Sample IVF Protocol/Cycle
The Pretreatment Cycle
The main goal of the pretreatment cycle is to suppress the pituitary to prevent premature ovulation during future ovarian stimulation.
Birth control pill is used to prevent the pituitary from releasing hormones that normally act on the ovaries, thus allowing the ovaries to rest and minimizing formation of ovarian cyst.
Lupron is an injectable medication that prevents the pituitary from selecting a single egg and cause premature ovulation. There is a week overlap in which birth control pill and Lupron are taken together to cause complete suppression of the pituitary. Lupron is continued throughout the stimulation of the ovaries.
The Stimulation Cycle
Ovarian Stimulation – While the pituitary is under Lupron suppression, the ovaries are stimulated by injectable medications that contain FSH and LH. The response of the ovaries are closely monitored by frequent sonograms and blood test.
HCG injection – HCG (Human Chorionic Gonadotropin) is a hormone that acts similarly to LH to cause final maturation of the eggs. HCG is given once several leading follicles reach mature size.
Egg Retrieval – Is performed about 36 hours after the HCG injection, the procedure takes 20 minutes and is conducted under IV sedation. Under ultrasound guidance, a thin needle is introduced into the pelvic space through the vagina and is used to aspirate eggs from the follicles within the ovaries.
Fertilization and Culture – After their aspiration, the eggs are isolated under the microscope and are fertilized with the sperm the same day. Fertilized eggs are cultured for three to five days.
Embryo Transfer – On the third or fifth day of culture, one or two embryos are transferred into the uterus using a soft catheter. The procedure is similar to an IUI, does not hurt and does not require sedation. Any remaining embryos can be frozen for future use if it meets criteria.
Endometrial Support – Progesterone is important for the maturation of the endometrium and maintenance of pregnancy.