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Short Protocol? Why?

(19 Posts)
LillyLeaf Sun 16-Sep-18 09:20:12

I'll be starting IVF in October on the short protocol. What reasons were you given for using short protocol and not long protocol?

Cattenberg Sun 16-Sep-18 09:28:16

I had IVF last year at a private clinic. I was on short protocol and thought it was because I was fairly old (35), and didn't have a great ovarian reserve. However, my doctor said that wasn't the case; he prefers short protocol as the egg quality tends to be better. He said that the NHS prefers long protocol as the cycles need less monitoring and are easier to schedule.

physicskate Sun 16-Sep-18 09:36:06

I had short protocol as I have polycystic ovaries and there was a risk of ohss. Had to go in for daily scans the second week of stims. 18 eggs collected!!

hoping2018 Sun 16-Sep-18 09:41:14

I spent ages trying to work out why they went for certain protocols and couldn't!

My first nhs cycle I had long protocol despite my diminished ovarian reserve (age 32) and they told me it was because long cycle gives you a higher chance of getting pregnant. Despite 20 eggs (completely unexpected given my high FSH) and 14 fertilised we had no good quality blasts on day 5. Weput back what we had - bfn and nothing frozen.

Cycle 2 privately with the same clinic one consultant wanted to change us to short protocol because I'd found the long cycle hard (really bad menispause symptoms and obviously uncomfortable as my ovaries were so large they were touching) he didn't say it would help with quality but I read that too?

However we then saw a younger newer consultant who said in the short protocol the lining of your womb isn't as good and we were unlikely to have anything good enough to freeze so said we should still go long....

We went long with a lower dose of menopur and I'm 20/40 pregnant after two embryos transferred on day 3 and this time we have 2 day 5 blasts in the freezer. (Still had just as many eggs and fertilised embryos - we also surgically retrieved my husbands sperm the second time which seemed to help quality)

So overall I find it baffling and still don't know how they decide ! And they don't seem to agree!! I'd just find a consultant you trust and let them decide xxx

LillyLeaf Sun 16-Sep-18 09:42:17

I'm 35 so I'm thinking maybe that is the reason, it's also a private clinic. My AMH is 15 so not low but not amazing either. I just thought long protocol was more 'normal' so I was worried the clinic weren't being clear about my chances and maybe something is wrong.

hoping2018 Sun 16-Sep-18 09:43:58

@LillyLeaf AMH of 15 sounds amazing at 35 to me!

I've got 4 friends who've had AMH checked all <32 years old and all have an AMH <9

LillyLeaf Sun 16-Sep-18 09:47:03

It is all very confusing. I don't have Pcos which I have read is one reason to have short protocol. I think I need the doctor to explain.

Bojangles33 Sun 16-Sep-18 09:56:16

We had short protocol, I have PCOS so I believe it lowers the risk of OHSS, but I think they now only do short protocol at my clinic! I think they all have different opinions so agree with pp about finding a consultant you trust and following their advice

IVFaugust2018 Sun 16-Sep-18 09:57:12

I've just had an NHS cycle where i was put on the short protocol. I'm 34 with no known fertility issues, AMH 25 and AFC 16. I guess it completely depends on the clinical opinion of your consultant.

I read up on the differences of the protocols and it seems that the short protocol has slightly lower rates of success that are cancelled out after 4 cycles - so after 4 cycles the birth rate for both protocols are pretty much equal. Northern European countries favour the short protocol as the effects are less gruelling for the woman - but I understand this could also be that IVF is free so needing more cycles has less of an effect. The long protocol tends to be favoured by countries where IVF is paid for by the individual historically but thinking is changing now to favour the short due to the lesser side effects experienced by the woman

Guio Sun 16-Sep-18 10:04:36

Hello I am 35 low amh and the NHS put me in the long one.When I asked as I will start in October they said they it is the one that suits me with my age and the one they use in most of the cases.

physicskate Sun 16-Sep-18 11:17:24

With a high AMH you may be at higher risk of overstimulation?? Just a guess... I didn't/ don't have pcos - just the cysts not he syndrome.

LillyLeaf Sun 16-Sep-18 15:48:07

It does seem it's down to the clinic and not entirely the individual's circumstances. On the plus side the drugs will be cheaper. Thanks everyone.

PhoebeMouse Tue 18-Sep-18 15:00:07

it does seem so random! i've got a low AMH and our consultant said they have higher success rates with short protocol with women with either low or high AMHs. And it worked for us! (and i was glad to only have to inject myself for 8 days!) but then again, my friend who also had a low AMH had 2 failed short cycles then moved to a different clinic who put her on the long cycle and that was the one that worked! who knows!!

NotLateInTheMorning Tue 18-Sep-18 15:54:08

Agree that it does all seem a bit random - and has never quite been explained to me. I do have low(ish) AMH.

ICSI 1 - short protocol - no luck

new clinic for round 2 and on long protocol - praying this one works

LillyLeaf Fri 21-Sep-18 07:43:03

If you did short protocol do you ttc the cycle before? Or are you not meant?

physicskate Fri 21-Sep-18 16:54:51

We did. You just aren't allowed to have unprotected sex during your actual cycle (which for short protocol is when you start injections.

AniSL Sat 22-Sep-18 08:12:26

I am now 37 but had just turned 36 when my protocol was discussed, we went with European clinics, my suggested protocol was short, my AMH, AFC, LH, FSH was very good, one clinic said it was comparable to someone in their 20s.
I noticed the European clinics prefer short, it has a less detrimental affect of both the woman and potential children.

I agree that it seems to be more about the clinic and consultant and doesn't seem to be an exact science, but then neither is infertility

welshweasel Sat 22-Sep-18 08:15:01

We had short protocol due to high AFC and not wanting to overstimulate. Ended up with 16 eggs, from which we got 4 day 5 blastocysts. One of them became our 2.5 year old son, two failed and I’m 21/40 with the final one.

PhoebeMouse Thu 27-Sep-18 11:18:22

@LillyLeaf yes we tried the cycle before starting short protocol. With us, we were given a date to start based on when the first day of my period was most likely to be. It came a day early so i had to take a contraceptive pill for just that one day and start on the agreed date. So basically your period has to start and then you take your first injection that night. Our nurse did say we could take a pregnancy test on the day just to be fully sure before starting the injections, so i did that just to feel sure!

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