IVF - difference between long and short protocol

[Thomasina76]

Thinking about doing IVF and from what I have heard the short protocol is much easier/shorter/fewer drugs etc. However, the fertility clinic I am at says that they recommend long protocol and prescribe the contraceptive pill for the down-regulation part as this results in much better response to the fertility drugs. Does anyone know when short vs long protocol is recommended?

I've done 3 cycles of long protocol so can't comment on when it is recommended vs short protocol. I'm sure someone more knowledgeable on that point will come along soon.

However the protocol has nothing to do with the contraceptive pill. Down regulation means artificially suppressing the bodies natural cycle for around 2 weeks before starting stimulation. Down regulation drugs (usually Buserelin) start on day 21 of a cycle, which is why it is longer as short protocol starts on day 2 or 3 of the cycle I believe. Some clinics also use the contraceptive pill to manipulate cycles. My NHS cycle was with pill first to match my cycle to their available appointments but my private clinic work with the body's natural cycle so don't use the pill first.

Thanks Bluenoses. How did you find the process? Were you successful? I think at the clinic I am at they do down regulation by using the contraceptive pill.

Oh OK. I was on the contraceptive pill and then down regulation drugs in my first cycle, as I said, NHS, not successful.

I am currently pregnant after my third cycle 8+2. I was also pregnant after my second cycle but sadly had a second trimester loss.

The process was fine once I got started but the waiting stages in between can be tough.

Good luck Thomasina.

I'm about to start IVF privately (have one DC conceived naturally) but don't feel like I know enough. My consultant hasn't mentioned 'long' or 'short' protocol, they did set out a timeline but there was so much to take in I can't remember exactly (obv will get more detailed information at next nurse consultation).
It sounds like they do the down regulation on day 21, whole thing takes about 8 weeks they said.

My gaeno said short protocol is recommended for older women/those who might have fewer 'good' eggs/ or those who run the risk of pof during ivf treatment. It's decided based on one of your blood tests - can't remember now which one. She did say longer protocol was the preferred option though as it's more likely to result in a live baby.

Blackcherries I would recommend reading Get A Life: His n Hers IVF story. Written by a lovely couple that went through 3 cycles and from both their perspectives. It's very informative and can give you a good idea of what to expect.

Ordered it, blueroses!

Long protocol is the default for most people with normal ovarian reserve

Counter intuitively, short protocol is used for both women who are likely to be poor responders (low AMH / diminished ovarian reserve) and also women who are at risk of hyperstimulation (high AMH / polycystic ovaries)

For women with DOR it avoids risking over suppression with down regulation - sleepy ovaries may not bounce back so well after being switched off.

For women with PCO the brakes need to be able to be slammed on quickly, and if someone is at risk of hyperstimulation then an hCG trigger can only be avoided on a short protocol, as you can't use a buserelin trigger on a long protocol cycle

I'm not sure where the idea that long protocol is more likely to lead to a live baby is from. The protocol that's most likely to lead to a live baby is the one that's best suited to the patient. I'm not sure where she's getting her data from?