Several IVF protocols can be used to stimulate the ovaries of in vitro fertilization (IVF) patients. Each has the same goal but in different ways; because some IVF protocols work better than others for some women as each individual is unique. We, at IVF Turkey, offer different protocols for different types of IVF cases.
Long Protocol IVF
Long protocol IVF, is the conventional IVF protocol which is also known as “luteal Lupron”, or “down-regulation”. Long protocol IVF takes around 4-6 weeks. The individuals have to take daily stimulating injections starting from day 21 of the cycle up to egg retrieval. It involves many more injections. Long protocol IVF, differs from other protocols involving a period of down-regulation. That is the reason this treatment is also known by the name “down-regulation” protocol.
Steps Of Long Protocol
- Blood and ultrasound: To choose the right protocol we at IVF Turkey, need to see the hormone levels of the couple. Before starting the Long Protocol; a blood test for hormone values, transvaginal ultrasound for to measure the follicle sizes, and consultation to learn the detailed fertility background will be planned.
- GnRH Agonists: This protocol uses Leuprolide (Lupron) injections starting on day 21 of the cycle the month before the IVF stimulation. This period is called “mid-luteal” timing. The protocol (also known as Long Lupron) takes its name from Lupron medication which is effective in preventing pituitary luteinizing hormone (LH) surge during controlled ovarian stimulation for in vitro fertilization (IVF). As part of the Down-Regulation protocol, it’s used to prevent premature ovulation during the ovarian stimulation process. It takes about a week to take hold.
- Stimulation: This step involves the subcutaneous injection of a medication containing FSH. The FSH drug is usually started within the first 2-7 days after the period begins. The dose is adjusted as the simulation progresses.
- HCG injection: HCG is the hormone that helps the eggs to complete the maturation process. First, the estradiol levels will be monitored, after reaching 1000 to 4000 pg/ml estradiol levels HCG shot will be done. HCG injection is taken only once in an IVF cycle.
- Progesterone: Progesterone is the name of the female hormone, which helps to prepare a receptive uterine lining for embryo implantation.
- Egg retrieval: The egg retrieval procedure is planned for 34-36 hours after HCG injection
- Embryo transfer
The main difference between GnRH agonists and GnRH antagonists is the duration of the suppressive effects of GnRH agonists (like Lupron). The Down-Regulation protocol is a longer process than the Antagonist Protocol.
IVF Short Protocol
The Short protocol also known as Antagonist Protocol is the most commonly used IVF protocol. Short protocol IVF treatment takes around 2 weeks. The individual will take drugs to stimulate the ovaries for just 5-9 days before egg retrieval.
Steps Of IVF Short Protocol
- Blood and ultrasound: To consider and choose the right protocol we at IVF Turkey, need to see the hormone levels of the couple. During Antagonist Protocol the first step will be a blood test for IVF hormone values, ultrasound (generally transvaginal ultrasound is preferred) to measure the follicle sizes and learn the couple’s fertility background in detail.
- GnRH Antagonist: The protocol takes its name from this medication which is effective in preventing pituitary luteinizing hormone (LH) surge during controlled ovarian stimulation for in vitro fertilization (IVF). This drug is taken subcutaneous injection, once daily starting on about day 6 of stimulation.
- Ovarian stimulation: Takes around 8-11 days. This step involves the subcutaneous injection of a medication containing FSH.
- HCG injection: HCG is the hormone that helps the eggs to complete the maturation process. HCG injections are taken only once in an IVF cycle.
- Progesterone: Progesterone is the name of the female hormone, which helps to prepare a receptive uterine lining for embryo implantation.
- Egg retrieval
- Embryo transfer
Natural Modified IVF Protocol
Natural Modified IVF is the protocol that focuses on the quality of eggs, rather than the quantity. With natural modified IVF protocol the natural menstruation cycle is supported with a low dose of stimulation. During the treatment, the individuals will be given medication for 3-4 days to keep the growing follicles healthy. Besides, the individuals will be given another drug to stop premature ovulation and avoid spontaneous ovulation.
Throughout the IVF cycle, the individuals will be followed by advanced ultrasound technology. Natural Modified IVF protocol involves ultrasound scans, egg retrieval, laboratory procedures, and embryo transfer just like the ones used in conventional IVF.
The Microflare IVF Protocol
The Microflare protocol is generally used for individuals with a low ovarian reserve or a history of a poor response to a previous IVF cycle or protocol. In this protocol, the word “Micro” refers to the use of a diluted dose of Lupron while the word “flare” refers to the stimulatory. The usage of diluted medicine and gonadotropins is aimed to maximize the ovarian response. The individuals are asked to take a birth control pill before the procedure. And the treatment starts after the last birth control pill is taken.
Steps Of Microflare IVF Protocol
- Blood and ultrasound: Like all the other IVF protocols the Microflare protocol also requires a blood test for IVF hormone values and transvaginal ultrasound to measure the follicle sizes in the ovaries.
- Diluted Lupron: After the last birth control pill, on day 4, the individual has to start taking diluted Lupron injections twice a day.
- Ovarian stimulation: Takes around 8-11 days. This step involves the subcutaneous injection of a medication containing FSH.
- HCG injection: HCG is the hormone that helps the eggs to complete the maturation process. HCG injections are taken only once in an IVF cycle.
- Progesterone: Progesterone is the name of the female hormone, which helps to prepare a receptive uterine lining for embryo implantation.
- Egg retrieval
- Embryo transfer
The Flare-Up IVF Protocol
The flare-up protocol is a type of stimulation used to “jump-start” ovarian response. In this protocol birth control pills are usually given for the month before the flare. Birth control pills help to avoid cysts that may be reactivated by the high LH levels.
With the flare-up protocol, the individuals will start to take GnRH agonist on menstrual cycle day 2. The GnRH agonist used in the flare-up protocol comes with diluted dosages. The day after starting injecting GnRH agonist, injections containing FSH will be added to the process. To complete the egg maturation HCG injections will be given a few days before the egg retrieval.
Letrozole Treatment Protocol
Letrozole helps to reduce the intra-ovarian aromatization of androgens to estrogens. Using letrozole during ovarian stimulation produces enough numbers of oocytes that increase the success of IVF procedures. Letrozole Treatment Protocol involves; monitoring with ovulation predictor kits and having intercourse.
During the letrozole protocol blood test for IVF hormone values and ultrasound will be planned on the menstrual cycle day 2 or 3. The individuals will start taking letrozole tablets on days 5, 6, 7, 8, and 9. Testing urine for color change will be done on the morning of day 10 or 11. As soon as the color change is seen on that day and the next day the couples have intercourse. It is important to schedule an appointment approximately one week later for a blood test to verify ovulation.
Main IVF cases are:
IVF is the most common fertility treatment used when;
- Poor Responders
- First Timers
- PCO cases
- Endometriosis cases
- Overweight cases
- Multiple IVF Failure cases
