When IVF doesn’t quickly work, patients become convinced that there is something wrong with their uterus or body that leads to the “rejection” of their embryos. Of course this may be true for some women, but in fact the problem is usually one on the side of the embryo – even high grade blastocysts have up to a 50% chance of having chromosome errors that prevent implantation or lead to miscarriage. Well done studies repeatedly suggest that so-called “implantation failure” is far more likely to actually be a problem of embryos.
However that fact is not always easy to communicate or accept and as a result, women tend to consider additional agents or supplements in the hope that this will improve their body’s chance of receiving embryos. One particular “cocktail” is a mixture of antibiotics, oestrogen tablets, aspirin and other stuff that is collectively called the Colorado protocol.
It’s been around for many years and from time to time patients ring me up and ask about it. I don’t even know how it got it’s name – I’ve never been to Colorado but I’m told the skiing is good. There is also a very good IVF unit there but I can’t believe they came up with it.
A study of the effectiveness of these kinds of supplemental agents on the chance of IVF working, was presented by a colleague in Melbourne, Dr Nicole Hope, at the recent World Congress of Human Reproduction. I got a bird’s eye view as I was the session chairman. I was delighted that Nicole was presenting an extensive analysis of this as over the last decade, there have been members of her unit that were using the Colorado protocol extensively.
Nicole’s study showed conclusively that various combinations of low dose aspirin, oestrogen, antibiotics, steroids or even the whole lot at once, has NO impact on the chance of IVF leading to pregnancy or reducing miscarriage. Equivalent people using NONE of these agents had the same chance of success. There was even some evidence of these supplemental agents doing some harm.
By the way, the talk after Nicole’s was delivered by a visiting researcher from Europe, where he showed that an extensive analysis of published papers showed no proven benefit from DHEA, but that’s a story we’ll do another time.
So, I’m now happy to formally announce the demise of the Colorado Protocol, and not before time. Please don’t ring me up and ask me if you can do it.