Long & Short Protocols...HOW long & HOW short?!

Hello - we have our first appointment with the consultant & nurse at the beginning of July and I just wanted to see if anyone can shed a bit of light on the difference between long & short protocols , how long they both are and what day of your cycle are they likely to start?

Basically how many days does the treatment go on for with both protocols, and do they both start with your period? What determines what protocol you go on? It's all very confusing & I can't find any real helpful info on this particular question on line. I would like to get a bit of a grasp on both protocols so I know what to expect :) Cheers! x

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  • Hi! This confused me too as it wasn't terminology my hospital used when discussing it with me but I'm on the long protocol. I started buserelin nasal spray to down reg on day 21 of my May cycle (which actually meant I started on 9 June). I have my baseline scan on 26 June. I should hopefully start injections after that for 10-12 days (I think). All going well that's followed by egg collection, transfer, the 2ww and a BFP (lol!). Good luck! x

  • Hi! God so that's quite long isn't it, all in all pretty much well over a month of drugs before BFP (fingers crossed!) then. Did your clinic talk through the different protocols at all? I keep reading constantly about them but when I asked a friend who'd had 2 cycles of IVF recently she just looked at me blankly, she'd never heard of either?! I'm really anxious because we've got a bloody holiday booked for the beginning of September (it's been booked for a year, family wedding, I'm a bridesmaid, can't get out of it arghhh) and I'm so scared it's going to clash with it all. Good luck to you too, how are you feeling with it all? x

  • Its been ok so far. I've been a bit weepy but that's all. The nasal spray is fine and to be honest I am quite enjoying the break from ttc ourselves! I think it will get harder once the injections start and I know the 2ww won't be fun at all! Once you see the clinic you will have a better idea of timescales and the holiday! We went away for a week before we started and it was good. I think it would be ok to go away whilst taking your nasal spray as long as your back for the scan. Let us know how you get on at your appointment x

  • Yes maybe you're right and it will be better if it works out with the holiday being before the treatment, got to be positive about it all! Glad it's all going well so far for you, being weepy is to be expected I guess, I mean when I'm hormonal anyway I'll get teary at an advert or something so God knows what it's like when you're on the treatment! Good luck and keep us posted, I'll let you know how the appointment goes in a couple of weeks...! x

  • I think there isn't that much longer on the long protocol in actual fact. Another thread I saw recently had more details on them both. I think (could be wrong) that the type of meds you get for each stage differs but the process isn't very different. Both start with an injection or nasal spray then a short wait before starting self injections. Try searching on here under short protocol and see what comes up.

    xx

  • From Diane Arnold, on recent thread on long&short protocol:

    Hi Babylonia. There are a few ways of performing an IVF cycle. The most popular one is the “long protocol”. This is usually started on day 1 or day 21 of your cycle, when you start taking the down regulation drug. Blood hormones are usually checked 10-14 days after the start of treatment to see whether you are ready for the stimulating drugs.

    The second way is through a “short protocol”. There is no down regulation and starts at the beginning of your period on day 1. The FSH, LH, oestradiol and prolactin levels are checked at the beginning, to see if OK to start the stimulating drugs. A careful eye is kept on you that you don’t produce too many follicles, and a low dose of a down regulating drug may be introduced if necessary. Obviously, if the FSH was raised, then you are less likely to stimulate well and the cycle most probably would be abandoned that time round.

    The “microdose” flare approach involves using lower doses of the GnRH-agonist Lupron or similar, beginning at the start of the treatment cycle rather than a more standard dose started two weeks before IVF treatment. The microdose flare is usually chosen when other stimulation protocols have lead to poor results.

    You will need to discuss all options further with your clinic/consultant to see which method will suit you, with your best interests at heart. Hope this helps.

    Diane

  • Ah wow, thanks smallcat - this is really helpful! x

  • I'm starting short protocol soon - I start stimming on day one and then take the drug that stops me releasing the eggs from day 5. Scan day 8 and likely egg collection any time from day 11-16 depending on how I respond. Then transfer 3 or 5 days after, and pregnancy test 16 days after transfer. So they try and mimics a normal cycle with egg collection around ovulation time and transfer when it would normally implant. Then period or bfp when you would usually get it if that makes sense? The long protocol they basically induce menopause and switch everything off and then kick start everything again with a similar protocol to the short I think, so the long is much longer

  • Hi newmrsb,

    Thanks for this, it's really helpful. The short protocol sounds much more preferable but I guess it's up to the clinic which one you go on! Do you know why they choose one over the other at all?

    Good luck with it all & hope you're not feeling too rough! Keep us posted, have everything crossed for you :) x

  • Hi penny, I said I would prefer the short one and he agreed that it was the easiest in terms of impact on your body. Plus as I have gotten pregnant naturally before I think they think I just need a little push in the right direction rather than completely stopping everything then starting it back up again - the amount of drugs they prescribe are based on your individual results from your Antral follicle count and baseline scan. the choice of drugs is down to the consultant - they believe that merional is better so that's why they use that instead of gonal F etc

  • That's interesting to hear, I've never been preggers before but the problem is with my husband's sperm not with me, everything looks fine at my end so I wonder which one we'll end up going with. It does seem odd to completely shut you down and start you up again if everything is OK. Like every other stage - it's a waiting game I guess! x

  • I've just started the short protocol on fairly low doses of menopur, similar to what the ladies above have described. I have a fairly high AMH apparently so they didn't want to risk over stimulation but they have to check with scans if anything is happening or if not, I'll start a higher dose. Should be going for egg collection after about 12 days. I havent found the injections painful as yet, which had worried me a bit. It's nice to be doing something constructive too rather than just waiting month after month. Fingers crossed for everyone xx

  • Hi Bunty83, the short protocol sounds so much better, I really hope I'm put on that! What are your reasons for needing treatment if you don't mind me asking? I know what you mean, it must feel great to finally be actively doing something now after waiting so long. I've been in between jobs for a while & it's been a bit of a nightmare not knowing when anything is going to start - seemed pointless starting a new job at the moment (luckily I've got a very supportive husband) arghh life is complicated! Good luck with your treatment, glad to hear you're not feeling too rotten with it (yet..!) x

  • Hi Penny, we have unexplained infertility as all the tests came back normal but we've been ttc for 2 years and nothing's happened. It's tough because I feel like there must be something wrong and without a diagnosis, how can you fix it? I think the main reason we are on the short protocol is my high AMH which means I have a high egg reserve so am at a higher risk of over responding and ending up with OHSS. I don't understand why some people need to down regulate, maybe someone else will know more. You sound like you're a bit in limbo too. If anything I've realised you may as well carry on as normal with your life or you could spend a lot of time waiting around and letting it take over your life. Hope things become clearer soon for you xx

  • Hi Bunty83, that must be so frustrating to not know what the problem is, I have to say I was strangely relieved when we had my husband's sperm results back (which were dodgy) because I was just like 'right ok we know what the problem is and we can do something to sort it'. On the other hand it means for you that you're both perfectly healthy, which is always good to know.

    What were your AMH results? Mine were '10' which the consultant said was fine as the minimum they want is 5, but these numbers meant nothing to me and I struggled to find any info really about them except it's about average for my age (33 - just!) x

  • Hi ladies just to get in touch with discussion where I am also in similar situation. From above I gather that I am on long protocol, starting nasal spray on 7 July and scan on 21st July. Hope things go very well for all of us. Keep updating, so it will be helpful for many like me, coming behind all those who started medicine already. In my case everything OK with me and it's shown issue with ICSI and am on second FEToday's temperature was 12 with 1.5 mph wind, allowing me to move about easily. Yesterday's in Inverness was 7 with wind 22mph.T. Fear and hope is kiling me as of yet....

  • Omg please ignore weather forecast discussion in above message.

  • Hahaa hopeforICSI thanks for the weather update! LOL! Good luck with your treatment, as soon as I have more info about what my treatment will be and which protocol I'm on I will update you all and find out how you're all doing. Thanks all so much for your replies, it's really wonderful having this little anonymous community of women all sharing their stories with each other, I'm finding it really helpful and informative! x

  • I think I was on the short... I took the concept ive pill for 21 days had a week off for my period then had 2 injections for a week and a half to 2 weeks roughly. Was scanned during the injection stage then straight into collection. I was allergic to buselin injections so this is why they decided on this method x

  • Thanks for your reply Penny. It is frustrating. It all looks good on paper and then zip every month. I would love some sort of diagnosis but it seems like we're just not that fertile and have been unlucky. Our consultant said after 2 years, our chance each month is 5%

    My AMH is 38 I think, I'm 32, so above average for my age. I think the worst thing is the uncertainty, it's not like a normal medical thing where you get a certain % risk or improvement, this is either yes it worked or no that's it. That's a lot of pressure.

  • Just to let you all know (if you're still interested!) that we decided that it would be best to start treatment after we return from holiday mid September, and I go for my baseline scan 3 days after we get back! I was worried it would be October by the time we kicked off but luckily it's going to be earlier. I start the contraceptive pill this week with my period & take continously until 10th Sep, then with that period the treatment all starts. It all works out well because I was due on while I was on holiday, but I will now be on the pill so hopefully no period to ruin the holiday! Bonus! My clinic only do the short protocol so that's what I'll be on. Feeling pretty excited now, just starting the pill this week even feels like the beginning of it all! Thanks for all your comments & advice, this site is brilliant x

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