Peculiarities of IVF protocols of ovarian stimulation
In cases if woman can’t get pregnant because of the total absence of ovulation, ovarian stimulation is prescribed. Usage of ovarian stimulation contributes to the normal functioning of ovaries after which nearly 60-75% of women successfully become mothers on their own.
Indications for ovarian stimulation:
health but not enough mature eggs;
abnormal weight (thinness or fullness).
Ovarian stimulation is conducted with the help of special IVF drugs (hormonal medicines) and controlled with US at the each stage of treatment. These medicines might be used in different combinations which are called “IVF medical protocols”.
Generally, 3 types of IVF protocols of ovarian stimulation are used:
long protoсol (Luteal Lupron protocol)
short protocol (Flare or Micro-flare protocol) used for patients expected to have a low response to ovarian stimulation.
Medicines which are used with each kind of the IVF protocols are the same but their dozes and duration of treatment differ. Selection of medicines and type of the IVF protocol of stimulation depends on woman’s age, health conditions, reasons of infertility, reaction of the organism for the medicines and results of the previous IVF attempts.
IVF protocols generally involve the use of 3 types of drugs:
GnRH-agonist (gonadotropin releasing hormone agonist) like Lupron, Decapeptyl, Diphereline;
GnRH-antagonist (gonadotropin releasing hormone antagonist) like Cetrotide, Ganirelix, Orgalutran.
FSH product (follicle stimulating hormone) to stimulate development of multiple egg like Gonal-F, Menopur, Puregon,
HCG (human chorionic gonadotropin) for final maturation of the eggs like Ovitrelle, Pregnyl, Choragon
What is the aim of IVF protocols of ovarian stimulation?
The main aim of ovarian stimulation by In-vitro Fertilization is to get 8-15 quality eggs appropriate for fertilization. IVF cycle might be successful even with one egg retrieved but successful rates are, for sure, much higher with more eggs.
The main goal of a fertility specialist by the ovarian stimulation:
Select an appropriate IVF medical protocol;
Monitor the progress of the patient’s ovarian stimulation process to regulate the doses of IVF drugs;
Trigger with HCG (human chorionic gonadotropin) in a proper time. Triggering in a wrong time might reduce success or even cause the development of ovarian hyperstimulation
How many follicles are necessary for getting pregnant with In-vitro Fertilization?
Usually, it’s not too difficult to get the enough amount of the mature eggs. The necessary minimum is just 3-4 mature eggs. But still there are cases when because of the poor response of the ovaries the quantity of eggs is too low. The most likely to be low responders for the ovarian stimulation are women:
who are over 37;
with low amount of antral follicles;
with enhanced FSH level;
with low ovarian reserve.