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What is the difference between short and long protocol?

2 fertility expert(s) answered this question

Answer from: Ahmed Elgheriany, MRCOG, MD, MSc

Gynaecologist, Fertility Specialist
GENNET City Fertility

In artificial or reproductive treatment, I mean IVF, we are using two kinds of protocols commonly. Long protocol – we’re starting from the mid cycle until the period, until the start of the period and then we carry on this protocol until the time of triggering the ovulation. This stimulation is called a long protocol. The other protocol called antagonist protocol – we’re just starting from your second day of the cycle by giving stimulation medication and then triggering – give some hormone to suppress the ovulation and then stimulate the ovary. Commonly, nowadays, we only use antagonistic protocol which is the second protocol for most of our cases as it’s the same response like long agonist protocol.

Answer from: Scott Nelson, Professor

Gynaecologist, Muirhead Professor of Obstetrics and Gynaecology at Glasgow Royal Fertility Clinic and Medical Director at Access Fertility

A short protocol is just a GnRH antagonist based strategy which essentially you have a period and then you start injections the next day or the day after day three of your cycle. Then you’ll add in that GnRH antagonist and you’ll kind of a few days later and people can do that on a fixed basis where it’s always the same day the cycle or if it’s doing what dynamic monitoring, then doing when the follicle gets to a specific size. That’s a short base because it can all be done within you know two weeks you start your period and you start stimulation. A long strategy is whereby you use GnRH agonist to facilitate disruption of your pituitary gland with your ovaries so that we can control that cycle. That happens in the preceding month so around about day 21 – you start that GnRH agonist. Then have your period and then start stimulation. Because of that kind of extra week in advance and therefore overall it’s taking two months to do the IVF cycle, that’s what it means by a long protocol. The stimulation drugs though are the exact same for these two strategies and how you take them on a daily basis is the exact same and the egg retrieval will be the same as well.

About this question:

What's the difference between long and short protocol?

Most common protocols used in IVF are the long and short ones. How are the protocols chosen and why? Who are the patients that can benefit from different stimulation protocols?

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