Patient's question:
Irregular menstruation, usually delayed by 15 to 30 days before the period arrives, light flow, prolonged follicular development, small follicles, generally around 1.5 to 1.8 centimeters in size, the follicles do not rupture or release. Menarche at the age of 14, with periods occurring every 28 to 30 days, lasting 5 to 6 days, with a moderate flow, neither too much nor too little. At the age of 18, due to rheumatoid-like knee joint pain, three injections of imported hormone-based medication, "Kenalog," were administered. From then on, menstruation began to become irregular, and weight gain occurred rapidly, increasing from 98 pounds to over 140 pounds.Doctor's answer:
(1) Long protocol: Inject GRHa during the luteal phase before the treatment cycle or on the second day of the treatment cycle until hCG injection. Starting from the day of GRHa administration, add gonadotropin preparations such as hMG or FSH for ovulation induction between days 14-21. This regimen utilizes the suppressive effect on endogenous gonadotropin secretion caused by high-dose continuous GRHa stimulation, known as downregulation. The long protocol is currently the most commonly used hyperstimulation protocol.(2) Short protocol: Begin using GRHa on the second day of the menstrual cycle, while administering gonadotropins until hCG injection. This protocol primarily leverages the transient surge of FSH and LH after GRHa administration (flareup), reducing the dosage and duration of exogenous gonadotropin use. The short protocol is suitable for patients with poor response to hyperstimulation in the long protocol.
(3) Ultrashort protocol: Use GRHa for a short duration from days 2-4 of the menstrual cycle, while starting gonadotropin preparations such as hMG on day 3. This regimen relies solely on the surge of FSH and LH caused by GRHa administration (flareup). The ultrashort protocol is suitable for older patients or those with poor ovarian response.
Advice: Relax, exercise more, and wish you a speedy recovery and family health.