Fertility drugs that are used by women to increase the production of follicles are given in many different ways and they are called protocols. Each patient has her own set of IVF protocols depending on her situation. To find the best IVF protocols for each woman, there are several factors that should be considered like her past medical history and medical dose. The patient will have the authority to decide which protocol she's most comfortable with.
Standard IVF Protocols
In a standard IVF protocol, there are four types of drugs given to patients. They are;
- Lupron - is a gonadotropin-releasing hormone (GnRH). It inhibits gonadotropin secretion to help prevent any premature ovulation. Instead of Lupron, sometimes Ganirelix is used to control the ovulation timing.
- Progesterone - is a hormonal drug that maintains and protects the development of early pregnancy.
- Gonadoptropins - are drugs containing FSH or both FSH and LH. It stimulates the production and maturation of eggs.
- Human Chorionic Gonadotropin (HCG) - is a drug that causes the release of eggs in the ovary.
Types of IVF Protocols
Agonist Protocol
Agonist protocol, or also known as Lupron protocol, is the standard protocol of all IVF stimulation process. For ten days women will be injected daily with Lupron to suppress stimulation in the pituitary. Patients will then be monitored daily until follicles are developed. When follicles begin to develop, they will be given another medication to increase the production of eggs. Once done, patients will be asked to take HCG shot.
Antagonist Protocol
Antagonist protocol is quite similar with agonist. In antagonist, another drug is used instead of Lupron and the treatment only takes one day. Some doctors also believe that lack of stimulation in the pituitary may help increase the ovarian response of some women with only few eggs. Like agonist, the last step is taking a HCG shot.
Flare Protocol
Flare protocol, or also known as microflare and short Lupron, is used when other IVF protocols fail. It is used in small amounts or just enough to stimulate the pituitary to release FSH to have a natural ovarian response. This protocol is intended to use a natural way of egg production. One disadvantage is fewer follicles will develop, thus decreasing the chances of producing many healthy eggs.
Natural IVF
From the word natural, this means no medications, drugs, or stimulators are given to the patient. The good thing here is that patients will not be exposed to any medication side effects but lesser chances to conceive from just one mature egg.
Issues that affect the success of an IVF procedure:
- Zona hardening - the longer it takes to penetrate the harder the eggs will be and become impenetrable.
- Temperature sensitivity - The temperature must be kept at 37°C while combining the egg and sperm to avoid any chances of egg failure.
- pH sensitivity - Keep fertilization dish at right temperatures to avoid any rise in ph level.
- Air quality - Always maintain good air quality inside the laboratory.
There is no best IVF protocol. What's best is to openly discuss different IVF protocols with your doctor and choose the protocol you're most comfortable with.