We understand that it can be daunting when you’re first starting out on your fertility journey, especially when so many medical terms are used.
If you’re embarking on IVF, one of the medical terms that may have caused confusion is ‘protocol,’ which is more than likely used by your fertility consultant.
Maybe you’ve heard of ‘short protocol’, or ‘long protocol IVF’, or even ‘natural cycle IVF’ and ‘mild IVF’, either way, if you’re not sure what these terms mean it can be confusing.
In this post we cover what these terms mean, how they differ from each other, and how you can decide which would be best suited to you.
What does the term IVF protocol mean?
The easiest way to come to terms with the word ‘protocol’ is to think of it as a fancy word for regime.
Protocol refers to the specific ovarian stimulation treatment plan that you will undertake as part of the IVF process.
Whether you have chosen to undertake a long or a short protocol IVF treatment, it refers to your personalised schedule for how the treatment will be carried out, when procedures will be undertaken, and which drugs will be administered.
What is the difference between long and short protocol IVF?
Long Protocol IVF
The long protocol IVF refers to the conventional IVF process. This usually involves an hormone injection called GnRH-analogue at around day 21 of your menstrual cycle. This process is called down-regulation and ‘switches off’ your own ovarian function, prior to inducing ovarian stimulation. You’re then asked to wait until the period starts and at stage you will have an ultrasound scan and possibly some blood tests before starting the daily hormone injections. You will be carefully monitored so we know when your follicles are at the right size and stage of development for aspiration. Egg collection follows approximately 2 weeks after you commence the daily hormone treatment.
Short Protocol IVF
There are typically three types of short protocol IVF. As the name suggests, short protocol IVF is a shorter process and is sometimes used when a woman has not produced that many eggs under the long protocol process, or in women with reduced ovarian reserve and/or older than 39 years, or in women with polycystic ovaries.
This starts with low daily doses of hormone injections between 5 and 9 days before egg collection. The aim of these injections is to support the development of the follicles without completing taking over and/or shutting the ovarian function. With this protocol it is expected to collect a smaller number of eggs but possibly of better quality as there would have been ‘in theory’ a more natural selection process.
Natural cycle IVF is carefully aligned with your natural menstrual cycle and involves no hormone injections to induce follicular development. We will use ultrasound scans to monitor follicle size, and egg collection is performed around day 14 of your cycle. The eggs are then fertilised, embryo development monitored in the laboratory and embryo transfer performed 5 days later. Natural cycle IVF is suitable for every woman who is still ovulating and wants to avoid stimulation medications or in women for who hormone therapy would be contraindicated.
Natural Modified IVF
Natural Modified IVF is a form of Natural cycle IVF which is carried out during your natural menstrual cycle, but is modified slightly with additional medication, including injections and in some cases tablets before your egg collection. The aim of the medication is to stop your spontaneous ovulation and keep your follicles developing. Ultrasound scans are used to monitor the growth of your follicles and allows our team to tailor the treatment accordingly.
In both variants of the IVF process, you will be carefully monitored to ensure that the treatment is going to plan and is on schedule. It is essential to confirm that your follicles are at the right size and stage of development for aspiration.
Advantages of Short Protocol IVF
- Short protocol focuses on egg quality and the approach may result in better laboratory and clinical outcomes.
- Fewer drugs means that there are less side effects and a shorter treatment duration, often meaning it is less stressful.
- Short protocol IVF may also be cheaper than a long protocol due to lower doses of hormone medications used to induce follicular development during the IVF treatment.
The following is an outline of potential IVF protocols, but at RHG we personalise our protocols around each patient and their personal needs to achieve the best possible outcome.
What determines which IVF protocol I am treated with?
The decision on which route you will take with the ‘protocol’ for the IVF procedure will ultimately lie with your fertility consultant as well as the clinic experience and preferences. Therefore, it is incredibly important that your fertility expert has all the information needed to weigh up both options.
At Reproductive Health Group, Professor Nardo and the team would certainly take your medical history as well as thoughts and concerns into consideration when deciding which protocol would be best for you. So, if you have any questions during the initial stages it is worth mentioning them. This will allow us to resolve any potential issues and provide extensive support.
Factors such as age, the primary cause of the subfertility, ovarian reserve as determine by available tests and how your body has previously responded to fertility treatments would also be considered when deciding whether short or long protocol IVF would be best for you.
So, there you have it, a significant part of the IVF process broken down and explained. If you do have any further questions, please feel free to contact us and book a consultation with one of our fertility experts.
Get started with RHG
The first step to getting started with RHG is to organise a virtual consultation with one of our consultants. This will provide us with the opportunity to review your medical case in detail, discuss your fertility journey and start to plan the best course of treatment for you. You can get started by booking an appointment here.