Controlled ovarian stimulation


The majority of patients at Antalya IVF will undergo controlled ovarian stimulation using what is known as the ‘short protocol’. In the ‘short protocol’ drug treatment starts on day 2 or 3 of your menstrual cycle, egg collection occurs on day 11-14 of your cycle and the transfer of your embryos to your uterus will occur 4 or 6 days after egg collection. In the ‘short protocol’ 3 drug types are commonly used, stimulating drugs, regulatory drugs and triggering drugs.

Stimulating drugs

The main drug in your treatment regimen is the drug needed to initiate and promote follicular growth commonly known as FSH. Many different product brands exist, which differ mainly as a result of their production methods. All the FSH containing drugs are administered by subcutaneous injection. For complete ovarian stimulation FSH will need to be administered daily for 9-10 days, but may depending on individual response be shorter or longer.

1. FSH only: Gonal F, Puregon, Fostimon
2. FSH+LH (HMG): Menogon, Menopur, Merional

Regulatory drugs

During ovarian stimulation a regulatory drug is required to prevent premature ovulation (the release of eggs from their follicles). The drug is started once the largest follicular reaches 14mm in size, also administered subcutaneously, and continued to the day of ovulation induction, usually 4-5 days.

1. GnRH antagonists: Cetrotide and Orgalutran.

Triggering drugs

During controlled ovarian stimulation, using stimulatory and regulatory drugs, follicular growth is checked regularly using ultrasound (and if needed blood tests). Once the largest 3 follicles reach 17mm in size ovulation can be induced using a trigger injection. The trigger injection must be administered at the correct time, to time the egg collection procedure correctly 36 hours after taking the trigger.

1. hCG trigger; Ovitrelle

2. GnRH agonist trigger; Decapeptyl

Pregnancy drugs

These drugs are used to improve endometrial lining of the uterus, to which the transplanted embryo adheres to, and promotes the hormonal environment required for pregnancy. These drugs are started on the day of egg collection and continued until your pregnancy test 14 days later, if pregnant you may have to continue with the drugs until the 10th week of pregnancy.

1. Progesterone; Crinone

2. Estrogen; Estrofem