Short or Long IVF Protocol: Which is Better?

by | Jul 21, 2023 | IVF

What is IVF?

In vitro fertilization, commonly known as IVF, is a ray of hope for couples struggling with infertility. It’s a remarkable assisted reproductive technology that has brought joy to countless families worldwide. If you’re on this fertility journey, understanding the different types of IVF protocols, especially the short IVF protocol, can be crucial in your pursuit of parenthood.

 

Types of IVF Protocols:

  1. The Long IVF Protocol: The long IVF protocol, also known as the agonist protocol, is the traditional approach to IVF treatment. In this method, patients take a daily injection of a gonadotropin-releasing hormone agonist (GnRH agonist) to suppress their natural hormonal cycle. Once the suppression is achieved, ovarian stimulation begins with the administration of fertility medications like follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This process takes around two weeks before egg retrieval.
  2. The Short IVF Protocol: The short IVF protocol, also called the antagonist protocol, is a more recent advancement in IVF treatment. Unlike the long protocol, patients start ovarian stimulation using FSH and LH injections without the initial GnRH agonist phase. However, after a few days of stimulation, a GnRH antagonist is introduced to prevent premature ovulation. This approach typically reduces the duration of treatment and may be a preferred option for some patients.

 

What is a Short IVF Protocol?

The short IVF protocol is an innovative alternative that streamlines the IVF process by eliminating the lengthy initial suppression phase. By bypassing this step, patients can proceed to ovarian stimulation more quickly, leading to shorter treatment cycles. This can be especially advantageous for those who have busy schedules or are eager to start their journey to parenthood without delays.

 

Short IVF Protocol Procedure Step by Step:

Step 1: Ovarian Assessment

Before commencing the short IVF protocol, a thorough ovarian assessment is performed. This involves a series of tests and ultrasounds to evaluate the ovaries’ health and determine the optimal dosage of fertility medications needed for stimulation.

Step 2: Ovarian Stimulation

Once the assessment is complete, the patient starts the ovarian stimulation phase. This typically involves self-administering FSH and LH injections daily. These medications encourage the ovaries to produce multiple eggs, increasing the chances of a successful IVF cycle.

Step 3: Monitoring and Follicle Growth

Throughout the stimulation phase, regular monitoring through blood tests and ultrasounds is conducted. This helps the fertility team assess the follicle growth and make any necessary adjustments to the medication dosage.

Step 4: GnRH Antagonist Introduction

As the follicles near maturity, a GnRH antagonist is introduced to prevent premature ovulation. Premature ovulation can result in the release of eggs before they can be retrieved, potentially compromising the IVF cycle’s success.

Step 5: Trigger Shot and Egg Retrieval

When the follicles reach the desired size, a trigger shot of human chorionic gonadotropin (hCG) is administered. This helps with the final maturation of the eggs. About 36 hours after the trigger shot, the egg retrieval procedure is performed under sedation. A needle is guided through the vaginal wall to collect the mature eggs from the follicles.

Step 6: Fertilization and Embryo Transfer

The collected eggs are fertilized with sperm in the laboratory. The resulting embryos are monitored for a few days, and the healthiest ones are selected for transfer into the uterus. The embryo transfer is a relatively simple procedure and usually does not require anesthesia.

 

What is the Short IVF protocol success rate in India?

On average, the success rate of the short IVF protocol in India is reported to be around 40% to 50% per treatment cycle. This means that approximately 40% to 50% of couples who undergo the short IVF protocol in India achieve a positive pregnancy outcome resulting in the birth of a healthy baby.

 

What is the Long IVF Protocol?

The long IVF protocol involves an intricate series of steps aimed at optimizing the chances of successful fertilization and implantation. It begins with a preparatory phase where the woman’s natural hormonal cycle is suppressed using gonadotropin-releasing hormone agonists (GnRH agonists). This initial stage, though time-consuming, allows for better control over the ovarian stimulation process.

 

Long IVF Protocol Procedure Step by Step:

 

Step 1: Ovarian Suppression

In the first phase of the long IVF protocol, the patient undergoes daily injections of GnRH agonists. These injections temporarily suppress the body’s natural hormonal cycle, preventing premature ovulation and ensuring that the ovaries remain in a quiescent state.

Step 2: Ovarian Stimulation

Once ovarian suppression is achieved, the next step involves ovarian stimulation. The patient receives injections of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to stimulate the ovaries to produce multiple eggs. Regular monitoring through blood tests and ultrasounds helps fertility specialists track the growth of follicles and adjust the medication dosage accordingly.

Step 3: Triggering Ovulation and Egg Retrieval

When the follicles reach an optimal size, a trigger shot of human chorionic gonadotropin (hCG) is administered to induce the final maturation of the eggs. Approximately 36 hours after the trigger shot, the egg retrieval procedure is performed under sedation. A thin needle is guided through the vaginal wall to retrieve the mature eggs from the follicles.

Step 4: Fertilization and Embryo Transfer

Following egg retrieval, the collected eggs are fertilized with sperm in a laboratory dish. The embryos are then monitored for a few days, during which they undergo cell division. The healthiest and most viable embryos are carefully selected for transfer into the woman’s uterus. This step, known as embryo transfer, is a critical and eagerly anticipated moment for couples, as it brings them one step closer to their dreams of parenthood.

 

Long IVF Protocol Success Rate in India:

On average, the success rate of the long IVF protocol in India ranges from 35% to 45% per treatment cycle. The success rate of the long IVF protocol in India, as in any country, is influenced by various factors. Some of the key determinants include the woman’s age, the cause of infertility, the clinic’s expertise, and the overall health of the couple.

It’s important to note that success rates can vary between different fertility clinics, as well as for individual patients undergoing multiple cycles. Furthermore, advances in medical technology, fertility research, and personalized treatment plans continue to impact success rates positively.

 

Short Vs Long IVF Protocol:

Aspect Short IVF Protocol Long IVF Protocol
Treatment Time Generally shorter treatment duration Involves an extended treatment timeline
Cost in India Maybe comparatively cost-effective This may involve higher treatment costs
Success Rate in India Success rates vary (average 40-50% per cycle) Success rates vary (average 35-45% per cycle)
Best for Poor Egg Quality Can be beneficial for poor egg quality May also be suitable for poor egg quality
Alternative Protocols Several alternative protocols are available Fewer alternative protocols are available
Shortest IVF Cycle Can be completed in a shorter timeframe Generally longer timeframe for completion

 

Best IVF Protocol for Poor Egg Quality:

The Long IVF Protocol, also known as the agonist protocol, is often considered the best option for poor egg quality. This protocol involves an extended ovarian stimulation phase to coax the ovaries into producing more eggs. By providing the ovaries with more time to respond to stimulation, the chances of retrieving a higher number of eggs, including potentially viable ones, increase.

The Optimized Long IVF Protocol tailors the treatment plan to the individual’s specific needs, making adjustments based on various factors, such as age, hormone levels, and response to medication. This personalized approach maximizes the chances of success, especially for women with poor egg quality.

 

Alternative IVF Protocols: Natural Cycle IVF

In cases of severely compromised egg quality, Natural Cycle IVF may be considered. This protocol aims to work with the woman’s natural menstrual cycle, retrieving the one dominant egg that naturally matures each month. While the success rates may be lower compared to conventional IVF, Natural Cycle IVF can be a gentle and minimally invasive option for certain individuals.

 

The Shortest IVF Cycle: Mini-IVF (Minimal Stimulation IVF)

As the name suggests, Mini-IVF, also known as Minimal Stimulation IVF, is designed to be a shorter and less intensive IVF cycle. This protocol involves using a reduced dosage of fertility medications, leading to the production of fewer eggs compared to traditional IVF. While it may not be specifically tailored for poor egg quality, some individuals may find Mini-IVF appealing due to its lower cost and lower risk of ovarian hyperstimulation syndrome (OHSS).

 

Conclusion

In the quest for parenthood, choosing between the Short and Long IVF Protocols can be a significant decision. While the Short IVF Protocol offers a streamlined approach with faster treatment times, the Long IVF Protocol allows for better control and personalization. Embracing hope, couples can find solace in the advancements of reproductive medicine and the unwavering support of compassionate fertility specialists. Whether it’s addressing poor egg quality or exploring alternative options, each step taken is a step closer to the cherished dream of building a family and fostering a future of boundless possibilities.

Read To Know: IVF Success Rates by Age & Number of Embryos

 

F.A.Q

Q: Is a long IVF protocol better?

A: The effectiveness of the long IVF protocol varies among individuals and may be more suitable for certain patients.

Q: What is the most effective IVF protocol?

A: The most effective IVF protocol depends on the patient’s specific medical history, age, and fertility issues.

Q: Why am I on the short protocol IVF?

A: Your doctor might have chosen the short protocol IVF based on your medical evaluation, aiming to optimize the treatment for your unique situation.

Q: Can the IVF protocol affect egg quality?

A: Yes, the chosen IVF protocol can influence egg quality, as different protocols impact the hormonal environment during follicle development.

Q: Which is the best embryo transfer method in IVF?

A: The decision on the best embryo transfer method in IVF depends on various factors, including the patient’s condition and the doctor’s expertise.

Q: Which stage of IVF is the most difficult?

A: The difficulty of IVF stages can vary for each patient, but the egg retrieval and embryo transfer stages are often considered more crucial and challenging.

Q: What are aggressive IVF protocols?

A: Aggressive IVF protocols involve using higher doses of medications to stimulate multiple egg production, usually considered in specific cases.

Q: When should I start the short protocol IVF?

A: The timing for starting the short protocol IVF will be determined by your doctor after assessing your menstrual cycle and medical history.

Q: Which IVF protocol is best for low AMH?

A: For patients with low AMH levels, certain IVF protocols like the antagonist protocol might be more suitable, but the final decision depends on individual factors and medical evaluation.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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