Random IVF Protocol Question

[callmeal]

I have a friend who is about to start her first IVF cycle. It's an antagonist protocol with lupron trigger. There's no progesterone at all listed on the protocol sheet she just sent me!

I don't think I've ever seen anyone cycle without some sort of progesterone support. Is that done? Is it common? I'm curious. School me!

[julie216]

callmeal,can't help you with that... I've been on 2 different protocols and a dear friend was on 3 different ones... and
progesterone was used in all of them. Very curious as to the reasoning behind this!

[mrsamyd]

I've done long Lupron and Microdose Lupron flare. Both have progesterone immediately after retrieval. That is odd.

[mnj05]

I did the same protocol for both of my cycles but progesterone was always included. That seems a little strange to me.

[callmeal]

Thanks ladies. I think it's really strange, too. She's cycling at Shady Grove, which I know is a really reputable clinic in the DC area, so it has to be legit, right? They are testing her P4 the day after trigger, according to the schedule; maybe they will decide based on those results what to do about progesterone?

I just wanted to bounce it off of you guys before I told her I thought it was super weird and that she should ask her RE about it.

[ruthie]

That was my first protocol at Shady Grove, but they planned for me to use Endometrin (I just looked up my protocol on my email). They thought I'd be a high responder and a Lupron trigger (as opposed to HCG) reduces the risk of OHSS. When they use Lupron triggers, they always test p4 the next day (my nurse explained the reason, but I can't remember). Turned out I was a crappy responder and that cycle was canceled, so no real experience with the full protocol.

In all honesty, I'd bet her nurse left the meds off the protocol worksheet. It's been three years, but I doubt they'd discontinue progesterone support.

[leahb12]

I'm also wondering if they left that off by accident. I've never had any medicated cycle (IVF or not) without progesterone support.

[amandaleigh]

For really high responders who are at risk of OHSS, REs will use a lupron trigger, to try to minimize the risk as well as the unintentional early rise in progesterone, I think. A rise too soon in progesterone will mess up receptivity for the embryo. That is why they test P4. I think if it is out of whack, they won't do the fresh transfer. in any case, I think all IVF has some kind of progesterone supplementation.

[callmeal]

Mystery solved! When my friend asked about it this morning, the nurse said she accidentally left the endometrin off the sheet.

You all were right! Thanks for all the input!