The diagnosis of infertility sounds like a sentence for women. But, fortunately, the current level of medical technology allows us to correct this frightening verdict and help a woman become a mother through IVF. Doctors distinguish between a long IVF protocol, short, Japanese and in the natural cycle. The doctor always chooses the path, who weighs all the positive and negative sides and prescribes treatment. The article will discuss the long IVF protocol, the indications and advantages of this method, the disadvantages and dangers, as well as the duration of this treatment.
Terminology. General concepts
IVF is a method of artificial conception. It consists of several approaches, which are called protocols in the medical environment. The most common are short and long IVF protocols. The duration of each period is determined by the doctor individually, he also selects the dosage of drugs, depending on the patient’s health status.
The length of the long IVF protocol by day is much longer than that of the short one. On average, it takes about 50 days, as a rule, this period is enough to create a stable artificial hormonal background. As a result of the protocol, 34% of women become pregnant.
The long IVF protocol is a sequence of stages of the use of hormonal drugs, research, ultrasound and other events. During the procedure, the production of sex hormones in a natural way is turned off, they are produced artificially. All processes are fully controlled by the reproductologist. The principle of measures of this method is to block the pituitary gland, the regulation and independent formation of the hormonal process are disabled, and then they cause artificial ovulation.
Indications: why do doctors choose a long protocol?
Doctors often choose this method, despite its duration. The long IVF protocol has several advantages and indications.
Indications:
- Ovarian cyst.
- Elevated levels of LH (luteinizing hormone).
- Uterine fibroids.
- Excess weight.
- Age to 35 years.
- Tubal obstruction.
- Endometriosis
It is this technique that becomes one of the last chances to get pregnant for women suffering from endometriosis. In addition, gynecological problems prevent the onset of pregnancy in a natural way. But many of them can be circumvented and adjusted. The long IVF protocol involves the introduction of the patient for some time into the artificial menopause, which positively affects the foci of endometriosis. Long protocol is not recommended for women aged, but exceptions are possible here.
There are a number of contraindications in which IVF is not possible:
- Anatomical abnormalities of the uterus, in which the embryo is not able to attach to the uterine cavity.
- Cardiovascular diseases.
- Oncology.
- Violation of the thyroid gland.
- Diabetes.
- Mental disorder.
In addition, there are a number of diseases in which the chances of conception with IVF are significantly reduced:
- Inflammation of the genitourinary system.
- Operations on the organs of the reproductive system.
- Poor quality at the partner of seminal fluid.
Each specific medical case is individual, which is why the choice of treatment method depends on the doctor and the results of the examination of the couple.
How is a long IVF protocol different from a short one?
Not all women after a short protocol manage to get high-quality eggs. Longer preparation for ovulation, its stimulation and control of the hormonal background with a long protocol make it possible to obtain high-quality biomaterial (standardized, matured and identical eggs). Also, with a long protocol, it is much easier to control the growth of the endometrium and adjust it in accordance with follicle maturation.
The difference between the long and short IVF protocol lies in the patient’s medical indications. Long, as a rule, is prescribed to women whose age does not exceed 35 years, in whom endometriosis, polycystic, uterine fibroids, overweight, and also if the short protocol did not bring a positive result. That is, a long protocol is recommended for women with poorer reproductive health conditions.
Otherwise, these methods are very similar: they use the same hormonal drugs (the difference is only in combination), the same procedure, only the duration of each of them differs.
Long IVF protocol: how long
The scheme of this method is more complicated than the short one, and it does not begin with the onset of the cycle, but a week before the onset of menstruation. Stages of a long IVF protocol by days (in detail) :
- Before ovarian stimulation, a regulatory phase is performed. About 20–25 days of the menstrual cycle, the natural regulation of sex hormones is stopped by medication. The duration of the stage is from 12 to 22 days. The specialist fully controls the hormones of the patient, drugs and their dosage.
- The regulatory phase is replaced by a stimulating one. On day 3-5 of a new cycle, stimulation of ovulation begins. The stage lasts from 10 to 16 days. And when the follicles reach the required size, the doctor injects the patient with an hCG injection (about a day before the follicular puncture).
- On days 16-22 of the cycle, oocytes are taken (under general anesthesia). On the same day, the partner gives sperm.
- Extracorporeal insemination of the egg is carried out 3-5 days after collection.
- A fertilized egg is placed directly in the uterus.
- Within 2 weeks after transplantation, a woman is prescribed progesterone (a hormone to support pregnancy).
- After 14 days, blood is given to determine the presence of pregnancy.
When considering in detail the long IVF protocol by days, it is clear that all stages are very important, at each of them a specific goal is achieved. The reproductive doctor constantly monitors the patient's condition, regulates the administration of medications.
The most common question for women: long IVF protocol - how many days does it take? This mainly depends on the individual reaction to the hormones and the health of the woman. But how long does the long IVF protocol last? Of course, much longer than short, in total this method of fertilization takes about 50 days, in addition, the duration depends on the length of the woman's cycle.
Method Advantages
This method has a number of positive characteristics:
- Control over hormonal processes in a woman’s body.
- Good quality oocytes.
- Exclusion of unexpected spontaneous ovulation.
- Good endometrial quality.
- High percentage of positive result.
- One of the only ways to get pregnant is for women who have endometriosis.
- Endometrial growth correction depending on follicular growth.
disadvantages
Despite the obvious advantages of the long IVF protocol, it also has some disadvantages:
- Delayed or malfunctioning menstruation.
- The risk of ovarian hyperstimulation.
- Possible hot flashes, fever.
- Age restrictions.
- Psychological stress due to the duration of the course.
Feel
Reviews of women who have undergone a long protocol differ depending on their well-being at the time of its implementation and effectiveness. Despite the long-term hormone therapy, many patients indicate that their health did not change much, and the course went well.
But there are negative comments, some women say that they had such side effects:
- Drawing discomfort in the stomach.
- Flatulence.
- Emotional and psychological instability.
- Pain in the chest.
- Weakness, drowsiness, headaches and dizziness.
Moreover, it should be noted that those women who noted side effects of IVF gratefully stated that they received the highest and long-awaited award in the form of pregnancy for all their suffering.
The dangers
Any intervention in the hormonal system of a person is dangerous to his health. The more intense the ovaries are stimulated, the faster they will be depleted. If a large number of good eggs matured with a long protocol, then it is worth freezing this biomaterial just in case, so as not to expose your body to the next protocol and not to deplete it additionally.
Doctors believe that Diferelin, a drug that is used to block the ovaries, can cause an early menopause and impair the quality of intimate life.
Reviews
Reviews on the long IVF protocol are generally positive. Doctors say that with this technique, more eggs mature, and their quality is much better than with a short one. In addition, they note that it is the long protocol in 34% of cases that leads to conception. In numerous forums, women claim to feel very well and have had excellent hormone therapy.
Many advise you to go only to trusted clinics and to professional doctors, since not only health, but also life depends on it.
Recommendations on how to increase the likelihood of becoming pregnant
What needs to be done to increase the likelihood of a long-awaited pregnancy?
- Do not take any medications, nutritional supplements, vitamin complexes on your own during protocol management and after replanting the embryo.
- If medications are taken on an ongoing basis, they should be reported to your doctor in advance.
- Do not drink alcohol, and completely stop smoking.
- Do not drink coffee or drinks that contain caffeine.
- Do not go on any diet, eat right and balanced.
- A few days before the removal of the eggs and two weeks after replanting the embryo, you should not have sex.
- Do not take a hot shower, bath, do not use the bathhouse and sauna.
- Do not overwork, walk more.
Men during the protocol should:
- Inform the reproductologist of all viral infections, lung ailments, and fever.
- Do not overwork or supercool before giving sperm.
- Do not smoke or drink alcohol.
- To do sports in moderation.
- Discard tight underwear.
Super Long Protocol
One variation of the long protocol is the super-long protocol. He has a longer first stage, blockers are taken from 2 to 3-4 months. This method is used for pronounced endometriosis, cystic lesions of two ovaries, myomas. Before starting such a scheme, a woman is prescribed additional tests and studies in order to clarify the diagnosis.
Long and super-long protocols are prescribed for women under 35 years of age. This is due to the fact that a successful follicular reserve is necessary for a successful result. Usually, after 35 years, the ovaries respond much worse to stimulation, so the effectiveness is much lower. The method, form and duration of treatment is determined only by the doctor, depending on the patient’s health status.
Instead of a conclusion
Like any intervention in the human body, the long protocol of IVF has its positive and negative sides. Before starting treatment, it is necessary to discuss in detail with the doctor all the possible consequences, dangers and risks. Each experienced specialist tries to minimize the likelihood of complications. But not everything depends on the doctor, medicines and procedures; when choosing any program and IVF technique, the main condition is a positive attitude. It is necessary to drive bad thoughts and tune in only to a positive result. Even temporary difficulties and side effects should not overshadow this wonderful period of a woman's life. Time will come and when the long-awaited baby is on hand, all the trials will seem a trifle.
A long IVF protocol most often helps to achieve a positive result. That is why it is worth to be patient, tune in to success, follow all the doctor's recommendations exactly, and the final goal will not take long.