Learn what IVF protocols are and how they work

IVF is not an easy or simple task.

Science helps with more and more means, women who, despite the problems they face, want to become mothers.

In vitro fertilization has rules, principles and procedures. These protocols are divided into large or small.

That is, if the doctor who monitors the woman’s condition, decides that she should take a large medication or a small, but always with the same goal, to achieve pregnancy.

It is known that IVF protocols involve the stimulation of the ovaries to produce many healthy eggs, so that they can be fertilized with the appropriate sperm in the laboratory by specialist embryologists and then the embryo can be transferred.

The difference between the two protocols lies in the administration of a GnRH analog. The medication remains the same.

However, the method and dosage of administration change. It depends on the woman’s age, but also how her body reacts to ovarian stimulation, based on experience from previous IVF efforts.

The big protocol concerns the suppression, ie the administration of bucerelin, leuprolide, triptorelin, setrolix and ganirelix.

The whole procedure begins with the cooperation of the doctor and the woman on the 21st day of the cycle, or the second day after the start of the period of a normal cycle of 28 days.

The administration of the medication lasts 10 to 15 days, after the end of this period an examination of the uterus is done with an ultrasound in the doctor’s office.

The level of estradiol in the blood is then measured by a blood test.

With the data of the ultrasound and the results of the blood test, the doctor has a complete picture of the progress of the condition.

There are times when the maturation of the follicles is not appropriate and that is why the treatment is continued for another week. At the end of this period, the examination is repeated.

If again the sedation is not what the doctor wants in order to proceed with the taking of the follicles, then synthetic follicle-stimulating hormone is provided for 4 to 6 days.

Immediately after this period, the test is repeated, both the ovarian and uterine ultrasound and the hematological test for estradiol levels.

The test is repeated with mathematical precision every two to three days and the situation is re-evaluated.

The goal is to fully monitor and create a meaningful picture around hormone levels, to achieve the coveted ovarian stimulation.

Medication is also given at the same time.

On the other hand, the follicles grow normally and steadily, in the environment that helps them to mature. Their diameter increases like estradiol.

In the final stage, follicle-stimulating hormone is given for the final maturation.

It is given as an injection late at night and about 36 hours before the final follicles are taken.

It is the so-called process of egg retrieval.

With a fine needle the doctor enters the body of the ovary and absorbs whatever of the follicles is mature. In high ovarian stimulation, a woman can produce as many as 25 follicles.

The point, however, is to be good at fertilizing. The operation is done with light intoxication and does not last more than 15 ‘.

The woman, especially if she has a lot of eggs, may feel a little pain, which passes after a while and in the last cases, with the administration of simple painkillers.

He may also see some blood, which is normal. All medicines are cut at the same time.

Their mission is complete. The woman can return to her work and her daily life with one day off, that is, of egg collection.

If there are many eggs, they are led to cryopreservation. However, some are selected for immediate embryo transfer after two to three days and after they have been fertilized in the laboratory.

The small IVF protocol is easier, has fewer drugs, is less expensive in terms of medication, and is for older women whose ovaries do not respond as effectively to stimulation.

However, even in this case, the sedative drug is administered within the second day of the normal cycle and the stimulant drug the next day.

The ultrasound and the measurement of estradiol are done at the beginning and on the 6th day of the injections. Otherwise the same procedure is followed as in the large protocol.

The method is mainly followed by women who do not want to take a lot of drugs and go to IVF in the most natural cycle possible.

Although not many drugs are taken or many eggs are produced, the success rates are very high.

Depending on the hormone levels, complementary medicines may be given for 12 to 15 days, as in conventional IVF.

Ultrasound and blood tests will determine the doctor’s tactics for the desired result.

That is why the follicles should be from 16 to 18mm in size and the value of estradiol ideal together with the thickness of the endometrium.

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