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The IVF Fertility Blog

A Note From Dr. Zhang on Trigger Time

I would like to discuss so-called trigger time.  There are a couple of things I would to take this opportunity to talk about and clarify with our patients.  First of all what exactly is a trigger?  We all know when a woman reaches a certain stage of her menstrual cycle and the follicle is ready to release, the woman’s brain will start the process of inducing ovulation.  Usually, the brain will know what chemical to release to trigger the ovary to relieve the follicle.  However, as we know, when women go through IVF, the egg retrieval will usually be during the daytime.   So even though we know the brain can trigger ovulation, it may comes at an inconvenient hour.   So that’s why we give patients called Synarel, which is a nasal spray, or Ovidrel which is an injestion medication.    They can replace the trigger from the brain during ovulation.   If we are able to trigger at a certain time, it enables us to do the retrieval during the daytime. This is reason why we need to give these triggers.  
One point that I would also like to discuss is when is the best time to trigger the follicle.  This is the most important and difficult part of in-vitro fertilization.  It is initially based on the size of the follicle and peak estrogen levels. However,  it’s not as simple on that.  It also depends on the patients age, what was the previous outcome of IVF attempt(s), how many follicles were developing, what is the exact level of estrogen, what is the exact size of follicle.  The optimal size of the follicle is 18-25mm. There is a big range for each patient. As physicians we need to know, what’s the optimal size for each individual patient. 

If you have any more questions regarding what kind of triggers, Synaral, or Ovidrel, please email me at john.zhang@nhfc.com and I will be happy to assist with any questions or concerns.

Have a wonderful day!


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