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simplified novel protocol for IVF/ICSI.

By: jehad yousef, private practice, Amman-JORDAN 22 August 2006

Question: A simplified novel protocol for IVF/ICSI. 20mg femara single oral dose on cycle day 3; and HMG 150-225 IU IM/day from day 3 and cetrotide 0.25mg SC/day from day 6 stimulation. When => 3 follicles > 18mm and endometrium >10mm, 5000-10.000 IU HCG is given IM, and egg collection is performed vaginally 36 hours later, ICSI is done for MII oocytes. Tow to three of best quality embryos available are transferred on day 2 or 3. Luteal support with vaginal progesterone (Cyclogest 400mg x2 daily). Cycle monitoring is by transvaginal ultrasound only. I have used such protocol on 5 patients (2 PCOS, 1 unexplained, 1 tubal factor and 1 severe oligospermia). All conceived intrauterine; no moderate or severe hyperstimulation and no multiples. I would like to hear comments and other experiences.

Replies (5) Write a reply... with letrozole the patient will need less goadotropins and this will actually reduce the costs. jehad yousef - 20 January 2007 Dear Dr. Yousuf, I am not too sure whether we get Femara in India. Can you suggest me some alternative? We are doing good no. of cycles with Antagonists but the results are same as Agonists, except the cost. Keep it up, Thanks, Dr. Chitre DR.PRADEEP L. CHITRE - 04 October 2006 Thank you JEHAD for the reference regards GOOLAM GH MOHAMED - 13 September 2006 Dear Dr. Mohamed. The recommendation for not using femara in COH for fear of congenital malformation in the developing fetus. In the protocol mentioned, by the time of fertilization and implantation there will be no traces of the drug, because of very short half life (45 hours). There are tow papers from Canada published in Fertility Sterility Journal 2006 Jun;85(6):1761-5, and American Journal of obyn, 2005 Feb;192(2):381-6. confirming the safety of using Femara in ovarian stimulation. jehad yousef - 01 September 2006 I too had excellent results with FEMARA and the protocol mentioned but stopped using FEMARA because it is not recommended for COH/OI but i wish we would be allowed to use it again GOOLAM GH Mohamed - 24 August 2006