The stimulation protocol is how the ovaries are stimulated to produce eggs during the treatment of In Vitro Fertilization. According to the American Society of Reproductive Medicine, fertility drugs are not linked to ovarian cancer. Indicatively, some ovarian stimulation protocols are listed below.
Long Protocol
In the long protocol, the use of the GnRH-agonist begins in either the latter phase of the previous cycle or at the beginning of the new cycle.
After the ovaries are desensitized, their stimulation with gonadotropins begins. The dosage of the medicine is individualized, tailored and adjusted during treatment.
Short Protocol
Used in ovaries with lower reserve.
GnRH-agonist is taken at the beginning of the cycle and then FSH stimulation is added.
Protocol of Antagonist
With the onset of the cycle, ovarian stimulation with gonadotropins begins. When the largest follicle is over 13 mm, the antagonist is given daily.
Natural Cycle Protocol
This is the so-called “In Vitro Fertilization without the use of medication”. No treatment is taken. The follicle grows without medication, similar to every other month. When it reaches the desired dimension, the egg is retrieved, fertilized, and the embryo is then transferred to the uterus.
Alternatively, the embryo can be frozen and the procedure may be repeated in the next cycle. The new embryo can be transferred along with the thawed, previously frozen, embryo. Using this method, we avoid repetitive embryo transfers.
The natural cycle is chosen by women who do not want to be treated or are poor responders and produce a small number of eggs after stimulation. Advantages of this approach are the minimum inconvenience due to the absence of medications, no possibility of overstimulation, and lastly, the lowest cost.
Mild Ovarian Stimulation Protocol
This procedure is called “Mini-IVF”. Ovarian stimulation is done with oral therapy, without injections. The ovaries produce fewer, but good quality eggs.
The embryos are recommended to be frozen and transferred during the following cycle due to the effect of clomiphene on the endometrium.
Overall, fewer injections, acceptable pregnancy result, lower probability of overstimulation, and lower cost are all advantages of this method.
Luteal/Latter Phase Protocol
The stimulation of the ovaries is done in the luteal phase of the cycle with the use of gonadotrophines.
After egg retrieval, the fertilized embryos are then frozen and transferred during the next cycle.
