Why do symptoms sometimes get worse before they settle when starting Lupron?

As a GnRH agonist, it can briefly increase hormone activity before suppressing it. Your clinic will explain what is expected in your specific protocol.

Is Lupron used the same way in every clinic?

No, some clinics use it for down regulation and others use it as a trigger option, so follow your own clinic's explanation of why you have been prescribed it.

Does it need refrigeration?

Check the patient information leaflet, as this varies by formulation.

What if a dose is missed?

Contact your clinic rather than trying to catch up or adjust the dose yourself.

GnRH agonist injection

Lupron (leuprorelin)

Also known as Leuprorelin acetate, Leuprolide

Written by Zayn Miah & R KhanomLast updated 17 September 2026Not clinically reviewed

Lupron is a GnRH agonist, given by injection, which initially stimulates and then suppresses the body's own hormone signals to the ovaries, depending on how and when it is used.

Why it may be used

In IVF it is used either to down regulate the ovaries before stimulation begins, in a long protocol, or in some cases as part of triggering final egg maturation instead of, or alongside, hCG.

Where it fits in a cycle

When used for down regulation it is typically started before the stimulation phase and continued into it. When used as a trigger, it is given as a single injection near the end of stimulation. Your clinic will specify which use applies to your protocol.

Side effects listed in the patient leaflet

Injection site reactions such as redness or bruising
Headache
Hot flushes
Mood changes
Tiredness
Vaginal spotting, particularly during down regulation
Joint or muscle aches

When to ring the clinic

•Rapid or severe abdominal swelling
•Severe abdominal or pelvic pain
•Breathlessness
•Passing noticeably less urine
•Sudden weight gain, or signs of infection at the injection site

Questions people ask

Why do symptoms sometimes get worse before they settle when starting Lupron?: As a GnRH agonist, it can briefly increase hormone activity before suppressing it. Your clinic will explain what is expected in your specific protocol.
Is Lupron used the same way in every clinic?: No, some clinics use it for down regulation and others use it as a trigger option, so follow your own clinic's explanation of why you have been prescribed it.
Does it need refrigeration?: Check the patient information leaflet, as this varies by formulation.
What if a dose is missed?: Contact your clinic rather than trying to catch up or adjust the dose yourself.

Safety

This page is general information only and does not replace advice from your fertility clinic.
The specific use of this medicine in your protocol, and its timing, must come from your clinic's written instructions.
The patient information leaflet in the box is the authoritative source for this medicine.
Tell your clinic about other medicines, allergies and medical conditions before starting.

Sources

Patient information leaflets and product characteristics, electronic medicines compendium (emc). Link checked 17 September 2026.
IVF: what is IVF and how does it work?, HFEA (UK fertility regulator). Link checked 17 September 2026.

Written by patients, not clinicians. This page has not yet been reviewed by a named fertility professional, so it explains published guidance and points you to the original source instead of giving medical advice. It is not medical advice. Decisions about your treatment belong with your own clinic. Read our editorial policy and corrections policy.