IVF Medication Protocols
Fertility drugs used to superovulate the ovaries by causing the production of numerous follicles may be given in a variety of combinations, which are called protocols. The physician determines the individualized specific treatment protocol for each patient. The following information describes the standard or initial protocol used for the majority of patients. Each patient’s protocol is individualized and may vary from the standard.
The physicians at Dallas – Fort Worth Fertility Associates use several standard and individualized protocols for IVF treatment other than the ones listed below, but two commonly used protocols are listed below.
Standard IVF Protocol
With the standard IVF protocol, four types of fertility drugs may be given:
Lupron: a gonadotropin-releasing hormone (GnRH) antagonist, which acts on the pituitary gland to inhibit gonadotropin (FSH and LH) secretion and prevent premature ovulation. Ganirelix is a GnRH agonist and may be used instead of Lupron to control ovulation timing.
Progesterone: helps supports endometrial development and maintain early pregnancy.
Gonadotropins: medications consisting of FSH alone or combined FSH/LH. They directly act on the ovaries to stimulate the development and maturation of the eggs
Human chorionic gonadotropin (hCG): known commercially as Pregnyl or Ovidrel, these medications act directly on the ovaries to cause the release of eggs from the ovarian follicles.
The Microflare protocol is a special stimulation protocol designed to optimize ovarian response in women who have demonstrated a previous poor response to a routine protocol, orb who may be at risk of having a poor response to fertility medications. The Microflare protocolconsists of a combination of oral contraceptive pills (OCP’s), Lupron (diluted), and gonadotropins designed to maximize your ovarian response. The term “Microflare” is derived in two parts: “Micro” refers to the use of a diluted dose of Lupron, micrograms instead of milligrams; and “flare” refers to the stimulatory or flare effect of Lupron when given this way— hence the term Microflare.
Starting on Cycle Day 3 of your menses, you will take 2-3 (sometimes up to 4) weeks of OCP’s then start micro-dose Lupron 3 days after stopping OCP’s, then add gonadotropins 2 days after starting Lupron. Please note: the day you start gonadotropins is still referred to as the Cycle Start Day.
- Ortho-Novum 1/35 (21-day packs ordered) will be given continuously for approximately 2-3 weeks.
- On Monday*, you will have a sonogram. If sonogram is normal (all follicles < 15 mm), then the birth control pill will be discontinued (last pill Monday) for a Saturday* Gonadotropin Cycle Start. Otherwise, you will remain on birth control pills for an additional week.
- On Thursday* morning, start the Micro-Dose Lupron 0.2 cc (40 μg), every 12 hours, and continue daily, until time of hCG. Please Note: Micro-Dose Lupron is a special diluted Lupron prepared by mixing 0.4 cc (2 mg) of standard Lupron with 10 cc of normal saline. This will be prepared by our office or your pharmacy.
- On Saturday*, start gonadotropins as ordered, typically 6 ampules given in divided doses (HMG: 2 vials in a.m./FSH: 4 amps in p.m.)
- Please return on Gonadotropin Day 4 (the following Tuesday*) for an estradiol level.
- If your Gonadotropin start day is Sunday, then add an additional day for these instructions, i.e. sonogram and stop OCP’s on Tuesday, start Micro-dose Lupron on Friday, gonadotropins start Sunday.
Printable IVF Calendars
We try to make infertility treatment as stress-free as possible.
We offer different treatment financing options. Infertility treatments can be expensive, and we try to control the cost as much as possible. We have a separate Web page that discusses infertility treatment costs and lists the insurance plans we accept.
Our financial counselors work closely with couples to determine the best means to afford their treatments
- Standard Protocol Calendar
- Microflare Protocol Calendar
- Sample IVF Calendar – Lupron and Birth Control Pills
- Treatment Calendar- Lupron Natural Cycle