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Alternative IVF Protocols

There are many reasons and combinations of reasons why couples are unable to conceive through natural methods. Just as your fertility struggle is unique, so is your route to pregnancy. Thanks to ever-evolving advanced reproductive technology, there are several successful fertility treatments available. Depending on your fertility diagnosis your specialist will help find the right treatment for you.

In vitro fertilization is a highly successful treatment for infertility. Countless couples, and individuals, worldwide have had successful IVF treatment and produced a healthy baby. What’s more, fertility specialists utilize IVF as a treatment to overcome many different infertility diagnoses.


The Body’s Response to IVF Protocols

The main objective when you begin IVF treatment is for your fertility specialist to be able to control your reproductive timing. This is accomplished through controlled ovarian stimulation (COS).

There are three commonly used methods for COS.

  • Antagonist Protocol, or Short Protocol: This method involves the least number of injections. For 10 days you’ll take injections of follicle-stimulating hormones (FSH) and luteinizing hormone. On about the 5th day Gonadotropin-releasing hormone antagonist will be added in order to control ovulation and prevent the eggs from releasing prematurely. The physician may add Lupron towards the end of the cycle to stimulate maturation of your eggs.


  • Short Lupron, or Long Lupron Protocol: Your doctor administers Lupron, typically on day 2 of your menstrual cycle, in order to facilitate, and control, ovulation. This is called the short Lupron protocol. This ensures maturation of your eggs, and allows your IVF team to retrieve several eggs at one time. Long Lupron protocol involves taking birth control pills, followed by taking Lupron for one week at which time the pills are stopped and Lupron continued until the FSH injections start. Lupron is then used in conjunction with FSH injections until the HCG trigger shot.


  • Flare, or Micro-dose Lupron Protocol: In women who are of advanced maternal age, or for those who’ve had a poor response to other protocols, your fertility specialist may recommend this protocol, involving a lower dose of Lupron which will be started at the same time as the FSH injections. Although there is no evidence this protocol is better than other, it can provide an alternative to regularly and commonly used antagonist protocol.


Alternative IVF Protocols

Lupron, as well as the Antagonist protocol, and Flare protocol are all very common for women undergoing IVF, and all accomplish the same goal; controlling and boosting ovulation for the best harvest of mature eggs. As your body responds in its own way you may find the more common IVF protocols are not your best option. No two IVF treatments are the same and your fertility specialist will customize treatment to suit your specific needs for IVF.

Patients who fail to respond to the common protocols for IVF are referred to, medically, as poor responders. When this occurs your doctor will consider alternative IVF protocols, as a better means for a successful outcome. Advanced reproductive technology is improving every day, so new protocols are always being introduced. The current alternative IVF protocols include the following.


  • Estrogen Priming Protocol: For some women, especially for those who have diminished ovarian reserve, it becomes necessary to help the response to the Antagonist protocol. This is done by administering estrogen, typically via an estrogen patch or an injection, sometimes along with additional Gonadotropin-releasing hormone. The use of estrogen provides optimal conditions for immature follicles to mature, and is very helpful in cases of prematurely aging ovaries.


  • Mini/Micro-IVF Protocols: For women who don’t respond to traditional stimulation of the ovaries at all, doctors use a micro, or mini dose of fertility medication to stimulate the ovaries. This is often administered orally, and is typically Clomid, or a similar medication. Mini/micro IVF produces very few eggs and can be suitable for patients who have very low egg reserve or those above the age of 46.


  • Natural Cycle IVF Protocol: For those women who don’t respond to, or can’t tolerate, the ovary stimulating medications, there is another protocol referred to as Natural Cycle. As you may infer from the name, this process is accomplished by your body naturally. Your cycle is monitored, and when the timing is right, egg retrieval is performed. As your body relies on your natural cycle, only one egg is typically produced.


Finding The Best Treatment For You

You and your fertility specialist will go over your diagnosis and determine the best course of treatment for you. As you see, IVF protocols vary and what works for most may not work for you. Whatever protocol is called for in your case, the fact remains that IVF is one of the most effective treatments for infertility and produce the most successful outcomes.

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