Anyone about to start Buserelin injections on long protocol IVF? (Importance to start during mid-luteal phase??)

[jenjen40]

Excited and anxious!! We're about to start our looooong awaited IVF... Been reading/studying an awful lot, and found this article which summarised my main concern about the timing to start down-reg (Buserelin):

ivf-worldwide.com/education...

It says, "In order to decrease the frequency of this "functional cyst" formation, it is recommended that GnRH-a be administered when the pituitary is less sensitive to gonadotropins. This can occur in the presence of progesterone in the serum of patients, and therefore it is suggested that GnRH-a be given during the mid-luteal phase..."

I think they're trying to say it's 'best' to start down-reg at mid-luteal phase, which is roughly 7 days after ovulation (if one's luteal phase is about 14 days).

As I'm due to start my Buserelin injection on the 2nd of August, which is my CD21, but I'm aware that my ovulation is already late this cycle, looks like it will probably be about 5 to 6 days late according to the 2 OPKs that I use and trust, as well as charting my BBT & cervical fluids. But every nurse I spoke to in my clinic seems to be unconcerned and too chilled about this, and just instructed me to start on CD21 regardless...

I'm not very convinced cos if I start on CD21, it'll be just 1 or 2 days post ovulation, which is ''early luteal'', not ''mid luteal'' when the progesterone level is higher...

Should I take a chill pill or should I try to express my concern and try to negotiate and convince them to let me start a few days later?? *_*

Thanks for reading and I would appreciate hearing your thoughts.

[DianeArnold Partner Nurse Fertility Network UK]

Hi jenjen40. You're best to go with what your clinic recommends. I was always taught start day should be either Day 1 or Day 21. By starting on Day 21 it is hoped that you avoid any ovarian cysts forming, but this can't be guaranteed. You will be monitored in any case. Good luck with it all. Diane