If your doctor has decided that the long protocol is your course of action, then this is the stage when you will begin down regulation. It involves effectively giving your doctor ‘control of your ovaries’. Don’t worry, you’re still in charge!
This simply means they will use medication to suppress your ovaries, using either birth control pills or a medication. This medication stops the pituitary gland in your brain from controlling your ovaries and prepares them for external stimulation.
You will take your drugs as injections or a sniffer spray for anywhere between 1-4 weeks. This course of GnRH medication will stop your ovaries actively developing eggs, meaning you will then be fully ‘down regulated’. Though as with everything, it all depends on the individual, timings may vary slightly for you.
We should also mention, that some people experience side effects with GnRH, that are similar to the menopause, such as headaches, hot flushes, night sweats and mood swings. But your GP will explain everything as you go along.
At the end of your down regulation, you will have a blood test to check that your oestradiol levels are low. You will also further blood tests and scans to make sure your ovaries have down regulated and the lining of your uterus is the correct thickness (approximately 3mm). If all looks good you’re all set to start treatment!
If you have been put on the short protocol, you will skip this down regulation stage. Instead, on day 3 of your period, you’ll have a scan, and then if all looks good you will begin stimulation.