Most of us have a general idea of how IVF works. But what’s less well known (unless you’ve had treatment yourself) is that you might end up needing a completely different medication plan, or protocol, depending on your individual fertility baseline.
This could mean anything from a short approach to the long protocol for IVF, or even something more specialised. So how do you know which one is right for you – and what happens if your plan needs to change?
For expert insight here, we’re excited to be partnering with the brilliant team at Fitzrovia Fertility, London’s boutique clinic for personalised fertility care.
Their philosophy centres on transparency and evidence-based fertility care, bespoke to your needs. With a team of some of the most experienced clinicians in the field, they offer a full spectrum of services – from fertility assessment and treatment, to complementary holistic therapies and mental health support, plus specialist expertise in PGT-A, recurrent pregnancy loss, hormonal health and more.
We sat down with Consultant Gynaecologist and accredited subspecialist in reproductive medicine Dr. Shirin Khanjani, Medical Director at Fitzrovia Fertility, to talk through how she chooses the right starting point, when she pivots, and the different ways a protocol can be tailored to fit your situation.
Over to Dr. Khanjani.
At Fitzrovia Fertility, we believe IVF should never be one-size-fits-all. As a bespoke clinic, we offer highly personalised treatment plans designed around each individual or couple’s unique fertility profile.
There are several IVF protocols in clinical use, and each serves a different purpose. The right approach depends on multiple factors, including:
Our consultants are deeply involved in research, frequently attend and present at international conferences, bringing the latest, evidence-based techniques to our patients in real time.
We offer a full spectrum of protocols from standard long and short approaches to more innovative strategies, adapting treatment based on time sensitivity, ovarian reserve, and medical requirements as needed!
The IVF short protocol is a well-established, widely used approach. It's often recommended if you have a good ovarian reserve, or if male factor infertility is the main concern.
It's also common for younger women, first-time IVF patients, or anyone where a quicker, more straightforward cycle is clinically suitable.
A typical short protocol runs as follows:
Here at Fitzrovia Fertility, I'll often add progesterone priming from day 14 of the preceding cycle, helping follicles develop in a more synchronised way and making the response to stimulation more predictable.
The long protocol can be particularly effective for patients with endometriosis, adenomyosis, or those planning a fresh embryo transfer.
It's also a strong option when a previous short protocol has resulted in fewer mature eggs than expected.
By suppressing your natural cycle before stimulation (often called ‘downregulating’ by IVF doctors), the long protocol allows for more control over follicle growth. This can lead to better synchronisation and egg maturity in selected cases.
Here's how a long protocol IVF timeline might look:
Fresh transfer or freezing depending on your endometrial readiness.
Yes! These are where our boutique, highly tailored approach at Fitzrovia Fertility really shines.
We routinely offer:
Sometimes, pivoting mid-cycle or adjusting for the next round can make all the difference.
I might suggest changing IVF protocol when:
At Fitzrovia Fertility, our team continually tracks your cycle’s progress and uses real-time data to help us adapt quickly to maximise your chance of success.
For low ovarian reserve, I’d focus on both quality and quantity.
At Fitzrovia Fertility, your plan might include:
There's no single best protocol for women over 40 – your treatment needs to be carefully tailored. Fitzrovia Fertility's aim is to optimise egg maturity and increase the number of high-quality blastocysts.
Depending on your ovarian reserve, history and goals, I might recommend:
Pre-implantation Genetic Testing for Aneuploidy (PGT-A) is also often advised in this age group, and is something we offer at Fitzrovia Fertility. As the likelihood of chromosomal abnormalities rises with age, PGT-A helps identify embryos with the highest implantation potential, lowering the risk of miscarriage or failed cycles.
In short – It doesn't increase the number of embryos, but it does improve the ability to choose the most viable ones.
For endometriosis, Fitzrovia Fertility works alongside leading gynaecologists at UCLH, the Cleveland Clinic and other endometriosis centres.
My approach may include:
Egg and embryo freezing is also offered for fertility preservation, if your endometriosis is moderate to severe.
With PCOS, my priorities would be to reduce the risk of OHSS, and maintain a steady hormonal environment for transfer.
This often involves:
After talking with Dr. Khanjani, one thing's clear – there's no "one-size" IVF protocol. The best plan is always the one that's designed for you. Sometimes, it changes along the way, and that's okay too.
Weighing up your next steps? Hop over to Fitzrovia Fertility's website to learn more about their services and success rates, and book in a consultation.
If your path does lead you to IVF, their team will work with you to find a protocol that feels right, fits your timeline, and is backed by the very latest evidence-based care.
Want to learn more? Bookmark some of our most-read resources:
Short, long or something different? How this consultant starts, pivots & builds a personalised IVF treatment protocol was originally published on The Ribbon Box, and is shared here with permission.
Table of contents
- Why do multiple different IVF protocols exist, and what's offered at Fitzrovia Fertility?
- When would you recommend the IVF short protocol?
- Who benefits most from the long protocol for IVF?
- Are there other personalised IVF protocols outside of the standard short and long?
- When (and why) might a protocol need to change?
- Which IVF protocol is best for specific situations?
- Ready to find best-fit, bespoke IVF treatment?