Leuprolide Dose for IVF Trigger
The recommended dose of leuprolide (Lupron) as an IVF trigger is 1 mg subcutaneously, administered 34-36 hours before oocyte retrieval.
Standard Dosing Protocol
- Leuprolide 1 mg subcutaneously is the established dose for triggering final oocyte maturation in IVF cycles 1, 2, 3
- The injection should be given 34-36 hours prior to scheduled oocyte retrieval, similar to hCG timing 3
- Some protocols use 500 micrograms subcutaneously, though 1 mg is more commonly reported 3
Dual Trigger Strategy
- In dual trigger protocols, leuprolide acetate 1 mg is combined with recombinant hCG 250 micrograms, both given subcutaneously 4
- The dual trigger approach produces significantly more MII oocytes (7.82 vs. 5.92) and day-3 grade-1 embryos (4.24 vs. 1.8) compared to hCG alone 4
- Serum LH levels 12 hours post-trigger are markedly elevated with dual trigger (46.23 mIU/ml vs. 0.93 mIU/ml with hCG alone), confirming adequate pituitary response 4
Physiologic Response
- Leuprolide induces a physiologic LH surge, with serum LH rising from baseline 12 mIU/mL to 136 mIU/mL at 12 hours post-injection, then declining to 17 mIU/mL by 36 hours 2
- This mimics the natural LH surge more closely than exogenous hCG 3
Important Caveats
- Leuprolide trigger is associated with luteal phase deficiency due to shorter duration of corpus luteum support compared to hCG 3
- Approximately 18% of patients may experience a short luteal phase when leuprolide is used alone 3
- Robust luteal phase support with vaginal progesterone (50 mg twice daily) is essential 3
- Luteal phase estradiol and progesterone levels are significantly lower with GnRH agonist trigger compared to hCG trigger 3