosis, then either a long or super-long protocol is prescribed. First, it is necessary to eliminate foci of pathological growth of the endometrium and restore the structure of the lining layer of the uterus so that the embryo can fixate in it.

For diagnosed endometriosis, Diferelin for IVF is prescribed in a depot dose and administered once every twenty-eight days. The course of therapy can last about three to six months, during which ovarian activity is suppressed. When the endometrium acquires a normal structure, ovulation stimulation begins.

Diferelin injections are made as follows:

1. The ampoule with the solvent is opened, the syringe is opened, and a needle is put on it.
2. A needle is inserted into the ampoule and the solvent is drawn out.
3. The cap is removed from the bottle filled with lyophilisate with the active substance, and the stopper is pierced with a needle. The solvent is injected internally.
4. The needle rises, but is not removed (it does not touch the solution). The bottle is shaken to dissolve the contents. Do not turn the container upside down.
5. The remaining air in the syringe is released.
6. The surface is prepared for injection - treated with an alcohol wipe. The injection is given intramuscularly in the abdomen, under the shoulder blade, in the shoulder or in the thigh (the area is chosen by the doctor or patient).
7. The skin area is grasped with the fingers of the free hand.
8. After inserting the needle, the solution begins to move under the skin by slowly pressing the syringe plunger.
9. The area is re-treated with an antiseptic.

The drug is contraindicated during pregnancy, during breastfeeding, and in case of individual hypersensitivity to the components. Diferelin is used with caution in women and girls suffering from osteoporosis, hypertension and polycystic ovary syndrome.


Possible side effects include:

• allergic reactions: from urticaria to Quincke's edema;
• increased blood pressure;
• tides;
• decreased sexual desire;
• headaches;
• pain in muscles or joints;
• decreased bone density, increased fragility;
• visual impairment;
• increased nervous excitability, mood swings, emotional instability;
• nausea;
• changes in body weight;
• discomfort during sexual intercourse;
• vaginal dryness;
• hyperemia and pain localized at the injection site.

With long protocols and a dosage of 3.75 mg, amenorrhea often occurs - absence of menstruation. Menstruation begins after hormonal levels normalize. But even with a short protocol, critical days are likely to be delayed for a period of five to ten to fifteen days, and this is considered the norm.

Price

The cost of a 0.1 mg Diferelin package, including seven ampoules of the drug, is about 2500-2700 rubles. 1 ampoule containing 3.75 milligrams of the active substance can cost from 5-6 to 10 thousand rubles or more, depending on the pharmacy chain where the purchase is made.

Reviews

Reviews about the use of the drug "Diferelin" during the IVF protocol:

• “A friend of mine was injected with Diferelin during IVF, but she also had endometriosis. And she became pregnant, so the drug really helps if used correctly and under the supervision of a doctor.”
• “I was prescribed six injections for an endometrioid cyst. There were a lot of side effects, as if you were going through menopause ahead of schedule. It took six months for my body to recover, but in the end I was able to get pregnant and give birth. The big disadvantage is the high price.”
• “I used Diferelin, there were almost no side effects. And the drug helped me.”
• “I started treatment, but had to stop it because I felt terrible. It's a pity".

Analogues of the drug

The only analogue of Diferelin with the same active substance is the drug Decapeptyl. Buserelin, Zoladex, Lucrine Depot, Eligardt have a similar effect on the female body and reproductive system. But for in vitro fertilization they are prescribed less frequently and have a less pronounced effect.

Diferelin is prescribed for IVF, but is used strictly according to indications and under the supervision of a doctor. If you have been recommended the drug, all you can do is wish for positive results and pregnancy.

One bottle contains triptorelin acetate . It acts as an auxiliary substance. The solvent contains sodium chloride and water.

• Lyophilisate for production solution for subcutaneous administration– 1 fl. Triptorelin (triptorelin acetate) – 0.1 mg. Mannitol – 10 mg. 1 ampoule of solvent – ​​water for injection, sodium chloride.
• Lyophilisate for suspensions for intramuscular administration 3.75 mg. Excipients: carmellose sodium, copolymer of glycolic and DL-lactic acids, polysorbate-80, mannitol . 1 ampoule of solvent – ​​water for injection, mannitol. Considering the characteristics of this dosage form, the drug contains the active component in excess. The goal is to ensure that the optimal dose is administered.
• Lyophilisate for cooking suspensions for intramuscular administration long-acting – 1 fl. Triptorelin (triptorelin acetate) – 11.25 mg. Excipients: carmellose sodium, copolymer of glycolic and DL-lactic acids, polysorbate-80, mannitol. 1 ampoule of solvent – ​​water for injection, mannitol. Considering the characteristics of this dosage form, the drug contains the active ingredient in excess. The goal is to ensure that the optimal dose is administered.

Release form

Diferelin – 0.1 mg

Available in bottles. The kit includes ampoules with solvent. There are 7 sets in the blister outline packaging. There is one package in a cardboard box. S.C. is introduced.

Diferelin – 3.75 mg

Diferelin – 11.25 mg

Available in bottles. The kit includes ampoules with solvent, a syringe, and two needles. There is one set in a cardboard box. Injected intramuscularly.

pharmachologic effect

Hormone a drug that is an analogue gonadotropin-releasing hormone.

Pharmacodynamics and pharmacokinetics

Is synthetic decapeptide , an analogue of natural gonadotropin-releasing hormone , which releases gonadotropin . The drug is quickly absorbed after administration. When administered intramuscularly, the active substance is quickly released.

Indications for use

Diferelin 0.1 mg

Rarely: increased blood pressure, nausea, vomiting, emotional lability, weight gain, blurred vision, pain in the area of ​​drug administration.

Very rare: joint and muscle pain, headache.

Additionally, Diferelin 3.75 mg

With prolonged use, it is possible that hypogonadotropic amenorrhea .

After treatment is completed, ovarian function is restored. Ovulation occurs approximately on the 58th day from the last injection. The first menstruation is on the 70th day. Important for contraceptive planning.

Additionally, Diferelin 11.25 mg

Men: possible at the beginning of treatment dysuric disorders , bone pain. Symptoms disappear within one to two weeks.

During treatment: decreased libido, impotence , gynecomastia , flushes of blood to the face.

Women: at the beginning of taking the drug, pelvic pain is possible. Disappears within one to two weeks.

Possible occurrence metrorrhagia one month from the start of injections.

Men and women: fatigue, , disturbed mood, irritability, sleep disturbance, blurred vision, paresthesia , profuse sweat, weight gain.

Instructions for Diferelin (Method and dosage)

Instructions for Diferelin 0.1 mg contains a short and a long protocol. The drug is administered subcutaneously.

Short protocol: The drug is taken from the second day of the cycle. At the same time, ovarian stimulation is carried out. Treatment ends one day before administration gonadotropin . The general course of treatment is 10-12 days.

Long protocol for Diferelin: The drug begins to be administered on the second day of the cycle. Entered daily. Approximately on the 15th day of taking the drug, stimulation with gonadotropins is carried out in parallel. The duration of treatment is individual and adjusted by the doctor.

Preparation of the solution: Before administering the drug, the solvent is introduced into the vial with the lyophilisate. Dissolve completely.

Diferelin 3.75. V/m. In case of illness prostate cancer - administered in an appropriate dose - 3.75 mg for a long time every 4 weeks. At premature puberty – 3.75 mg administered every 28 days. In case of illness endometriosis diferelin depot drug is administered in the first five days of the cycle every month. At female infertility the drug is administered on the second day of the cycle.

Diferelin 11.25 administered in a volume of 11.25 mg every three months.

Preparation of the solution: Immediately before administering the drug, the solvent is introduced into the vial with the lyophilisate. Dissolve completely, gently shaking the contents of the bottle.

Overdose

To date, there have been no reports of overdoses.

Interaction

Cases of interaction have not been described.

Terms of sale

On prescription.

Storage conditions

At temperatures up to 25°C, out of reach of children.

Best before date

Diphereline and alcohol

When taking any drug, it is not advisable to use alcohol . When combined, the effect of treatment may be reduced. If we are talking about female infertility , then in this case it is prohibited to combine the drug with alcohol.

Pregnancy is a desired state for many women, but its occurrence naturally is not always possible. Modern medicine has developed reproductive technologies that help to get pregnant, carry and give birth to a child. Diferelin is a drug that is often used for artificial insemination. What is it for and does it have side effects?

Mechanism of action of Diferelin

Conditions for prescribing Diferelin 3.75 are:

• prostate cancer;
• premature puberty;
• endometriosis;

In a large dosage of 11.25 mg, the drug is used for the treatment of hormone-sensitive prostate tumors with metastases, for the treatment of endometriosis of genital and extragenital localization.

Diferelin in IVF protocols

Diferelin injection before IVF is intended to stimulate the ovaries.

Diferelin in a short protocol:

• The drug is required in a minimal dose.
• From the second day of the menstrual cycle, a solution prepared from the dry powder of one bottle is injected daily under the skin.
• Human chorionic gonadotropin is prescribed on the same day.
• 10-12 doses of Diferelin are used per course.
• One day after discontinuation, the last dose of human chorionic gonadotropin is administered.

Diferelin 0.1 in a long protocol:

• The first bottle is administered on the 21st day of the menstrual cycle, then one bottle daily, monitoring the level of E2 estrogen.
• After reaching their concentration below 50 pg/ml, stimulation is carried out with gonadotropin. Often this is day 3-5 of the new menstrual cycle.
• Stop using 1 day before stopping the administration of gonadotropin, when the follicle increases to 17-19 mm according to ultrasound.

If a woman misses one injection of Diferelin, this is not critical. The next injection is given at the usual time.

The condition of the ovaries and their response to stimulation is regularly assessed using ultrasound. If the response is excessive, the drug is discontinued, because there is a risk of developing ovarian hyperstimulation syndrome.

It is possible to use Diferelin 3.75 during IVF in a long protocol:

• The drug is injected once under the skin of the anterior abdominal wall on day 21 of the cycle.
• A depot is formed that releases the hormone into the blood for 20 days.
• Stimulation is carried out according to the same scheme as with daily administration of the drug.

After IVF (direct embryo transfer), Diferelin is administered for 2-3 days to suppress ovarian function.

Diferelin and endometriosis

If an IVF procedure is planned against the background of existing endometriosis, then a long or extra-long protocol is used. The goal is to reduce pathological lesions and achieve pregnancy during the period of remission. Diferelin is administered for 2-6 months. Diferelin-depot is injected subcutaneously every 28 days. The work of the ovaries is deeply suppressed. After a significant reduction in endometriosis, ovulation stimulation begins.

The incidence of pregnancy due to endometriosis is low. This is explained by immune disorders and changes in the endometrium that do not allow the embryo to implant.

Diferelin: adverse reactions

Adverse reactions from Diferelin 3.75 during IVF include the appearance of amenorrhea during an extra-long protocol.

The following side reactions are typical for Diferelin 0.1:

• vaginal dryness;
• decreased libido;
• tides;
• allergic reactions - skin itching, urticaria, Quincke's edema;
• dyspepsia - nausea, vomiting, abdominal pain;
• rise in blood pressure;
• headache, visual disturbances;
• emotional lability, mood swings;
• muscle and joint pain, osteoporosis.

Even in short IVF protocols, a delay in menstruation of up to 5-15 days is possible; this is not considered a pathology. In some cases they stop altogether. Adverse reactions disappear after normalization of hormonal levels.

The use of the drug is prohibited in case of individual intolerance, existing pregnancy, or breastfeeding. Prescribed with great caution in patients with osteoporosis, polycystic ovary syndrome and arterial hypertension.

The use of Diferelin during IVF has positive reviews and a high pregnancy rate. If the drug is used against the background of endometriosis, adverse reactions cause concern for many women.

The absence of pregnancy after treatment causes negative responses from patients who do not always realize that the problem of endometriosis lies not only in the presence of pathological foci, but also in deep immune disorders.

If the use of Diferelin does not lead to a cure, do not use it again, but switch to similar drugs.

Yulia Shevchenko, obstetrician-gynecologist, especially for the site

Useful video

Female infertility. Carrying out ovarian stimulation in conjunction with gonadotropins [hMG (human menopausal gonadotropin), hCG (human chorionic gonadotropin), FSH (follicle-stimulating hormone)] in in vitro fertilization and embryo transfer programs, as well as other assisted reproductive technologies.

Contraindications Diferelin lyophilisate for injection 0.1 mg

Pregnancy and breastfeeding: pregnancy must be excluded before starting drug therapy. Hypersensitivity to GnRH, the drug Diferelin, its components or other GnRH analogues. The drug should be used with caution in patients with polycystic ovary syndrome and depression.

Method of administration and dosage Diferelin lyophilisate for injection 0.1 mg

Short protocol. The drug Diferelin 0.1 mg is administered subcutaneously, starting from the 2nd day of the cycle (simultaneously starting ovarian stimulation), and treatment is completed 1 day before the planned administration of human chorionic gonadotropin. The course of treatment is 10-12 days. Long protocol. Daily subcutaneous injections of the drug Diferelin 0.1 mg begin on the 2nd day of the cycle. With desensitization of the pituitary gland (E2

A drug Diferelin 0.1- gonadotropin - hormone-releasing hormone analogue, antitumor agent.
Triptorelin is a synthetic decapeptide, an analogue of natural gonadotropin-releasing hormone (gonadotropin-releasing hormone).
Animal and clinical studies have shown that after an initial period of stimulation, long-term use of Diferelin 0.1 mg suppresses gonadotropin secretion with subsequent suppression of ovarian function.
Chronic use of Diferelin 0.1 mg suppresses the secretion of gonadotropin (follicle-stimulating hormone and luteinizing hormone). Suppression of intermediate endogenous peaks of luteinizing hormone makes it possible to improve the quality of folliculogenesis, increasing the number of maturing follicles, and, as a result, increase the likelihood of pregnancy per cycle.

Pharmacokinetics

Indications for use

Mode of application

Side effects

Contraindications

Pregnancy

Interaction with other drugs

Overdose

Storage conditions

Release form

Compound

Additionally

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