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

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

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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