Updated by the Progyny Clinical Team — August 2025.
There are different ways to stimulate the ovaries during in vitro fertilization (IVF). The goal is to collect enough healthy eggs to create embryos and improve the chance of pregnancy. Each IVF protocol, whether traditional or alternative, follows a specific process.
Traditional IVF protocols
Short Lupron (antagonist protocol)
This is the most common IVF protocol. It uses the fewest injections and works well for most patients.
You may be told to take birth control pills before starting or to come to your clinic on the second or third day of your period.
When it’s the right time to begin, you’ll take follicle-stimulating hormone (FSH) and luteinizing hormone (LH) injections for about 10 days. Around day five, a medication called a gonadotropin-releasing hormone (GnRH) antagonist is added to prevent early ovulation.
For final egg maturation, your reproductive endocrinologist (REI) may use a Lupron trigger or a dual trigger (Lupron plus human chorionic gonadotropin, or hCG). This reduces the risk of ovarian hyperstimulation syndrome.
Long Lupron
This protocol may be used for younger patients or for those who had poor embryo quality with other methods.
You may or may not take birth control pills before starting. If not, your REI will likely start Lupron in week three of your cycle (after ovulation). If you took birth control, Lupron may be started without confirming ovulation.
Lupron temporarily stops the brain from making FSH and LH. After taking it for a set time or once your period starts, you’ll visit your clinic to begin injectable gonadotropins (FSH and LH). At that point, your Lupron dose will usually be lowered. Using Lupron before and with hCG helps control your cycle and prevents early ovulation.
Microdose Lupron flare
This is often suggested if other treatments haven’t worked well, or for patients age 35 and older. It uses a very low dose of Lupron, usually taken twice daily, starting one to two days before hCG injections.
This small amount of Lupron can make your body release more of its own FSH at the start of the cycle. Combined with medication FSH, this can help the ovaries produce more eggs. After several days, the Lupron’s main role becomes preventing early ovulation.
Alternative IVF protocols
Estrogen priming
This method may help patients who respond poorly to the short protocol. It can help more follicles develop at the same time. It involves using an estrogen patch, sometimes with a GnRH antagonist or birth control, before starting hCG.
Mini-IVF
This approach uses fewer medications. Your REI may prescribe fertility pills, such as Clomid, or low doses of hCG to collect one or two eggs at a time. While this can mean fewer side effects, it often produces very few eggs and may require multiple cycles to achieve pregnancy.
Finding the right protocol
The best plan for you will depend on your age, anti-Müllerian hormone (AMH) levels, follicle count, medical history, and family goals. Talk with your reproductive endocrinologist about your options.
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Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.