Need Help with Parenthood? Here’s Your (Trigger) Shot

Trigger shots are a hormonal fertility treatment that can bump up your baby-making odds by helping you ovulate or time ovulation.

Assisted reproductive technology (ART) can seem crazy complicated if you’re new to the fertility fam. But don’t worry! We got you covered.

Here’s a deep dive into the trigger shot and how it may increase your chances of conception 👶.

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So what exactly is a trigger shot? 

Standard trigger shots contain human chorionic gonadotropin (hCG). The hCG works like the luteinizing hormone (LH), a hormone produced by the pituitary gland. LH helps your eggies mature, prepare for fertilization, and ovulate.

This can be useful if:

• you don’t ovulate
• you want to control the timing of your ovulation

Why not just use LH? hCG is used instead because the half-life of LH is really short — meaning it doesn’t stay around long in the body — so it can’t be used for trigger injections.

Trigger shots can be injected under the skin (subcutaneously) or into your muscle (intramuscularly). Most folks DIY it, but some peeps prefer to take it at a doctor’s office.

The options: Ovidrel, Novarel, or Pregnyl

The three head honchos of trigger shots are:

• Ovidrel contains 250 micrograms (µg) of recombinant-hCG. The hormones are sourced from Chinese hamster ovary (CHO) (yes this is a real thing).
• Novarel is available in vials of 5,000 or 10,000 USP of chorionic gonadotropin. It’s derived from the urine of pregnant people.
• Pregnyl has 10,000 USP of chorionic gonadotropin. It’s also derived from pregnant people’s pee.

Your doc will let you know which medication and dosage will be the most egg-cellent for your unique situation.

Lupron, the other trigger shot

Lupron is a type of trigger shot that stimulates LH production. But instead of using hCG, it contains a GnRH agonist — a type of drug that indirectly stimulates ovulation.

Lupron is usually limited to (and might be the safest option) for folks at risk of ovarian hyperstimulation syndrome (OHSS). This condition can happen if the extra hCG hormones cause your ovaries to swell.

OHSS *can* be life threatening if severe. Some folks experience pelvic discomfort, nausea, vomiting, or diarrhea. But severe cases can cause blood clots and shortness of breath.

How does the trigger shot work for IUI or IVF?

Trigger shots are usually combined with other fertility treatments. This includes intrauterine insemination (IUI) and in vitro fertilization (IVF). Here’s the deets.

IUI

IUI (aka artificial insemination) is a popular procedure that can increase your chance of bun-in-oven status by injecting sperm right into the uterine cavity. This procedure can be done with or without a trigger shot.

Here are the basics of using IUI with the trigger shot:

1. You may or may not be given an oral or injectable medication to stimulate egg production.
2. Meanwhile, collected semen is “washed” in a lab. That means the seminal fluid is removed so there’s a higher concentration of sperm.
3. Your doctor will monitor egg development via ultrasound or discuss other ways to time IUI, such as ovulation predictor kits.
4. You’ll use a trigger shot to help the ovaries leggo your eggos once your doc gives you the go-ahead.
5. During your ovulation window your doc will complete the IUI procedure.

IVF

IVF is a complex, multi-step procedure where the sperm and egg are combined outside of the uterus in a lab. The resulting embryo (or embryos) is then transferred to the uterus.

Here’s the DL:

1. You’ll take a medication for 8 to 14 days to help you produce more eggs.
2. You’ll take a trigger shot to make sure your eggs are ready to be collected.
3. Your doc will collect your eggs. The amount of eggs depends on your individual situation. (P.S. Don’t worry about the pain. You’ll be placed under sedation.)
4. The eggs are combined with sperm to create embryo(s) in a lab. You and your doc will discuss how many embryos you want to transfer depending on your situation and pregnancy maximizing goals.
5. The embryo(s) are inserted into your uterus during the transfer procedure.

Who will need to use a trigger shot?

Trigger shots can help folks with any type of infertility, including unexplained infertility and conditions that makes conception more difficult like:

• endometriosis
• uterine fibroids
• primary ovary insufficiency (POI)
• polycystic ovary syndrome (PCOS)
• anovulation (when your body doesn’t release eggs on its own)

Trigger shots can also help to time ovulation in noninfertile same sex couples.

Are Clomid and a trigger shot ever used together? 

Clomid is an oral fertility medication that can help get your cycle on track. It can be used on its own or with a trigger shot.

Like the trigger shot, Clomid dosage and timing depends on your unique situation.

Other meds can also be used with the trigger shot, like the PCOS med letrozole.

How much will it cost?

Trigger shots usually range from $50 to $250. But the total cost of fertility treatments used with the trigger shot can be hella pricey.

IUI can cost $300 to $1,000 or more, and IVF can cost around $15,000 or more, according to Planned Parenthood. The precise price depends on your insurance and what tests or medications you’ll need.

How long after the trigger shot do you ovulate?

Ovulation timing is uber important to enhance the success of your conception session. The trigger shot helps you pinpoint the timeframe. After taking the shot, ovulation usually occurs within 36 to 38 hours. But the exact timing is up for debate.

With IUI, a 2020 study saw higher pregnancy rates in folks who were inseminated 42 hours after the trigger shot. But another study found no major difference between folks inseminated immediately after a trigger shot or those inseminated 36 to 40 hours later.

With IVF, you take the shot once your follicles are big enough. (Your doc will let you know.) Then your eggs are retrieved about 36 hours after you take the shot.

What are the side effects?

Trigger shots are typically considered safe. But it can come with side effects like:

• bloating
• stomach or pelvic pain
• abdominal pain or tenderness at the injection site

Ovarian hyperstimulation syndrome (OHSS) is also a risk, which is when extra hCG makes your ovaries to swell and fill will fluid. This is why folks at risk of the syndrome may be given the Lupron trigger shot that doesn’t contain hCG. Although it’s rare, severe OHSS can be a medical emergency.

Signs of OHSS include:

• pelvic discomfort
• nausea
• vomiting
• diarrhea
• abdominal bloating
• blood clots (in severe cases)
• rapid weight gain (in severe cases)
• shortness of breath (in severe cases)

Let your doc know if you have any side effects that last for more than a few days.

When can you take a pregnancy test?

The hormone in trigger shots (hCG) is the same hormone used to detect pregnancy. So if you take a pregnancy test right after the shot, you might get a false positive. To avoid this, your doc may give you a date to take a pregnancy test.

You can also wait for your period and see if Aunt Flo misses her monthly visit. Or, you can ask your doc for a blood test. This can sometimes confirm a pregnancy sooner than an at-home pee test.

Testing out the trigger shot 

An at-home pregnancy test can help you see how long the trigger shot lingers in your bod.

The pregnancy test should show a strong positive sign right after you get the shot. Each day, the positive sign will get lighter as the hormones leave your system.

If your eggo really is preggo, the positive sign will get darker the closer you get to your scheduled period.

Reminder: Get your doc to confirm a pregnancy. At-home tests aren’t always 10/10 reliable.

What are the odds of pregnancy?

Some studies have found trigger shots are associated with higher pregnancy rates when used in IUI cycles, but the results are inconsistent.

In a 2017 study, researchers compared pregnancy rates between people who took a trigger shot with IUI. They found that 18.1 percent of peeps who took the shot got pregnant — only 5.8 percent of those who didn’t take the shot got pregnant.

Just keep in mind, everyone is different. Success rates depend can on:

• age
• type of infertility
• use of fertility drugs
• other underlying conditions

Bottom line

Trigger shots contain the “pregnancy hormone” hCG. They can, well, trigger ovulation and increase your chances of getting pregnant. They’re commonly used alongside IUI or IVF treatments.

Your doctor can help you come up with a top notch fertility treatment based on your unique situation.

Just remember, infertility is NOTHING to be ashamed of. It can take a long time to find the right mix of treatments ❤️. In the meantime, finding infertility support may help you on your journey to bébé.