Optimized Stim Protocol
The choice of protocol depends on age, BMI, AFC, AMH, and previous response.
- Long Protocol (Down-Regulation): This protocol involves using a gonadotropin-releasing hormone agonist (GnRH agonist) to suppress natural hormone production before starting ovarian stimulation with follicle-stimulating hormone (FSH). It aims to prevent premature ovulation and optimize follicle growth.
- Short Protocol (Antagonist Protocol): In this protocol, ovarian stimulation with FSH begins early in the menstrual cycle. GnRH antagonists are later introduced to prevent premature ovulation. This protocol is usually shorter in duration compared to the long protocol.
- Mild Stimulation Protocol: This protocol involves using lower doses of gonadotropins to achieve a milder response from the ovaries. It may be suitable for women who are more sensitive to ovarian stimulation medications or those at risk of ovarian hyperstimulation syndrome (OHSS).
- Natural Cycle IVF: Instead of stimulating multiple follicles, this protocol focuses on retrieving the one naturally selected dominant follicle during a woman’s natural menstrual cycle. It may be an option for women who do not respond well to traditional stimulation protocols or prefer a less invasive approach.
- Modified Natural Cycle IVF: This protocol combines aspects of natural cycle IVF with minimal stimulation using low-dose gonadotropins to encourage the growth of one or a few follicles.
- Freeze-All Protocol: In some cases, a “freeze-all” approach is employed, where embryos resulting from IVF are cryopreserved (frozen) instead of being transferred immediately. This allows for a subsequent frozen embryo transfer (FET) cycle, which may provide a more favorable uterine environment.
- Duo- Stim: Double ovarian stimulation during both follicular and luteal phase of the ovarian cycle.
It’s essential to discuss the potential risks, benefits, and success rates of each protocol with your doctor who can evaluate your specific circumstances and make an informed recommendation based on your needs.