After all the items on your IVF checklist are complete, your fertility coordinator will send in your prescription, and create a calendar that outlines the individual stimulation protocol developed by your physician. The calendar dating is based on your menstrual cycle start, and includes a schedule of medications and appointments for your IVF cycle. Your coordinator will send the calendar through SRM’s secure patient portal and will review your individual protocol and medications with you.
We want to provide you with the best chance for success and part of this process is injection training. During the injection class you will participate in a hands-on injection technique demonstration. This is part of your checklist.
Suppression Check and Cycle Start
Your suppression check appointment may include a blood draw and/or an ultrasound, depending on your individual treatment plan. If your protocol includes an ultrasound, the sonographer or provider will measure your uterine lining and check your ovaries for any follicles or possible cysts. You will also meet with a fertility coordinator, who will further review your calendar and provide instructions for medications, monitoring appointments, and possible egg retrieval and embryo transfer dates.
As your IVF cycle proceeds, you will need to schedule morning monitoring appointments as instructed, which include both blood work and ultrasounds. Further monitoring appointments are ordered as needed, and you will receive a call or portal message after each appointment with instructions.
Egg Retrieval and Sperm Collection
Once you are ready for egg recovery as determined by an SRM physician, you will be given another medication (hCG or Lupron) exactly 36 hours prior to egg retrieval. This medication will bring the eggs to final maturity. Egg retrieval involves the use of an ultrasound-guided needle to gently remove the eggs from the ovaries. You will be asleep (IV anesthesia) during the procedure and should experience little or no discomfort. Your partner or donor sperm is collected on the day of egg retrieval.
Fertilization and Development of the Embryos
After the egg retrieval, the embryologist prepares the eggs with the sperm in the laboratory. You will receive a preliminary report regarding the number of eggs retrieved by the physician prior to leaving the center that day. The following day, we will call you to discuss how many eggs were fertilized.
Embryo transfer will take place 3–5 days after your egg retrieval. On the day of your embryo transfer, the SRM physician will share the final embryology report and, typically, will recommend transferring 1 or 2 embryos. The embryos are then transferred through the cervix into the uterus via a small catheter with ultrasound guidance.
Two weeks after egg retrieval, you will return to SRM for a blood pregnancy test, called a quantitative hCG. If pregnant, SRM will have you repeat this blood test, followed by one or more ultrasounds, before referring you to an obstetrician for ongoing care. If your pregnancy test is positive, you will continue the hormone medications for 6 more weeks in order to support early pregnancy.