The ‘long protocol’ or agonist regimen is used more rarely today, as it has been replaced by the shorter, more patient-friendly ‘short protocol’.
Treatment with the long protocol begins during the previous cycle. A hormone (agonist) that suppresses the function of the pituitary gland during the following ovary stimulation phase is administered via injection or nasal spray. This prevents premature ovulation.
After the preparatory treatment with this agonist, the actual cycle stimulation begins. Treatment with stimulating hormones (FSH, FSH/LH, hMG) takes place after hormone analysis and/or ultrasound once bleeding has started. These tests check whether the ovaries are free of cysts and in the desired resting state. The stimulating hormone can be administered by the patient herself or by her partner, under the abdominal skin with easy-to-use injection sets or a pen.
During treatment with these hormones, the growth and ripening of the ovarian follicles is observed using ultrasound and hormone testing.
When a sufficient number of ripe ovarian follicles are available, the stimulation treatment and administration of the agonist is stopped. The last necessary step, the maturation of the egg cell, is initiated with the injection of hCG, which then also triggers ovulation. Some 35-36 hours later, we carefully remove the egg cells by means of follicular/ovarian puncture.