Microdose Lupron Flare Protocol for IVF - Sample CalendarIn Vitro Fertilization Microflare Protocol
Posted on September 21, 2020 by Inception Fertility
The sample schedule and calendar below is for IVF stimulation using the flare protocol.- The flare protocol is used to "jump start" ovarian response to stimulation in poor responders, in women of advanced reproductive age, and in women with low ovarian reserve.
- As women lose eggs due to aging, it can be hard to stimulate ovaries to produce enough follicles and eggs for a good chance for success with in vitro fertilization.
- This sample in vitro fertilization cycle shows a microdose Lupron flare plan with timing of drugs, ovarian stimulation monitoring, and IVF procedures.
Flare IVF Protocol Calendar
USING BIRTH CONTROL PILLS
| Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
|---|---|---|---|---|---|---|
| 1 Birth control pill | 2 Birth control pill | 3 Last birth control pill (of about 14 pills) | 4 No meds | 5 No meds Baseline blood and ultrasound | 6 Start diluted lupron (DL) twice daily | 7 DL twice daily |
| 8 DL twice daily Start of stimulation shots | 9 DL twice daily Stimulation day 2 | 10 DL twice daily Stimulation day 3 | 11 DL twice daily Stimulation day 4 Blood and ultrasound | 12 DL twice daily Stimulation day 5 | 13 DL twice daily Stimulation day 6 | 14 DL twice daily Stimulation day 3 Blood and ultrasound - follicles now are ready HCG trigger shot at night |
| 15 | 16 Egg Retrieval Procedure | 17 Fertilization check in morning Start progesterone | 18 | 19 Embryo Transfer Procedure Day 3 transfer of cleavage stage embryos | 20 | 21 Embryo Transfer Procedure Day 5 transfer of blastocyst stage embryos |
| 22 | 23 | 24 | 25 | 26 | 27 | 28 |
| 29 | 30 Blood pregnancy test |
Key to flare IVF calendar:
Blood and ultrasound = blood test for IVF hormone values (estrogen levels in IVF stimulation are important) and transvaginal ultrasound to measure the follicle sizes in the ovaries. These visits usually take about 20-30 minutes in our offices and can be scheduled as early as 6:30AM.
DL = diluted Lupron, a subcutaneous injection of a very low dose of Lupron. This drug is taken twice daily starting on the third pill free day (after the last birth control pill).
Stim = ovarian stimulation. Involves subcutaneous injection of a medication containing follicle stimulating hormone (FSH), which causes multiple follicles containing eggs to develop in the ovaries. Ovarian stimulation with a flare usually lasts about 8-11 days.
HCG injection = subcutaneous or intramuscular injection of a medication called HCG, which causes the eggs to complete the maturation process.
Progesterone = vaginal cream or suppositories or intramuscular injection of a medication (female hormone) called progesterone. This drug helps to prepare a receptive uterine lining for embryo implantation.
Egg retrieval procedure = procedure to get eggs from the ovaries
Embryo transfer procedure = procedure to put embryos in the uterus
The example above is a typical flare stimulation cycle. Most patients will need 3 or 4 visits for monitoring the stimulation (shown as "Blood and Ultrasound" on the calendar) before the HCG trigger shot. It depends on the woman's response to the ovarian stimulating medications.
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