What reasons have you been given for ... - Fertility Network UK

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What reasons have you been given for undertaking long or short IVF protocols? Help! I’m baffled...

19 Replies

So...my consultant has recommended a long protocol for my next cycle. To date I’ve had 1 long followed by 2 short (almost 2 years later).

The long protocol (age 39) yielded 7 day 5/6 blasts and the short one (the better of the two at age 40) yielded 4 day 5/6 blasts and 2 day 7 blasts.

He’s not given me any clear reason for this selection. I am conscious that age is likely to be playing a factor.

Before I commit to a long protocol with more drugs at higher doses, I’d welcome feedback from others as to the reasons you were advised to do short over long protocol or vice verse?

It’s a minefield!

Thank you!

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19 Replies
Sayusayme profile image
Sayusayme

Hey dear I have been into both short and long protocol three years back but my embryo were of bad quality so now I have used donor egg

in short I am gonna be surrogate to my husband's sperm and donor egg😁😁😁😁😁😁.

It's funny how life has taken wrong/right turn which I don't know , uncertain about future ,am just moving on like a water ....

Beginning in my ivf I use to cry cry cry but now I have no tears left,have become numb and surrendered myself to universe because this process of not under my control......

So dear whatever you can you do trust your clinic ,follow all instructions ,do your best and leave the rest to universe.

And I wish you all the happiness and love and things go in your favor.

I will pray to universe to make this ivf a successful one because I don't want anyone to go through what I have gone...

Wish you alllll best and may God bless you this time with miracle💕💕💕💕💕💕💕💕 but make sure your Doctor and you have clear conservation before dumping in all the drugs in your body...take care and let me know

Mary80 profile image
Mary80 in reply toSayusayme

"in short I am gonna be surrogate to my husband's sperm and donor egg"

That is my next plan. I can't come and develop depression and madness all in the name of being childless, 2 failed ivf, one miscarriage and friends getting pregnant. Life is sometimes so unfair, just can't deal. Good luck

Sayusayme profile image
Sayusayme in reply toMary80

Hey dear

Its difficult but we have to keep moving on ....

I wish u all the best too

Hi,

I only have experience with a long protocol. I did it last year when I was 34 years old after 2 ectopic pregancies (natural conception). In my case, the problem were my fallopian tubes. My ovarian reserve (AMH and all other hormones) was OK.

Doc said that he wanted good quality embryos over quantity and that's why I was going to do a long protocol. He said that with good blastocysts the risk of another ectopic was reduced. I got 5 embryos (good grade 5 days blasts). But even with one good quality embryo, my fresh transfer ended up being my 3rd ectopic pregnancy.

I had 4 frosties and now I'm 22 weeks pregnant after FET#2.

Good luck! ;)

in reply to

Congrats

Mary80 profile image
Mary80 in reply to

congratssssss and all the best

KayCan profile image
KayCan

Hi, at my initial consultation I was told I would do the long protocol but after doing all the diagnostics, I was told I would be doing the short. This was due to my low ovarian reserve (I'm 39) and was advised that this would be best as the long protocol involved down reg and they said it might be hard work to fire it back up again. The short is obviously less stress on the body but I would have gone with the advice of the clinic either way.

I got 7 eggs, 4 of which made blastocyst, 3 on ice and 1 in my tummy 🥰

in reply toKayCan

Congrats!

Mary80 profile image
Mary80 in reply to

congrats and good luck.

EmGLA profile image
EmGLA

Hello

I have PCOS and therefore have relatively high AMH and lots of follicles (they just won’t grow in my case). I am on short protocol as I’m at risk for over stimulating. From the research I’ve done ladies with low AMH and those with PCOS tend to be on short protocol.

Good luck!!

Xxx

Lowamh profile image
Lowamh

I have low AMH and we switched from short to long protocol and had far better results. With low AMH they would normally recommend short protocol. It’s all hit and miss and depends on the individual so I’d go with the consultant’s advice. Unless you don’t feel like the advice is right, in which case you could get a second opinion x

Bluetop1981 profile image
Bluetop1981

Hi,

I did the long protocol last year as I have endometriosis and they wanted me to down regulate for about 4 weeks first. I ended up with OHSS so have just had two short cycles to embryo batch. The long protocol gave me 9 eggs and zero made it to blast. In the 2 short protocols 19+16 were collected. Still to be thawed and taken to blast stage so I can’t comment on the change in quality but so far I have 12 day 3 embryos in storage 🤞🏼.

Push the doctor to explain his reason - you can’t have the confidence to follow through with his decision if you don’t understand the thinking behind it. Good luck!

in reply toBluetop1981

Thank you.

I think I do need a justification.

It’s more time, drugs and money to do the long protocol. I got OHSS on long following a twin pregnancy from transfer (later miscarried). I have high (for my age) AMH and PCOs.

I was threatened OHSS with my first short protocol, but with a freeze all blast cycle it didn’t materialise.

It seems everyone is given different reasons which makes me think it’s a bit of a lottery what will work / won’t.

purplerain2000 profile image
purplerain2000

Hi so short protocol is normally recommended for the more mature lady with low egg reserve and long protocol is advised so your body goes into down regulation and the clinic almost shuts off your system them restarts with the intention of a high follicle count? I has 2 x short and 2 x long and the best results I had were with short. It is quite conflicting as the last clinic I went to recommended long protocol and yet a top clinic in London said it was a complete waste of time to do a long protocol based on my age and low egg reserve. It is always good to try new protocols however I would get as much information as possible from you clinic and speak with them in more detail about why they recommend this protocol for you. Good luck and hope this helps. x

in reply topurplerain2000

Thank you.

I have contacted the clinic for rationale but will likely proceed with the long protocol in anycase.

I am an oddity insofar as I am old (41) but have high AMH and AFC for my age due to PCO (not syndrome).

In terms of egg numbers, the short protocol was best (got 20 from one cycle) but in terms of quality, the long protocol gave us the most blasts (of 14 embryos that fertilised from 16 collected we got 7 blasts and our son). I was 39 then, so recognise long or short procotol I need to manage my expectations of numbers and quality.

Seems that we all get differing rationales for why one over the other that makes me think it’s really just down to testing what may work better for different women.

I had the long protocol for my first round, with private infertility. I felt it was a bit aggressive on my body, making my periods a week late, increase muscle ache and tiredness and more sensitive to ovulation pain. Thankfully the symptoms have calmed. Due to getting 15 eggs we ended up with 5 embryos which fragmented and no transfer. We changed to the nhs consultant as private because we wanted a different approach. The nhs consultant was also going to use the long protocol. I said we had that experience and asked for other options so he offered the short protocol and said we might have less eggs than 15 we were OK with this. We are waiting to start treatment hopefully b4 Xmas.

in reply to

Good luck to you. I agree short is much easier on the body having done both.

Down reg drugs give me horrendous headaches. I remember the last time my colleagues assumed I’d been out on the piss. My head hurt so much I threw up. So in fact, very much like a hangover!

MontsJ profile image
MontsJ

Generally a short protocol is used for women with PCOS who are at high risk of OHSS in order to try and avoid OHSS, and those with low AMH and a low AFC who are expected to get low numbers of eggs to avoid oversuppression of their ovaries. Your first cycle is a bit of an experiment, I suspect given you don’t have PCOS or DOR they thought a long protocol would work best. But as you developed OHSS they are trying to avoid that by using a short protocol in your next protocols. Well that would be my best guess! I do think clinics don’t do enough to explain their decision making to women and some of us like to understand. Good luck you you x

Hi all,

I thought I’d follow up with the response from my doctor, more for completeness / incase of interest to others.

Basically in my case he said that I stimulate well under both protocols and that while the short protocol is often used for the more mature lady due to AMH and AFC being lower that doesn’t apply to me.

My IVF history suggests that while I create lots of eggs under both protocols, with the greater control of the long protocol, we seem to yield more quality embryos (ie those that reach day 5/6).

Therefore while there are no guarantees, he thinks this is the best way of trying to yield as many blasts as possible in the hope we have 1-2 that are normal. At 41, we need a lot of luck or a large number of blasts (and still some luck) to get a normal one.

Clearly everyone is different, but I feel more comfortable knowing the rationale.

Also, as I have miscarried several times with FETs, we’re proposing genetic testing of the blasts we do get. This is simply to attempt to avoid further miscarriage and the time it takes to recover and move on (time at 41 I don’t feel I have).

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