Even for seasoned fertility patients, the world of IVF can be an overwhelming place. When I first started fertility treatments I – very naively – thought it wouldn’t get as far as needing to have IVF. I was convinced that a couple of rounds of ovulation induction would be all that I needed. After all, my only problem was ovulating, right!? So when my consultant advised me that the next step would be short protocol IVF, I wasn’t really sure what that would entail. Naturally, Google became my friend and I was met with a minefield of different terminology, protocols and medication names.
Short vs Long Protocol IVF
Thankfully I was able to narrow my searches down somewhat. I’d been told that I would be doing short protocol IVF. And yet when I walked into my first appointment, I felt none the wiser. I didn’t really know what was to come next.
Now that I’m no longer an IVF newbie, I feel obliged to share my experiences of short protocol IVF in the hopes that it’ll help someone else who is currently feeling like I did.
So, let’s get into the nitty gritty of things. When you’re told you’ll be doing IVF, your consultant will tell you whether you’ll be following a long or short protocol. Essentially, this is exactly what it says on the tin: the long protocol is…longer!
If you’re following a long protocol, you’ll start treatment on day 21 of a menstrual cycle and it’ll continue for around four to six weeks. However on short protocol, your treatment starts at the beginning of a cycle – typically either day 2 or 3 – and will only last for a couple of weeks.
Who is it for?
Long protocol is the more traditional style of IVF. Though short protocol IVF is used as an alternative by many clinics depending on the reason for IVF.
Back in February when I was added to the IVF waiting list, my consultant told me that I’d be doing short protocol IVF because I have PCOS. I didn’t question why this was the case but since doing my own research, I’ve found out that this protocol is preferred to avoid the risk of over stimulating the ovaries and developing OHSS.
Because I don’t ovulate regularly, I have a high ovarian reserve. In IVF, the aim of the medication is to stimulate the ovaries into producing more mature eggs than normal. My body’s been hanging onto my eggs so there’s a chance that the medication – even in low doses – would send me into overdrive.
But like most things in life, we’re aiming for quality, not quantity. So a less prolonged period of stimulation is what was needed in my case.
It’s not just PCOS warriors who may be better suited to a short protocol IVF, though. It’s also recommended for women who have previously not responded well to a long protocol cycle, those who are striving for a better egg quality and also older women.
Other Benefits of Short Protocol IVF
Of course, the decision isn’t always just down to clinical presentations. Whilst I happily went with the flow on my first IVF cycle, I fully intend to discuss any changes to my IVF protocols going forward.
It’s important to self-advocate on this journey to parenthood and there are many other reasons that you might prefer to complete a cycle following short protocol. Firstly, taking less medication over a shorter period of time reduces the costs of IVF. This is a particularly important factor for those who are having to self-fund treatment.
Not to mention that less medication will, most likely, result in fewer side effects. The shorter time frame will undoubtedly be much easier to plan for and arrange around other life commitments. With frequent monitoring appointments throughout the cycle as well as the egg collection and subsequent transfer, it goes without saying that a shorter protocol would make it easier to fit in around work and other responsibilities.
An Example of Short Protocol IVF
As you now know, the short protocol IVF cycle is relatively short. At the start of your menstrual cycle, you’ll be asked to ring your clinic to get an appointment. This is for a baseline scan and to do an injection teach. For me, the appointment was scheduled for first thing on cycle day 3.
The baseline scan is to check what’s going on in your ovaries and to measure the thickness of your womb lining. If everything looks OK, you’ll be able to pick up your medication and a fertility nurse will show you how to self administer. I did my first injection with the nurse before going home.
For the first few days, you’ll inject medication to stimulate egg production in your ovaries. In my case, this lasted for 5 days and I was injecting with menopur. After the five days I was back to the clinic for a scan to see how I was responding. At this stage, everything was going great. I was told to keep taking the menopur at the same dosage for another five days as well as starting a second injection. The job of this second medication – ganirelix – was to prevent ovulation.
After 10 days of stimulation, the scan showed that I was ready to trigger. Originally, the plan was to trigger with ovitrelle. However, because I had a lot of follicles showing on the scan, this was changed to buserelin. Buserelin is used as a trigger to try and prevent OHSS. I took my trigger injection that evening and 36 hours later, I went in for my egg collection.
In my experience, the whole process went pretty quickly! From baseline scan to egg collection took just 12 days. This could be a little longer if your ovaries aren’t as quick to respond to the stimulation drugs. Following the egg collection, I had another 5 day wait to get to transfer day. In the run up to this, I was taking estradiol and progesterone to support the embryo once it had been transferred.
If you’ve not already read how my short protocol IVF cycle panned out, check it out here.