Before a woman undergoes in vitro fertilization (IVF) treatment there must be a careful study about her medical history so she will be provided proper medication be able to receive personalized care for the IVF Protocol.
Deciding on the IVF protocol
From the patient's medical history, the doctor will be able to determine her ovarian reserve which will be the basis for the medication dose she will receive during her pre-treatment. If she has enough ovarian reserve, she will only need a small dose but if she does not have sufficient eggs, she may need a much higher dose of medication. Through her medical records the doctor will also get an estimate of her ovarian sensitivity to hormones. Her age and BMI (Body Mass Index) are also needed to determine the IVF Protocol for her pre-treatment.
Types of IVF Protocols
When the doctor has all the information about the patient's ovarian reserve and sensitivity, the proper dose of stimulating medication can be prepared. There are several standardized IVF Protocols and the right IVF Protocol should be selected for the patient who will undergo IVF treatment.
The Natural Start Cycle IVF Protocol can be applied to a patient when she starts her treatment at the beginning of her menstrual cycle. If she has no cysts, she can take the stimulating medication that was prepared for her. This approach is very simple. The medication suppresses the ovaries before ovarian stimulation. This will prevent the eggs from developing quickly so that all the eggs will be ready at the same time.
The long IVF Protocol is the longest of all IVF Protocols. The deepest and longest suppression takes place in this IVF protocol. Suppression occurs several weeks with birth control pills, converging with GnRH agonist which is much more suppressive. By the time the patient is finished with long IVF Protocol, her ovaries are well suppressed. However, there can be a risk if it will go beyond the procedure, the ovaries will be overly suppressed. If this happens, the stimulating medication will not be effective. Long IVF Protocol is not good for a woman with low BMI (less than 11) or other factors which indicate sensitivity to suppression.
For the OCP- antagonist IVF Protocol, birth control pills are used for moderate suppression. Once the cycle begins, GnRH antagonist is used to prevent ovulation. This IVF Protocol has fewer infections and side effects.
Another IVF Protocol is the Estrogen priming. Estrogen patch or Estrace tablets are used at the start of day 21 in the IVF cycle before stimulation. Estrogen priming is very effective in lowering down Follicle-Stimulating Hormone (FSH) levels, which can benefit women who have marginal ovarian reserve. In order to stop ovulation, antagonist is paired with Estrogen priming.
The last of the IVF Protocols is the Flare Cycle. In this IVF Protocol, OCP or estrogen-only pre-treatment may be involved but GnRH agonist must start exactly the same time as the stimulating medication which is important in this IVF Protocol.
The application of the appropriate IVF Protocol and medication should be discussed properly with the doctor to get optimum results from the IVF treatment.