IVF Antagonist Protocol


So, you’ve had your consultation, finished all your preliminary diagnostic testing, and you’re ready to get started with treatment.

Based on your results, your doctor has determined that your IVF cycle will follow the “IVF Antagonist Protocol.”

The IVF Antagonist Protocol, Explained

There are several IVF protocols that can be used to stimulate the ovaries of in vitro fertilization (IVF) patients. With each, the goal is to retrieve the optimal number of eggs required to obtain enough healthy embryos to result in at least one pregnancy.

Here, we outline the basic steps you’ll follow with the IVF Antagonist Protocol.

You will start the IVF Antagonist protocol at the start of your menstrual cycle. You should contact your doctor’s office to notify them of the first day a full flow occurs, so they can instruct you about when to go in to the office for an ultrasound and blood work (baseline visit).

In some cases, you will start a birth control pill first. Birth control pills can be given for 14-21 days to prepare your body for IVF by regulating your ovarian hormones, and by preventing ovarian cysts. They are also beneficial in timing the start of your IVF cycle.

After completing birth control, or following your baseline visit, you will begin the IVF antagonist protocol.

In this protocol, you will take injectable hormonal medications containing follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) to stimulate the ovaries to produce more eggs than typically mature in a given month.

An “antagonist” medication, either Cetrotide or Ganirelix, will be added to your daily regimen in order to prevent ovulation. This medication is started when your estrogen level rises above a certain threshold, or based on the size of your largest follicle on ultrasound, and is continued until the time of your hCG trigger shot.

Dr. Taraneh Gharib Nazem is Senior Fellow in Reproductive Endocrinology and Infertility at the Icahn School of Medicine at Mount Sinai/Reproductive Medicine Associates of New York. She is a board-certified Obstetrician Gynecologist. Dr. Nazem completed her residency in Obstetrics and Gynecology at the New York University School of Medicine, where she was elected administrative chief resident and graduated with the Robert F. Porges Honor Resident Award, for outstanding performance.