To begin your infertility treatment, you will call us on the first day
of menses before your scheduled IVF cycle. On the third day, you will visit
our office for a blood test to determine your progesterone
level, an indicator of ovarian function. You will receive instructions to
begin taking a prenatal vitamin, as well as birth control pills and/or Lupron,
designed to "turn off" your body’s natural ovarian stimulation
process and synchronize your treatment. Whether you are taking Lupron alone,
or overlapping Lupron and the pill, your menstrual period should begin 7-10
days after the start of the Lupron injections. On Day 3 of your period, you
will visit us for evaluation and instructions to begin your stimulation
medications.
During a natural ovulation
cycle, a woman usually produces one egg each month. At various points in your
IVF cycle, you will take different prescribed hormones – your medication
protocol - designed to either suppress your own reproductive cycle, stimulate
your ovaries to produce multiple follicles and eggs, promote the ripening of
the mature eggs, or prepare your body for implantation and pregnancy.
Stimulation medications, called gonadotropins, are taken by subcutaneous
injection (under the skin) once or twice daily. They replace your natural follicle
stimulating hormone (FSH) to trigger a very precise, uniform stimulation.
If they are successful, the ovaries will produce multiple follicles and high
quality, mature eggs. Because these powerful hormones produce significant
changes in your system, their effects are tracked by blood tests and ultrasound.
Your hormone levels and follicular development are tracked throughout a
stimulation cycle. If required, your medication protocol (the type and dose)
may be altered for optimum results. When the follicles are mature, usually
between 16 and 20 millimeters in diameter depending on your stimulation
medication, you will take an intramuscular injection of hCG to prepare for egg retrieval.
A variety of medications are available and
your physician will choose the drug or combination of stimulation drugs that
are best in each case. They include:
Human Menopausal Gonadotropin (hMG:
Perganol, Humegon and Repronex) – stimulates the development of
multiple follicles and eggs during a cycle, hMG is derived from the urine of
post-menopausal women.
Follicle Stimulating Hormone (FSH:
Gonal F and Follistim) – stimulates development of the
fluid-filled sacks containing the eggs, this drug is available in a natural
form, derived from the urine of postmenopausal women, or as a
"recombinant" or manufactured drug.
Human Chorionic Gonadotropin (hCG:
Pregnyl, Profasi and Ovidrel) – produced by the placenta during
pregnancy and extracted from the urine of pregnant women, hCG
triggers ovulation, releasing the eggs.
During your stimulation cycle, the male partner will begin antibiotics to
protect against bacteria that may be present in semen. He also will be given
specific instructions for semen collection, or if appropriate, coordination of
microsurgical
sperm collection procedures.
For more information about infertility medications, visit the medications
page in our web site.
You will be required to visit our office, as
instructed, in the East Wing of Saint Barnabas Medical Center between 6:30 and
7:30 a.m. on weekdays and between 7 and 8 a.m. on weekends. This allows us to
track your progress and adjust your medications if necessary. The frequency of
these visits is every one to four days, depending on how you respond to the
drugs. Ultrasounds will track the number and size of your follicles, and blood
work will indicate estrogen levels, allowing the IVF team to determine when
your eggs are mature.
