Confused by the IVF Alphabet soup? Learn the difference between different infections in simple terms in this blog post.
If you’ve started your IVF cycle, you’ve probably encountered a pharmacy bag full of mysterious abbreviations — HMG, HP-HMG, U-HMG, r-FSH… and a dozen needles that make you feel like you’re prepping for a space mission.
At our clinic, we like to decode these for patients early on, because understanding what’s going into your body is empowering, not intimidating.
So here’s a clear, no-jargon guide to IVF injections and what each of them actually does.
Why Do We Use Injections in IVF?
During a natural cycle, your brain releases two key hormones — FSH (follicle-stimulating hormone) and LH (luteinizing hormone) — in tiny, precise pulses.
These stimulate the ovaries to grow one egg.
In IVF, we want to help the ovaries grow multiple eggs, safely and predictably, so that we can retrieve several mature oocytes at once. To do that, we use controlled ovarian stimulation (COS) — a fancy way of saying “we nudge your ovaries with hormones that mimic what your body already makes.”
And that’s where the injections come in. Although there are many more types of injections and the pharmaceutical market is continuously evolving, here we’ve discussed 3 types of injections most commonly used.
1. U-HMG – Urinary HMG (Conventional Form)
Sometimes referred to as “urinary HMG,” this is the earlier version of HMG with minimal purification.
It’s mostly been replaced by HP-HMG in modern IVF practice, but may still be used in certain setups for cost or availability reasons.
- Pros: Economical and accessible.
- Cons: Less pure, slightly more allergic reactions, and variable potency.
At our clinic, we rarely use conventional U-HMG now, given the consistency we achieve with HP-HMG and recombinant options.
2. HP-HMG – Highly Purified Human Menopausal Gonadotropin
This is the refined cousin of HMG. It’s still derived from urine, but the purification process removes most unwanted proteins and contaminants.
- What it does: Same as HMG — promotes follicle growth, but cleaner and more consistent.
- Pros: Higher purity, fewer side effects like bloating or injection site irritation, more predictable response.
- Cons: Slightly more expensive than regular HMG.
Think of it as switching from filter coffee to a sleek espresso machine — same goal, just a smoother process.
3. r-FSH – Recombinant Follicle-Stimulating Hormone
This one’s fully lab-made using recombinant DNA technology — no human urine involved.
It contains only FSH, not LH, and offers good consistency and precision.
- Pros: Highly pure, precise dosing, predictable response, prefilled pens for easier use.
- Cons: More expensive, and sometimes too “clean” — women with lower LH may need LH supplementation alongside.
In short: r-FSH is modern, elegant, and reliable, but not automatically “better” for everyone. In face, it is most commonly used for patients with PCOS where they have higher levels of LH and hence external supplementation of LH is not needed. It all depends on on your hormone profile and previous cycle responses. It is important to remember that HMG might be a better option for some and your doctor will tailor-make your protocol.
How We Choose Which Injection You Get
There’s no universal “best” injection. We personalize stimulation based on:
- Age and ovarian reserve (AMH, AFC)
- Past response to stimulation
- Hormone levels
- Budget considerations
- Whether we need FSH alone or FSH + LH
In some women, adding LH (as in HMG or HP-HMG) supports estrogen production and egg maturity. In others, pure FSH works beautifully.
That’s why one patient’s protocol can’t be copied to another — IVF is science, but also fine-tuning.
Common Concerns Patients Ask Us
“Why so many injections?”
Because follicles grow gradually — each day’s dose keeps the process balanced. Skipping doses would be like stopping a car midway uphill.
“Can I mix brands?”
Sometimes yes, under supervision. We often tailor doses by alternating HP-HMG and r-FSH in the same cycle.
“Are they painful?”
They’re given subcutaneously (under the skin). Most patients say the anticipation is worse than the injection itself. Ice packs help more than bravery speeches.
What We Believe
At our clinic, we explain every injection before starting. You’ll know what each one does and why you’re taking it. There’s no mystery medicine here — only carefully chosen hormones helping your body do what it’s already designed to do, just with a little extra guidance.
After all, IVF isn’t about “stronger” drugs — it’s about smarter use of them.
Ready to Begin Your IVF Journey?
If you’re about to start treatment and want to understand your protocol better, our team will guide you through every step — from your first injection to your embryo transfer.
Call us or book your consultation now.
