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Sunday, 20 April 2014

IVF regimes explained

There are many protocols that are used in IVF. The commonest ones are
  • Long protocol: In this regime, GnRH analogs are started on the 18th to 21st day of the cycle (contraceptive pills are taken daily from the 2nd day of the period). Once downregulation is confirmed on scan/blood tests, ovarian stimulation is started with daily  injections of FSH or hMG alongside the analog injections. This continues till the leading follicles are 18mm or so. At this point, the last analog injection is given and a trigger injection is given to enable eggs in the follicles to complete their maturation and be ready for "pick-up".  The egg collection is scheduled approximately 36 hours later.
  • Short or Flare protocol: GnRH analog is started on the second day of the cycle and the ovarian stimulation the next day (i.e., 3rd day). The rest of the regime is the same as long protocol. This is particularly used for women with lower ovarian reserve.
  • Antagonist protocol: This is the latest kid on the block. Ovarian stimulation is commenced on the day 2 of the cycle and the daily GnRH antagonist injections are added on the day 6 of stimulation or once the leading follicles are >13mm. Both injections continue till the leading follicles are 17mm or so. On this day, the last antagonist is given followed by the trigger injection. The egg collection is scheduled approximately 36 hours later.
I hope this has clarified the readers' understanding of the different types of protocols that are used in IVF. There are of course subtle variations that exist but this post was to give a broad understanding of the process.

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