Endometrial Preparation Protocol for Receivers of Eggs
Preparation Options
| Preparation Type | Details |
|---|---|
| Natural Cycle | Suppression starts on Day 21 of the previous cycle. |
| Contraceptive Cycle | Suppression starts 5-7 days before the end of contraceptive intake. |
Ovarian Suppression Guidelines
| Medication | Dosage and Application Method | Duration |
|---|---|---|
| Nafrelin | 200 mcg: 2 intranasal applications every 12 hrs (until period); then 1 every 12 hrs | Until Progesterone administration. |
| Triptorelin | 0.1 mg: Subcutaneous injection in the abdomen daily. | Until Progesterone administration. |
| 3.75 mg: Deep intramuscular injection, administered once. | One-time dose. |
Endometrial Preparation
| Medication | Dosage and Method | Frequency |
|---|---|---|
| Estradiol | 100 mcg (Evopad): 2 patches transdermal | Change every 72 hours. |
| Estradiol valerate | 2 mg (Progynova): Oral administration | Every 8 hours. |
Monitoring:
- Timing: Between Day 7 and Day 9 of treatment.
- Procedure: Transvaginal ultrasound to evaluate:
- Endometrial thickness (≥5 mm).
- Trilaminar characteristics.
- Ovarian activity (should be absent).
Preparation Options
| Preparation Type | Details |
|---|---|
| Natural Cycle | Suppression starts on Day 21 of the previous cycle. |
| Contraceptive Cycle | Suppression starts 5-7 days before the end of contraceptive intake. |
Ovarian Suppression Guidelines
| Medication | Dosage and Application Method | Duration |
|---|---|---|
| Nafrelin | 200 mcg: 2 intranasal applications every 12 hrs (until period); then 1 every 12 hrs | Until Progesterone administration. |
| Triptorelin | 0.1 mg: Subcutaneous injection in the abdomen daily. | Until Progesterone administration. |
| 3.75 mg: Deep intramuscular injection, administered once. | One-time dose. |
Endometrial Preparation
| Medication | Dosage and Method | Frequency |
|---|---|---|
| Estradiol | 100 mcg (Evopad): 2 patches transdermal | Change every 72 hours. |
| Estradiol valerate | 2 mg (Progynova): Oral administration | Every 8 hours. |
Monitoring:
- Timing: Between Day 7 and Day 9 of treatment.
- Procedure: Transvaginal ultrasound to evaluate:
- Endometrial thickness (≥5 mm).
- Trilaminar characteristics.
- Ovarian activity (should be absent).
Progesterone Administration
(Starting on Day of Egg Devitrification)
| Medication | Dosage and Method | Frequency |
|---|---|---|
| Micronized Progesterone | 200 mg (Utrogestan/Progeffik): Vaginal | Every 8 hours at 4:00 pm. |
| Progesterone Gel | Crinone 8%: Vaginal | Every 24 hours at 4:00 pm. |
| Progesterone Injection | Prolutex 25 mg: Subcutaneous | Once daily at 4:00 pm. |
Embryo Transfer and Post-Transfer Protocol
| Event | Details |
|---|---|
| Blastocyst Transfer | Occurs on Days 18–20 of preparation (no later than Day 22). |
| b-HCG Test | Performed 10 days after transfer. |
| Positive b-HCG | Increase estradiol to 300 mcg and Progesterone to 400 mg. |
| Low b-HCG | Recheck every 48 hours. |
| Ultrasound Check | Conducted 2 weeks after first blood test. |
Key Reminders
1DO NOT INTERRUPT Estrogens and Progesterone until the pregnancy test.
2If administering Progesterone vaginally, continue according to the schedule on the day of embryo transfer.
3For positive b-HCG:
- Estradiol: Increase dosage every 72 hours.
- Progesterone: Increase to 2 capsules every 8 hours.
Embryo Transfer and Post-Transfer Protocol
| Event | Details |
|---|---|
| Blastocyst Transfer | Occurs on Days 18–20 of preparation (no later than Day 22). |
| b-HCG Test | Performed 10 days after transfer. |
| Positive b-HCG | Increase estradiol to 300 mcg and Progesterone to 400 mg. |
| Low b-HCG | Recheck every 48 hours. |
| Ultrasound Check | Conducted 2 weeks after first blood test. |
Key Reminders
1DO NOT INTERRUPT Estrogens and Progesterone until the pregnancy test.
2If administering Progesterone vaginally, continue according to the schedule on the day of embryo transfer.
3For positive b-HCG:
- Estradiol: Increase dosage every 72 hours.
- Progesterone: Increase to 2 capsules every 8 hours.
