What are the IVF protocols? Which program is right for me.

The common protocols include: conventional (including ultra-long/long/short/antagonist protocols, the following conventional protocols are representative of the display description), natural cycle, luteal promotion, micro-promotion (micro-promotion and enhanced version of micro-promotion).

Whichever option:

1, first of all, there must be “food”, which is the first condition.

The “no rice cooker” warns us that without an underlying follicle (AFC), even the best doctor can’t retrieve an egg (note that ovulation disorders such as “anovulation” do not fall into the “no rice” (Note that ovulation disorders such as anovulation do not fall into the “no rice” category).

To undergo IVF, you must first have a certain number of basal follicles AFC and AMH values; AMH is released by the granulosa cells of the early developing egg and has been scientifically proven to help protect and mature the egg. As the number of eggs decreases, the level of AMH gradually decreases; AMH can also predict the response of the ovaries to injections of fertility drugs, helping doctors to formulate the IVF treatment plan; the AMH value, combined with the number of basal follicles detected by ultrasonic testing, can also provide a reasonable prediction of the number of eggs remaining in the ovaries (ovarian reserve).

2, clear whether there are factors affecting the growth of eggs: eggs grow in the ovary, such as the ovary and its environment is not good, will directly affect the quality of eggs.

According to the World Health Organization, infertility factors fall into three categories

1) Internal causes – diseases of reproductive organs: inflammation or lesions of the ovaries and surrounding sex organs (fallopian tubes/uterus/pelvis/vagina, etc.), e.g., chocolate cysts, endometriosis, pelvic inflammatory disease, etc.

2) Endogenous-endocrine: mainly refers to hormonal disorders such as FSH/LH/insulin, which affects egg growth. Manifestations include polycystic ovary syndrome PCOS, decreased ovarian reserve function DOR, functional hypothalamic amenorrhea (FHA) hypothalamic and pituitary gland dysfunction, premature ovarian failure, and menopause.

3) Others: Lifestyle and living environment including sleep/diet/exercise/smoking/stress/emotions. The older the age, the more cases of chromosomal abnormalities (derived from PGT-A test) in embryos.

The goal of IVF ovulation is to achieve the highest number of high-quality eggs in a woman’s ovulation cycle. In order to achieve this goal, different protocols have been developed, and the descriptions of the different protocols vary from country to country and from doctor to doctor (some very little, some very much), so I won’t go into all of them here. In general, the main difference is the type of drug and its effect (please refer to the article published by the National Institutes of Health https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486909/). Looking at the results of different patients, the number of PGT-A blastocysts that pass using the following protocols will be higher at different ages.

1. Conventional program/lutealization: the suitable age span is relatively large, usually from young to 37 years old, the long program or lutealization will get more blastocysts, but the older the age, the smaller the dose of drugs used should be to have a better effect, at the same time, after the age of 35 years old, such as factors affecting the growth of the eggs, the effect will be greatly reduced; in addition, we have also observed that this age group of women, according to the endocrine difference, the In addition, we have also observed that women in this age group, depending on the endocrine differences, the body’s response to different programs is also very different. In conclusion: it is suitable for women of good age and health. As long as you find the right doctor, it is not a problem to have 6 to 14 PGT-A blastocysts in one cycle.

For example, a 27-year-old patient + adequate food + no factors affecting egg growth started with 2 P-overs on the antagonist regimen and later obtained 13 PGT-A blastocysts on the long regimen.

For example, a 36-year-old woman with AFC 6 and AMH 1.12 starts with luteal boost to obtain 1 PGT-A blastocyst, and switches to a growth regimen on cycle 2 to obtain 6 PGT-A blastocysts.

For example, a 37-year-old patient with AFC11 and AMH2 started with a long protocol and 0 blastocysts; later, 6 PGT-A blastocysts were obtained using luteal boost.

2. Micro-promotion and micro-promotion enhancement

When it comes to micropropagation, some people will think that they have a lot of food and there is no need to engage in such a small dose, worry that a cycle down a blastocyst is not, and some people even think that micropropagation is a scam. In fact, not, micro-promotion originated in Japan, for women over 35 years of age, especially with the presence of factors affecting egg growth is very friendly.

For example, a 33-year-old woman with AFC3, AMH 0.3, and micro-promotions obtained 1 blastocyst via PGT-A.

For example, a 40-year-old patient with AFC3, AMH0.3, and FSH12 was assessed by the physician as needing 3 cycles of micropropagation, resulting in 1 blastocyst passing PGT-A in 1 cycle.

For example, 36 year old patient + reduced grain + factors affecting egg growth, 0 P-passing blastocysts using a long protocol of nearly 500 dose/day; 3 P-passing blastocysts were obtained later using a micropropagation booster.

But pay attention, no matter which kind of ovulation program, we have to find the right doctor, even in the same clinic, the ovulation techniques of different doctors are very different, choosing the right doctor can help us take a lot less detours.