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Microdose Lupron Flare Protocol for IVF - Sample CalendarIn Vitro Fertilization Microflare Protocol

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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 stimulation shots

9

Day 2 of stim

DL twice daily

10

Day 3 of stim

DL twice daily

11

Day 4 of stim

DL twice daily

Blood and ultrasound

12

Day 5 of stim

DL twice daily

13

Day 6 of stim

DL twice daily

14

Day 7 of stim

DL twice daily

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.