IVF Protocols. Ovarian Stimulation

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:

vv_ico health but not enough mature eggs;

vv_ico irregular ovulation;

vv_ico cystic disease;

vv_ico 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”.

ivf_medicines--300x224Generally, 3 types of IVF protocols of ovarian stimulation are used:

vv_ico long protoсol(Luteal Lupron protocol)

vv_ico antagonist protocol

vv_ico 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:

vv_ico GnRH-agonist (gonadotropin releasing hormone agonist) like Lupron, Decapeptyl, Diphereline;

vv_ico GnRH-antagonist (gonadotropin releasing hormone antagonist) like Cetrotide, Ganirelix, Orgalutran.

vv_ico FSH product (follicle stimulating hormone) to stimulate development of multiple egg like Gonal-F, Menopur, Puregon,

vv_ico 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:

vv_ico Select an appropriate IVF medical protocol;

vv_ico Monitor the progress of the patient’s ovarian stimulation process to regulate the doses of IVF drugs;

vv_ico 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:

vv_ico who are over 37;

vv_ico with low amount of antral follicles;

vv_ico with enhanced FSH level;

vv_ico with low ovarian reserve.