Hi Ocean - hope this helps
Long protocol
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- CD 21 Suppressions (eg. Lucrin, suprefact) until AF. Lucrin suppresses the follicles from growing until the gonaltrophin drug (eg puregon, gonal-F) is added
- CD1 – AF, lucrin continues
- Around CD3 Stimulation drug added to boost follicle growth. Because of suppression stage,the follicles hopefully will grow more evenly. that does not happen to every woman, however, there should still be a “lead pack” of follicles that are responding to the stims. Lucrin continues to prevent premature ovulation
- Usually first scan is D7 of stims, usually another 1 or 2 scans in between before trigger
- Trigger then ER
Short (Antagonist) Protocol
- Around CD3 start stims, As no suppression stage, possibility egg growth may be more uneven. Focus is on the lead pack.
- More monitoring is done by doctors to adjust stim dosage & monitor follicular growth.
- Usually first scan D5 of stims, and more regular scans in between (every 2-3 days)
- Trigger then ER
Long protocol has been around for 30+ years. Traditionally, antagonist was used with older ladies as some ladies over-suppressed at suppression stage and did not response at stim
stage. Now some clinics use the anatagonist protocol as it is relatively shorter & faster, and someitmes lucrin got effects such as headache and backaches,etc. Research says there is no significant different in egg quality and number of eggs between the 2 protocols for most women, but sometimes one protocol ends up working better than the other for some women. I tried both protocol and got same number of eggs each time.
On going for Fresh#2, it’s your choice ltimately, but do have a discussion to your doctor. I had 2 frozen from Fresh#1 and after discussing with my Doc, we went for another Fresh as didn’t want to wait a cycle time if the snowbabies did not survive thaw since got only 2. But Imel's 2 rmbbies survived thaw & she did get pregnant. So it all depends on the embbies. Most doctors will recommend to use up embbies first as sometimes the 2 we put in may not implant, but the FET ones turn out to be the strong ones (as they survived a day or 2 longer), but he also helped us weighed the risk of possibility of cancelled cycle due to no embbies surviving as we were likely going to do medicated FET.
Often embbies that look 'great' at Day2/3 do not survive to day 6/7 for implantation. So don't despair, and often the snowbabies end up the strong candidates for BFP.
Re qualifying for grant for Fresh#2 if you had an earlier child, it’s in MOH’s website FAQ :
Go to MOH > Home > FAQ > Policies > Co-funding for ARP at restructured hospitals
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