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short vs long IVF protocol

Tue Aug 16, 2016 5:25 pm

Can anyone tell me their experiences with short or long IVF protocols, ideally if you've had both, why and what ended up working for you?

I'm about to start my IVF journey after 5 failed IUIs and I've consulted with two RE's at two different clinics. One wants to put me on a long protocol using estrace for the first two weeks. The other doctor wants to use a short flare protocol. I'm 40 with a very high ovarian reserve (but probably not so many high quality eggs), I'm borderline PCOS and respond very well to injectables.

Any advice or experience to share would be much appreciated! :)

Re: short vs long IVF protocol

Wed Aug 17, 2016 8:43 pm

Hey Pandagrl
I have not completed my FET cycle yet, as I am going through it now. However, my protocol for IVF was BCPs for 4 weeks (skipping a week in between 2 week intervals); then started 150 iu menopur and 150 iu of follistim. I used to Cetrotide to prevent ovulation and had a retrieval after 11 days of stims. That resulted in 16 retrieved,12 fertilized and 10 frozen embies. 3 of those 10 were tested for chromosome issues. 2 came back looking great!!! (Note: I am also borderline PCOS and I am currently on Metformin and Levothyroxine for slight hypothyroidism)
My FET protocol so far consists of more BCPs for one week. Overlap with Lupron and have a baseline appt 8/29 morning!!! :mrgreen: Estrace and progesterone will follow!
I'm not sure which protocol is better. I've been on the long protocol and I don't think my egg quality is where it could have been. This protocol (short) seems like everything else went so smooth and my embies seem healthier! Just my experience.

Re: short vs long IVF protocol

Thu Aug 18, 2016 5:43 am

Thanks Johnnyswifey. So your IVF cycle was the long protocol and the FET is short? Is that what you're saying?

I am finding this overwhelming. I know theres a bit of trial and error involved but it's hard to think about having to do more than one ivf though I realize that's probably the norm... :(

Re: short vs long IVF protocol

Thu Aug 18, 2016 6:05 am

Hello,i don't have any experience with long protocols so I can't say what would be best.
I had a short protocol including Bemfola(GonalF) and Cetrotide and a Decapetyl shot to trigger Bcs of the risk of OHSS,i had 22eggs,19matures and I have 9 blastocyst day5,ofc the doctor took into consideration my age and my AMH bcs that is very important during this process,pls don't think im trying to say ur old or anything I'm simply trying to say that age is a factor during this process and doctors choose protocols based on that and the AMH.If you do respond well to the injectables I believe a short protocol would be easier but I can't say if it would be better.good luck.

Re: short vs long IVF protocol

Thu Aug 18, 2016 11:29 am

Hi Danaa, thanks for sharing your experience. My AMH is really high and I'm a high responder so the expectation is that I would have a lot of eggs but not many good ones (cuz of age). My understanding is that one of the down sides of a long protocol is that it can suppress your ovaries too much and make the response too low/slow, so you yield fewer eggs. However, the idea is to make sure that all of the follies and eggs that do develop mature which increases your chance of having good quality eggs. The short protocols are apparently great for women who are low responders or have low ovarian reserve. They are more aggressive protocols that aim to yield more eggs. However the danger is that with fast and aggressive stimming you'll produce a lot of immature eggs that can't be fertilized. With the longer protocols they try to control how quickly your follies are growing with the aim to make them all more or less the same size. They don't have as much control over a short protocol and apparently the size of follies therefore varies greatly. This is the information I have been able to find online and I was hoping to corroborate it by hearing about people's actual experiences.

I guess what's confusing to me is why they would put women with high ovarian reserve who are high responders on a short protocol? But perhaps I have misunderstood the information. Also, since i am older, even though I have a lot of eggs, most of them are probably not good so maybe the short protocol would give me more of a chance of producing more good eggs? Not sure if that makes sense though... I think I feel a bit more comfortable with the longer protocol but wow am I scared to be wrong!!!! And I can'tknow until I try :(

Re: short vs long IVF protocol

Thu Aug 18, 2016 1:02 pm

Hmmm and i thought they put women that are poor responders on a long protocol.
A short protocol doesn't mean an aggressive protocol,is all about the dosage,a good doc will always have control over everything.
I don't see why someone who responds pretty good to the drugs shouldn't be on a short protocol,I mean if you can have a good response by stiming the woman only for 10-14days why not do it?!
Sure there might be a few eggs that are empty but that is where age has a huge role.
I think finding a good doctor is the key in this process.If you trust him you trust his decisions

Re: short vs long IVF protocol

Fri Aug 19, 2016 7:51 am

It's so confusing! Everyone seems to have a different understanding. I definitely don't trust the doctor that wants to put me on the short protocol but that is because of other weird things he said. The doctor that wants to put me on the longer protocol seeems to be better, I like her much better. So I will go with her. These doctors are at two different clinics. I should mention that it isn't a super long protocol like when they give women birth control pills for 2 or more months before they start stims. I will be on the e-priming protocol so I have to start estrace on day 20 of my current cycle, and then we start stims on day 3 after af comes. So I will be on estrace for about a week before I start stimming. From what I have read about this protocol I think it will be good for me.

Re: short vs long IVF protocol

Fri Aug 19, 2016 10:06 am

Im a firm believer in going with your gut.Do as you feel.

Re: short vs long IVF protocol

Fri Aug 19, 2016 8:30 pm

Hey Pandagrl. Previous cycles were long protocols, but I changed clinics and went to have a short protocol; which was this past cycle. My FET is another protocol specific to freezing and thawing my 5 day embies!!

Re: short vs long IVF protocol

Mon Aug 22, 2016 5:51 am

Thanks for clarifying, and good luck to you! fingers crossed for a BFP soon!

Re: short vs long IVF protocol

Tue Aug 23, 2016 5:51 pm

Thanks so much! :kisses:
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