What Medications Should I Bring for IVF in China? Detailed Cycle Medication List and Precautions

Opening: Real Consultation Scenario

1. Direct Answer: What Medications Do You Actually Need to Bring for IVF in China?

For IVF treatment at a正规 domestic reproductive center, all ovulation induction drugs, down-regulation drugs, trigger drugs, and luteal support drugs are prescribed by the doctor based on the patient's specific condition. Patients obtain these medications from an outpatient pharmacy or the hospital pharmacy. There is no need to bring prescription medications from other sources on your own.

The main items that patients need to prepare or bring themselves are the following two categories:

• Daily chronic disease medications: Such as antihypertensives, Euthyrox (levothyroxine sodium), antidiabetics, anticoagulants, etc. You must inform your doctor before starting the cycle to assess whether adjustments are needed.
• Dietary supplements explicitly recommended by the doctor: Such as folic acid (0.4–0.8 mg/day), Vitamin D, Coenzyme Q10, DHEA (for specific populations), etc. These supplements should be used under the guidance of a doctor and should not be increased on your own.

2. Classification and Effects of Commonly Used Medications in the IVF Cycle

The following table lists the most common medication types, representative drugs, and their core functions in the domestic IVF cycle, making it easier for patients to understand:

All the above medications are prescription drugs. The specific choice and dosage are entirely determined by the attending physician based on factors such as age, ovarian function, and previous cycle responses. There is no "one-size-fits-all" medication plan.

3. The Doctor's Perspective: Medication Safety is the Bottom Line in IVF Treatment

From the perspective of a reproductive specialist, medication safety is the most fundamental bottom line in IVF treatment. There are several points patients need to understand:

• Bringing medications of unknown origin or using hormonal drugs not prescribed by the doctor can disrupt cycle control and even lead to cycle cancellation. Clinically, we have encountered patients who took "regulating drugs" on their own, causing abnormal hormone levels and forcing a delay in starting the cycle.
• Doctors are more concerned about whether patients take medication on time and in the correct dosage, as well as monitoring the response after medication. For example, during ovarian stimulation, regular blood tests for estradiol, LH, progesterone, and ultrasound monitoring of follicle size are needed to dynamically adjust the dosage based on results.
• Different brands of ovulation induction drugs (imported vs. domestic), although containing the same active ingredients, may differ in purity and injection experience. Patients can express a preference, but they cannot switch medications on their own during the cycle.
• Luteal support drugs come in various forms (oral, vaginal, injectable). They cannot be arbitrarily interchanged because absorption methods and blood concentrations differ.

4. The Most Easily Overlooked Details

These details may seem minor, but if not handled properly, they can directly affect the treatment outcome:

• Storage of refrigerated medications: Gonal-f, Puregon, Cetrotide, etc., need to be stored at 2–8°C. After picking up the medication from the pharmacy, you must carry it in an insulated bag with ice packs. Immediately place it in the refrigerator upon arriving home (do not freeze). Pay special attention if the travel time to the clinic exceeds 1 hour.
• Relatively fixed injection time: It is recommended to inject ovulation induction drugs at the same time each day (e.g., 8–10 AM), with a fluctuation of no more than 1 hour, to ensure stable blood concentration.
• Medication record: It is advisable to use a memo or medication record card to log the daily injection time, dose, and injection site to avoid missed or double injections.
• Rotation of injection sites: For abdominal injections, rotate areas (upper left, lower left, upper right, lower right) to prevent local induration that could affect absorption.
• Differences in luteal support formulations: Crinone is a vaginal gel; you need to lie flat for 15 minutes after application. Progesterone injection is an oil-based solution; you must press the injection site for more than 5 minutes to prevent leakage.

5. Common Pitfalls to Avoid

The following situations occur repeatedly in the outpatient clinic. I hope you can avoid them in advance:

• Changing medication or adjusting dosage on your own: Thinking "the follicles are growing slowly, so I'll add an extra shot" or "I'm afraid of ovarian hyperstimulation, so I'll reduce the dose" — this is absolutely forbidden. All dose adjustments must be made by the doctor.
• Forgetting to take medication or double-dosing: Especially for protocols requiring medication both in the morning and evening, it's easy to get confused. It is recommended to set a phone alarm and use a pill organizer with compartments.
• Improper medication storage: Storing refrigerated medications in the refrigerator door shelf (unstable temperature) or freezer (freezing renders them ineffective) is a common mistake. They should be placed in the middle-back section of the refrigerator.
• Using expired medications: Check the expiration date each time you receive medication. Discard expired medications immediately.
• Lending or selling medications: Each patient's medication plan is personalized. Your medication may not be suitable for someone else, and vice versa. This is not about saving money; it is a risk.

6. Actual Medication Process in an IVF Cycle

A complete IVF cycle medication process is usually divided into the following stages, each with different medication logic and goals:

1. Down-regulation Phase (only for long/ultra-long protocols): Injection of GnRH agonist (e.g., Diphereline) to suppress pituitary function, usually lasting 14–28 days. This phase may be accompanied by low estrogen symptoms (hot flashes, insomnia), which is normal.
2. Ovarian Stimulation Phase: Daily injection of gonadotropins (FSH/HMG) for 10–14 days. During this period, blood tests and ultrasounds are performed every 2–4 days. The doctor adjusts the dose based on follicle size and hormone levels.
3. Trigger Phase: When the leading follicle diameter reaches 18–22 mm, an injection of HCG or GnRH-a is given. Egg retrieval occurs 34–36 hours later. The trigger time is precise to the hour and cannot be advanced or delayed.
4. Luteal Support Phase After Egg Retrieval: Luteal support medication (oral/vaginal/injectable) starts on the day of egg retrieval and continues until 12–14 days after the transfer. If pregnancy is confirmed, it continues until 8–12 weeks of gestation, with gradual dose reduction and discontinuation.

7. Medication Schedule

From the start of the cycle to the transfer, the approximate medication timeline for a fresh embryo cycle is as follows:

The above is for general situations. Actual timing may vary depending on the protocol and individual response. For example, the antagonist protocol has no down-regulation phase, and the stimulation period may be shortened to 9–12 days; while the ultra-long protocol's down-regulation phase can last 2–3 months.

8. Special Situation Management

Different populations require targeted medication adjustments. Here are several common situations:

Polycystic Ovary Syndrome (PCOS)

PCOS patients are sensitive to ovulation induction drugs and are prone to Ovarian Hyperstimulation Syndrome (OHSS). The medication principle is: low starting dose, slow increase, close monitoring. Common protocols include the antagonist protocol or mild stimulation protocol. GnRH-a may be used instead of HCG for triggering to reduce the risk of OHSS.

Advanced Age or Poor Ovarian Response (POR)

Patients aged ≥40 or with low ovarian reserve (AMH < 1.0 ng/mL) may require: increasing the starting dose of ovulation induction drugs, adding growth hormone (GH) or DHEA, using the PPOS protocol or dual stimulation protocol. These patients may need a longer medication period and more frequent monitoring.

Endometriosis

Patients with endometriosis often use the ultra-long protocol, where the down-regulation phase is extended to 2–3 months to fully suppress lesion activity and improve the pelvic environment. During this period, GnRH agonists are used, which may be accompanied by significant low estrogen reactions that require symptomatic management.

Thyroid Dysfunction

Patients with hypothyroidism or hyperthyroidism need to adjust thyroid function to the normal range before starting the cycle (TSH < 2.5 mIU/L) and continue medication (e.g., Euthyrox) during the cycle, monitoring TSH levels. Thyroid medication should not be stopped on your own, as it affects embryo implantation and development.

9. Frequently Asked Questions

Conclusion: Doctor's Advice