In the past , standard IVF protocols for superovulation would use down-regulation with GnRH agonists ( such as Lupron) , and these were known as either the short or the long protocols. Long protocols would start 7 days before the cycle started, which meant that patients would end up having to take shots for 20 days a daunting prospect for most women, and because this put them off, they refused to explore the option of doing IVF
The newer protocol uses the GnRH antagonist ( such as Cetrorelix) , which means that patients require fewer injections. Not only is this kinder for the patient, it's also less expensive. Even better , we usually collect more eggs, and their quality is better too. Finally, the cherry on the cake is that it reduces the risk of ovarian hyperstimulation, which means it provides lots of benefits without any risks !
This is called the Letrozole Antagon protocol, which uses a combination of Letrozole , which helps the patient grow more of their own endogenous follicle-stimulating hormone, in combination with Gonal F, which is exogenous follicle-stimulating hormone. This starts from Day 2 of the cycle, and this combination of both internal and external hormones helps the patient to grow more eggs. Because we use the GnRH antagonist for down-regulation from Day 7 onwards, we can trigger ovulation with a GnRH agonist, so that the risk of hyperstimulation is zero.
This new protocol allows both patients and doctors to get the best of both worlds - better and more eggs, with lesser risk and fewer injections !
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