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Calendar
of a typical IVF Cycle Treatment |
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| How
a normal IVF Treatment cycle works is
explained here detailing the day of
starting of treatment, day of Blood
tests, Injections, Ultrasound examinations,
day of Egg Collection, Embryo transfer
etc., to let the patient know as to
how many visits she has to make and
the plan of treatment involved in a
normal case. |
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Starting of Down
Regulation |
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Day
-22 |
| Starting
of Down Regulation by GnRH aganist |
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If
all the required blood tests# have been
done, IVF patient's treatment starts
from the 22nd day of a menses cycle,
if it is a down regulated IVF cycle.
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GnRH agonist (GnRHa) injections are
to be injected s/c in the evening around
5-7 PM daily till the second day of
following menses for down regulation.
Other tablets are to be continued as
prescribed. |
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Starting
of Stimulation after Menses (Day 0) |
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Day
2 |
| Blood
Test U/S Scan Starting of Ovarian
Stimulation Continue GnRH a Injections
with less amount as required |
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Patient
reports on the second/third day of menses
in the morning for Blood test for (Estradiol
- E2 < 50pg/mL, Prolactin - PRL < 17
ng/mL) and also for Ultrasound examination
of ovaries to make sure that ovaries
are quiet without any cyst development.
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If the above tests are OK, she is
given Hormone Injections (FSH) to be administered
i/m every day in the evening. The same
dose is continued for about 5 days without
any break. Please remember that the
dose of GnRHa is normally reduced depending
upon patient's response. |
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Starting
of Stimulation after Menses (Day 0) |
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Day
7/8 |
| Blood
Test for E2 and U/S scan Above
Injections Continue |
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After
5 days of the above FSH injections,
we need to adjust the dose of the
this by checking the blood Estradiol
(E2)level and U/S scan of ovaries (how
many follicles) to either increase or
decrease the dose.
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So, patient reports in the morning to
give blood and reports again in the
evening for U/S scan. Dose is decided
accordingly for the next 3-4 days.
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Day
of Triggering with hCG |
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Day
10/12 |
| Blood
Test for E2 and U/S scan Above
Injections Continue hCG in the
night as instructed |
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At
this time many patients are almost
ready for another type of injection
called hCG (this will make the eggs
mature i-e to make the eggs ready
for fertilization). Patient reports
for blood test in the morning and
for U/S scan as well.
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Depending upon the results of the
above, time is fixed for triggering
injection (hCG)
in the night and egg collection date
and time is also fixed for Egg Collection.
This (hCG) injection should be given
around the fixed time only. After
hCG all the injections are stopped
and patient is asked to report with
overnight fasting for egg collection
(requires mild anaesthesia).
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Day of Egg
Collection |
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Day 12/14 |
Day of Egg Collection
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Husband to give sample of
Semen
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Day of IVF or ICSI
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Injections for preparation
of Uterus starts |
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Patient
should report at least 60 to 90 minutes
before the procedure with overnight
fasting as told. No blood test is
required on this day. Injections like
antibiotics etc., are given in preparation
for the procedure after she reports.
Egg Collection operation takes about
45 to 90 minutes to complete. Soon
after the operation, patient and her
husband are informed about the number
of eggs collected.
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Embryology lab will decide the
procedure of fertilization either by IVF or ICSI depending upon
the Husband's semen sample on that
day. Patient, after the operation,
can go home by evening to late evening.
She has to continue taking the new
injections for preparing her uterus
to be ready to receive her embryos
in 2-3 days.
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Result
of Fertilization |
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Day
13/15 |
| Injections
to continue Know the embryos available
Surplus embryos? |
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In
the morning after the day of Egg Collection,
the laboratory will confirm the result
of fertilization. If more than 10
embryos are available, surplus embryos
can be frozen-stored for future use
on this day.
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Day of Embryo Transfer (ET) |
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Day
15/17 |
| Day
of Embryo Transfer Come for ET
with full bladder |
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Normally, depending upon the
development and number of embryos
available, embryo transfer (ET) is
done either on Day 2 or Day 3 after
Egg collection.
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Decide the number of embryos to be
transferred taking into account the
various risk factors and report for ET
with preferably full bladder (to
enable the doctor to visualize the
uterus by U/S scan during ET).
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Day
of Embryo Transfer (ET) |
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The objective of producing and
transferring your embryos, out of your
gametes, has been achieved.
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Now the patient and her family will
eagerly await the result of our effort
for about 14 days. Meanwhile, all the
injections & other medications are to
continue and keep the hospital
informed of any changes.
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Day
of Pregnancy Test (bhCG) |
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Give
a sample of blood to know if you are
pregnant or not by quantitative bhCG
assay. In case, it is positive, we
can check once again in 48 hours to
know if the pregnancy is viable for
the moment or not by the doubling
level of bhCG.
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Two weeks from then U/S scan will
reveal the presence of a sac
indicating further viability of the
pregnancy. Invariably, all the IVF pregnancies require some form
of pregnancy support in the form of
either injection, gel, pessaries.
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