In vitro fertilization program includes several important stages, among which especially important one is the stimulation of superovulation or SSO.
The SSO Protocol in IVF is represented by a set of procedures based on the introduction of medications, the purpose of which is to stimulate the growth of follicles to obtain reproductive material (mature eggs).
The SSO Protocol, which includes the selection of medications and the scheme of their administration, is developed on an individual basis, taking into account the follicular reserve of the body. Highly qualified specialists provide patients who have applied to the Medical Plaza center with an individual approach when drawing up IVF programs and developing the SSO Protocol, as well as constant monitoring of the growth of follicles and state of endometrium. It is important to remember that the final result of an in vitro fertilization program depends on the competence of the specialist's actions.
TYPES OF IVF PROTOCOLS
There are several types of IVF protocols that have some differences before the end of superstimulation stage and egg production. In the future, they are identical, except for the need for cryopreservation of biological material.
Types of IVF protocols differ depending on the range of medications used and the total duration of stage. So, there are short, ultra-short, long, hyper-long protocols. In addition, as part of the presence of natural ovulation, a natural protocol is used that excludes the use of medications that stimulate follicular growth. The number of most used protocols often include long and short ones:
- Short IVF Protocol. It implies the preservation of hormonal background, as well as the use of medications that exclude onset of premature ovulation.
- Long IVF Protocol. This Protocol uses medications that stop the production of luteinizing hormones. Against the background of reducing indicators to minimum levels, drugs that stimulate the activity of the ovaries and the growth of follicles are used.
Developing protocols, specialists collect and analyze data on the state of the reproductive system, patient's hormonal background, and features of menstrual cycle. This information is necessary for selecting the most appropriate individual program.
SHORT IVF PROTOCOL
Duration of a short IVF Protocol is no more than 12 days. During this stage, which begins at the 3rd – 5th day of menstrual cycle, medications that stimulate activity of both ovaries and growth of follicles are used. The Protocol is considered successful if both ovaries respond to the used therapy.
It should be noted that in the framework of natural menstrual cycle female reproductive systems produce one follicle. The production of two or more is considered a rare exception. Since the egg itself is enclosed in the follicle, it is impossible to determine its presence using ultrasound. As part of such research, microscopes are used if necessary.
LONG IVF PROTOCOL
The length the IVF Protocol generally depends on the length of the woman's natural menstrual cycle. On average, this stage takes at least 3 to 4 weeks. Long protocol is used if the patient's reproductive system has a sufficient reserve of follicles.
Primary stage of the protocol is performed during the luteal phase, that is, on the 19th – 20th day of the menstrual cycle. During this period, patients are given medications that stop the production of LH hormone. This Protocol may use various forms of medication, such as deposited or daily injections or nasal sprays. Against the background of a decrease in LH hormone to the minimum indicators, specialists begin conducting procedures aimed at stimulating superovulation. This stage usually takes no more than 12 days.
IVF protocols are maintained on an individual basis. After the start of the procedure, depending on the results obtained, the specialist has the right to change the scheme, the dosage of prescribed drugs, cancel or, on the contrary, introduce new medicines. It is important to note that the responses to the therapy performed in different patients can have huge differences, even if identical protocols are used.
In some cases, under the influence of therapy, the patient may develop ovarian hyperstimulation syndrome. In order to prevent it, blood tests to determine the level of estradiol are required as part of the IVF Protocol. Overestimation of indicators means saturation of the body with drugs used to stimulate the growth of follicles. In this situation, it is necessary to suspend the therapy used.
According to statistics, a successful IVF Protocol is more often the result of long-term stimulation. This is partly due to the fact that this procedure is only applied to women with sufficient follicular stock, which makes it possible to choose the best quality material. Percentage of successful pregnancy in the long Protocol is slightly higher than in the short one.
POSSIBLE COMPLICATIONS
Despite constant monitoring by a specialist and taking measures to prevent possible complications, cases of unsuccessful IVF protocols, in which the embryo transfer is canceled, are not an exception. In the vast majority of cases, the response of the patient's reproductive system to the therapy used is hyperstimulation syndrome.
Against the background of danger of developing this syndrome, specialists can reduce the dosage of drugs or completely cancel their use. In the absence of positive results of preventive measures, that is, against the background of the development of the syndrome, the patient may be prescribed hemostasis correction and specialized dietary nutrition as treatment. In severe cases, treatment in a hospital setting is required.
CHOOSING THE IVF PROTOCOL
So, how the IVF Protocol is conducted and how to choose its type? The choice of Protocol is a very difficult task for specialists, to solve which the doctor must take into account all characteristics of the patient's body and all possible risks. It is a rational choice that determines the response of ovaries to the therapy. However, it is important to note that a specialist can not affect the quality of biological material.
Consider options for IVF protocols that are used somewhat less frequently than the ones listed above:
- Hyper-long protocol. It is used in case of the presence of a number of diseases in the patient, including cysts, endometriosis, uterine fibroids. Involves the use of deposited drugs for 60-90 days before the start of stimulation therapy. The need to use medications is to suppress the menstrual cycle and slow down the growth of benign tumors.
- Natural Protocol. Excludes the use of medicinal stimulants.
- Protocol with minimal stimulation. Drugs are used for a long period of time and are administered in small doses.
- Ultra-short Protocol. This type of Protocol is applied to women with poor follicular reserve. In its framework, the introduction of stimulating drugs begins on the third day of the menstrual cycle and lasts about ten days. As a rule, the introduction of drugs begins with high dosages.
In addition to the above options, others are also used, for example, the IVF Protocol with a donor egg. In General, it is important to remember that the result of in vitro fertilization depends on the justification of the choice of Protocol. And success of procedures is determined by degree of qualification of the doctor. Specialists of our center are professionals of the highest level and guarantee an individual approach to each patient. We will help you to achieve positive results and to become happy parents!