Short vs long protocol

[ccsea]

Hi guys, I’ve got another conundrum 😖

I’ve had two failed rounds of IVF on the short protocol. Both cycles resulted in far fewer than expected eggs collected and only ever one low quality embryo transferred each time. Only difference between the two cycles was my gonal f dose was doubled for the second round. But this didn’t seem to make much. difference. I have an AMH of 13.5 and an antral follicle count of 15. I had 5 eggs collected on the first and then 6 eggs collected in the second round.

I’m now preparing for my third cycle and my consultant recommended trying the short protocol again but with an initial higher dose of stimulation and then dropping the dose to give more follicles a chance to reach a good size. On my first two rounds I took the trigger shot when only two follicles had reached a good size but there were about 6 smaller ones that were just moving a lot more slowly.

I understood her logic and felt good about giving that a go at the time. However I have since read that sometimes people are recommended a long protocol to achieve a greater yield of developed mature follicles. I went back to my consultant and she has said that this can also be used and she would be happy to change my plan. She basically said there are pros and cons of both, neither are a guaranteed.

So now I’m completely stuck as to what to try! Has anyone had a similar experience? I know I respond a little bit to the short protocol so maybe 3rd time lucky?! But maybe I will respond much better to the long and give that a go 🤷‍♀️

Help! Any advice is massively appreciated 🙏

[Redsequin]

Hi there. So sorry your egg yield was disappointing. I did short protocol followed by long protocol with growth hormones added for the same reason as you. I found the long protocol quite gruelling and only saw a subtle change in my results: 6 eggs vs 4/3 embryos vs 2 embryos. However, my clinic seemed surprised as I think it’s more common to see a greater change. Personally, I think it’s always worth giving a different approach a shot if that’s something you can afford.

[ccsea in reply to Redsequin]

Hey, thanks so much for your reply. I do find the prospect of doing the long a bit more daunting as it goes on for so much longer! But as you say, it does feel worth trying a different approach if the other way hasn’t worked twice. Did the long work for you? I hope so 💛

[Redsequin in reply to ccsea]

It is such a mission doing long protocol but I think otherwise you might always wonder what if. And, yes! It did work for us. We're so lucky to have a 5-month old daughter from one of the embryos from our long protocol cycle! 💜

[ccsea in reply to Redsequin]

Ahhh that’s wonderful! Worth the mission! 💛

[Savvy_teapot]

I still did the short protocol 3rd time around. I would get a yeild of 10 or 11 which would decrease until I had 1 good egg left. My 3rd round the egg did stick though. My 1st round they said my follicles needed to be bigger to get more mature eggs so they waited for them to get to a better size this would be a day or so. Also they changed to frostimen which my consultant on 3rd round liked. Poor morphology so partner on Proxeed and Impryl. Also did a scratch mainly as I didn't have a lot to change and wanted to change something. Oh and used embryoscope. But it was NHS round so paid a bit more for embryoscope and scratch. Please message me if you have any other questions! Sounds like a super tough decision. 💜

[ccsea in reply to Savvy_teapot]

Thanks so much for your message and congratulations on it working third time! I’m really hoping it’s 3rd time lucky for me too! Which drug were you on before they switched to fostimon? I’ve been on gonal f and menopur for my first 2 cycles. It sounds like we might have had similar outcomes as my first 2 rounds it looked like I had about 12 follicles growing but as one or two grew a lot more quickly than the others they never collected that many. I know it only takes one, but I can’t help feeling that if they can get more that increases the chances of a good one being in the mix! Thanks again 💛

[Savvy_teapot in reply to ccsea]

It was menopur and gonal f. I think fostmin isn't hugely different it is just what that consultant wanted to use. I really have my fingers toes crossed for you. Everyone is so different!

[JA-fnuk Partner Nurse Fertility Network UK]

Difficult choice - your doctor will choose the best protocol for you based on your history ,previous response etc There is no one size fits all . It is tailored for the best results Just to say good luck when you start treatment

Take care

Janet

[ccsea in reply to JA-fnuk]

Hi Janet, thanks so much for your reply. My consultant initially recommended going with the short protocol again but with tweaked meds. Then when I asked her whether it’s worth trying the long protocol, she said that can also work and she’d be happy to switch her recommendation. So basically the decision is down to me 😬. I’m leaning towards going long I think. Thanks for messaging x

[StarsAllAround]

Hi ccsea, my first cycle was short protocol and didn't work, second cycle was long protocol a little more successful but transfer failed, third cycle was long protocol with a few tweaks and was successful. If short protocol is not working for you then it worth trying something different. Good luck x

[ccsea in reply to StarsAllAround]

Thanks so much for your reply. So happy it worked for you! I’m leaning that way it just seems a bit crazy that I’m basically choosing as my consultant said either could work. I’m close to tossing a coin as this stage!

[Eggfreezing36]

I don't have any advice as I just did what my clinic said...but I am at CRGH, 37 with low AMH and was suggested long protocol. CRGH are a top clinic so if they are suggesting it, perhaps you could try?