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Different Fertility Doctor, Different IVF Protocol

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A blog by Megan Swanek, August 20, 2014

I have officially started my second round of IVF and already, things are much different. When I went for my first round of IVF, I had no idea that there were so many different medication options. Or, that the protocol would be different not just from woman to woman, but also from clinic to clinic for the same woman. You can read more about different protocol options here.

My new doctor at HRC Encino is putting much more of an emphasis on the down regulation of my cycle. He has me on Lupron for 14 days prior to starting any stimulation medication. The first time (at a different clinic), I was only on Lupron for 3 days prior to starting the stimulation medication. Lupron is used to "shut down" our body's reproductive hormones by causing the pituitary gland to release high amounts of FSH and LH (luteinizing hormone) for several days until the reserves are depleted.

Since continued use of Lupron stops the pituitary gland from producing new supplies of FSH and LH, the amount of these hormones being released per day becomes really low after about a week. The goal with this is to ensure that my blood levels of LH are low enough during the last few days of follicle growth, because high levels of LH leads to poor egg quality. If the rise in progesterone happens too soon, it could cause inappropriate maturation of the uterine lining and lead to a less of a chance of embryo implantation. And implantation is the goal!

So with this new knowledge, Sunday morning found me pretty darn excited to start injecting 20 units of Lupron. No more fear of needles or anxiousness because I’ve been through this before. I’ll continue the daily injections until I have my appointment next week, when they check my hormone levels with a blood test. Provided that my body has responded, I will start my stimulation medication at that time. Since I’m participating in The Ivy Study, that’s also when I will find out if I’m in the study group (AFOLIA), or in the control group (Gonal-F).

I follow a lot of other women on the IVF journey over on my Instagram and just yesterday, I was alarmed to discover a girl had her round cancelled because her body didn’t respond to the Lupron. I didn’t even know that was a possibility! Knowledge may be power, but in this case, not knowing some things is a whole lot better for our stress levels. I am hoping and praying that my body will respond and I will be given the green light next week. Stay tuned.

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