Stimulation Protocol

There is no single IVF stimulation protocol — clinics use a variety of approaches tailored to each patient's ovarian reserve, age, and prior response. The main categories are: antagonist protocols (GnRH antagonist added from day 5–6 to prevent premature ovulation; most common today), long agonist protocols (GnRH agonist starts in the prior luteal phase to suppress the pituitary), and mild/mini IVF (low-dose or oral medication to retrieve fewer eggs with less risk).

Protocol choice affects trigger type, OHSS risk, and freeze-all decisions. Poor responders may benefit from agonist flare (microdose Lupron) protocols. Patients with PCOS often use antagonist protocols with an agonist trigger and freeze-all to minimize OHSS. Individualized dosing using AFC and AMH data is associated with better outcomes.