Center for Assisted Reproduction

What to expect during an IVF cycle

By CARE Fertility on May 30, 2019

Dr. Kathy Doody with a patient

Starting an IVF cycle can be both exciting and nerve-wracking. Our team at CARE Fertility understands these emotions, and works to make sure our patients are comfortable throughout the entire process. For those new to IVF, here’s what to expect:

The first visit

At CARE Fertility, we schedule a visit to initiate the IVF cycle. This includes four different parts.

  1. A review of the patient’s IVF calendar so they can determine when their appointments are most likely to occur. It’s important to note that appointment dates may change depending upon patient response, but this visit will still provide you with a good overview.
  2. Written instructions regarding the dosing of medications. As the IVF cycle progresses, the patient’s dose will be given over the phone, after that day’s hormone tests are reviewed by the doctor.
  3. A mock or trial embryo transfer (if not done previously) so that the doctors have a measurement of the depth of the endometrial cavity.
  4. A meeting with one of our embryologists to answer questions and review information about what happens in the IVF lab on the day of retrieval, as well as the monitoring of the fertilized eggs over the next five days prior to embryo transfer. CARE Fertility takes pictures of the embryos on days 3 and 5, which are then shared with the patient when they come in for their transfer.

Medication

You’ll receive three different types of injections when progressing through your IVF cycle. They include:

  1. “Fertility injections” to increase the number of follicles. These medicines include Menopur, Gonal-F and Follistim. 
  2. Injections to prevent premature ovulation.
  3. A “trigger shot” of either hCG or Lupron, depending upon the type of stimulation. The majority of patients take this after 10 to 12 days of stimulation with the “fertility injections”.

All three of these injections are SQ, meaning they consist of a small needle that goes underneath the skin. We promise that they’re easy to give and relatively painless! You can visit Freedom MedTEACH for a more in-depth look at medications commonly used during IVF.

Multiple appointments

All IVF cycles will involve multiple appointments. You’ll be spending a lot of time with our team of fertility experts! Most of these appointments involve ultrasounds and blood tests to check hormone levels.

The number of visits varies depending upon the type of stimulation, which in turn is largely based upon the woman’s egg count. We’ll have a better idea of how many appointments you need once we get started.

Egg retrieval

The egg retrieval is scheduled 36 hours after the patient receives their trigger shot. The retrieval is done in the operating room with intravenous sedation by a board certified anesthesiologist. You will not be awake and will not feel pain. Dr. Kathy likes to call this a patient’s “morning margarita!”

The egg harvest typically takes about 10 minutes. The eggs are collected using ultrasound guidance. Afterward, the patient will be moved to recovery. If needed, pain medicine can be given.

After about 30 minutes in the recovery room,  the embryologist will review the number of eggs harvested and the sperm parameters with the patient or couple.

Semen sample

Collecting a semen sample on the day of retrieval can be anxiety-provoking for the man involved. This is why we recommend collecting a backup sample, which can be frozen prior to the start of the cycle. We’ll save you some extra stress this way!

Additional hormones

Patients will begin taking estrogen tablets and progesterone (most commonly taken vaginally) following the egg retrieval. This is continued until about nine weeks of pregnancy, if the cycle is successful.

Embryo transfer

Fresh embryo transfers are done on the fifth day after the egg harvest. Patients will take Valium about 30 minutes before their arrival. Though this is not a requirement, most patients find that it helps to decrease their feelings of stress and anxiety.

The embryo(s) are then transferred using a soft tube that is placed through the cervix and into the uterus. Don’t worry - this isn’t painful at all!

Patients will also need to arrive with a semi-full bladder. This allows our doctors to use a transabdominal ultrasound to visualize the placement of the embryo(s). It also straightens out the angle between the cervix and the uterus, allowing the soft tube to enter the uterus more easily.

The patient can empty her bladder immediately after the transfer - once the embryologist has flushed the transfer catheter under the microscope in the lab to ensure the embryo was released. We won’t make you hold it for too long!

Patients can then return to work and normal activity the day after embryo transfer.

The importance of self-care

Throughout the entire IVF process, we encourage our patients to focus on self-care. Now more than ever, it’s important to pay attention to yourself, and be honest about what you need during this time. 

Curious for some ideas on how to practice self-care? This blog post outlines it all.

A few things to remember

If you’re new to IVF, you probably have a lot of questions - and that’s okay! It’s important for patients to make sure they have asked all of their questions before we begin. Our team wants you to feel comfortable with what you’re about to embark on.

We’re also often asked about privacy when it comes to an IVF cycle. The truth is, it’s completely up to each patient. Some want to keep their cycle private, and others want to share. We encourage you to do what you’re most comfortable with, whether it’s telling all of your friends and family or none.

There’s a lot you can’t control when it comes to an IVF cycle, but you can control who you share this experience with. 

And remember: our team at CARE Fertility is here to answer your questions and make things as easy for you as we can. Don’t hesitate to contact us with any questions or concerns!

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