Ep 303: Everything You Need to Know About Trigger Shots

Fertility Docs Uncensored is hosted by Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center. In this episode, our docs take a deep dive into one of the most pivotal decisions in an IVF cycle: when and how to trigger for egg retrieval. They break down the thought process behind choosing between an HCG trigger and a Lupron trigger, explaining why the choice isn’t one-size-fits-all. One of the biggest advantages of a Lupron trigger is its ability to dramatically reduce the risk of ovarian hyperstimulation syndrome (OHSS), a key consideration for patients with a high response to medication. But Lupron doesn’t work for everyone. The docs explain why patients with hypothalamic amenorrhea must use HCG to ensure proper follicle release, and why a fresh embryo transfer also requires an HCG trigger for optimal luteal support. The docs also discuss the many clinical clues that guide trigger timing. These include a patient’s historical response to stimulation, whether they’re planning a fresh or frozen transfer, and crucial hormonal cues such as a drop in estrogen that can signal impending ovulation. They even share how sometimes they bring patients into the office for an ultrasound on retrieval day to confirm that spontaneous ovulation hasn’t occurred. Finally, they cover the selective use of combined HCG + LH triggers, and which patients benefit most from this approach.  This is a must-listen for anyone wanting a behind-the-scenes look at how reproductive endocrinologists make one of the most important calls in an IVF cycle. This podcast was sponsored by US Fertility.