IVF TREATMENT PLAN
The stimulation protocol is called an “antagonist protocol”.
Our aim is to stimulate the ovaries to produce 8-10 eggs.
Eggs cannot be seen on scan. They grow within fluid filled sacs called follicles.
Some women may respond poorly and some too much. The response varies from person to person.
Please avoid intercourse during your treatment cycle.
You will be asked to inform the unit at the start of your period – (ie) day 1 of your period.
On day 2, you will need to have a baseline hormone blood test – FSH, LH and estradiol.
We will do a scan on day 2 and start stimulation with hormone injections after we confirm that your uterine lining is thin and there are no cysts in the ovaries.
The starting dose of Gonadotropin (hormone) injection will depend on your age, the number of follicles seen on day 2 and hormone test results and we will be decided by your doctor.
You will have hormone injections for 5 days continuously and on day 5 you will have a repeat blood test on an empty stomach. Our staff will tell you what time to come in. Your first scan after the start of treatment will be on day 6 and we will be able to tell you how your ovaries are responding.
Based on the blood tests and scan we will make necessary adjustments to your injection dosage.
From day 6, we may need to do scans very often, usually on alternate days and repeat blood tests when necessary.
We will start the next medication when the largest follicle reaches 14mm. This next injection is the “antagonist”.
This is given to prevent follicles from releasing the eggs spontaneously before we pick them up.
This will be given until the final day of stimulation.
We will give you injections for a total of 10-12 days.
When the follicles reach the correct size, we will give you another hormone injection which produces the final maturation of the eggs.
About 35 hours after the final injection we will do an egg pick up under anesthesia as outlined in the egg pick up instructions which we have provided to you.
After the egg pick up, we will be able to tell you how many eggs we have retrieved.
Your husband will need to provide us with a semen sample on the day of the egg pick up.
Your husband will need to masturbate and discard semen about 3 to 4 days before the intended egg pick up date.
We will start giving you vaginal progesterone gel to make your endometrium (uterine lining) ready to receive the embryos.
We will be able to tell you how many of these have fertilized on the following day.
We will be able to tell you how many embryos have divided and how good they are (ie) their grade – A, B or C.
We will transfer embryos on day 2, day 3 or on day 5.
Please read the embryo transfer instructions provided.
Egg Pick Up Instructions
You will be advised to come to the hospital on the night before the pick up if you live far away. Alternately, if you live nearby you could come to our centre at 7 am.
We will check your BP, temperature and pulse rate after your admission.
You will have to starve for at least 6 hours before the egg pick up. Please avoid water also.
Please have a shower in the morning and do not use powder/deodorant/perfume. (They can harm the eggs.)
Please remove all jewelry before the procedure.
Before the procedure, we will inset and IV cannula and start IV fluids.
You will also be given two injections to reduce stomach acidity.
Please make sure that you inform the nurse and doctor about allergies to medications.
Please make sure that your bladder is emptied just before the procedure.
The egg pick up will be done under light general anesthesia. This will enable you to wake up soon after the procedure is over.
The time taken to complete the procedure will depend on the number of eggs but usually does not take longer than 20 minutes.
You may have slight abdominal pain and minimal bleeding after the procedure.
If you have any other problems, please do not hesitate to inform us immediately.
You can have something to eat and drink about 4 hours after the procedure.
You will receive one dose of antibiotic after the procedure to prevent infection.
Bed rest is not required. It does not increase your chance of becoming pregnant.
Your embryo transfer will be done on day 2, day 3 or day 5.
The day will be decided upon by your clinician and embryologist who will discuss this with you.
We will be able to tell you how many embryos you have and their quality (Grade) before transfer.
We will also discuss about freezing extra embryos (if you have any).
Embryo transfer does not need anesthesia.
The procedure will be done in the operating theatre.
You will need to have a full bladder before the procedure.
Please do not use perfume/deodorant/power etc. because these are very harmful to embryos.
You will be expected to lie down for about fifteen minutes after the transfer.
You may empty your bladder after the procedure.
We will advise hormone tablets and a vaginal gel to be used after the embryo transfer.
You can go home whenever you wish after the embryo transfer.
We will do a beta HCG which is a blood pregnancy test about 16 days after the transfer.
You can resume your normal activities after the embryo transfer.
You do not need to rest in bed until your pregnancy test. This will not increase your chances of becoming pregnant.