In preparation for your Fertility Centre in Pakistan, birth control pills may be given in the cycle prior. Although this may seem counter-intuitive, taking birth control before beginning IVF could increase your odds of success while decreasing risks such as ovarian hyperstimulation syndrome or cysts.
Not every healthcare provider prescribes birth control pills prior to each cycle, instead asking you to track ovulation instead. They will likely recommend an ovulation predictor kit but may suggest basal body temperature charting instead if you’re experienced at charting cycles.
As soon as you recognize ovulation, notify your healthcare provider as soon as possible. After this has taken place, fertility clinics may prescribe GnRH antagonists or agonists such as Lupron for injection; there may also be nasal spray versions or implants available for purchase.
These medications allow your provider to have complete control over ovulation once your treatment cycle starts. If it doesn’t happen on its own, your provider may try another approach and prescribe progesterone – this would likely bring on your period sooner than otherwise.
Again, however, this may differ depending on your provider. Always follow their instructions.
IVF Treatment Cycle Your first official day of the IVF treatment cycle starts when you get your period. On day 2, a healthcare provider may order bloodwork and transvaginal ultrasound imaging tests.
These initial tests, known as baseline bloodwork and ultrasound exams, take place on day 1. Your healthcare provider will measure estrogen levels – specifically E2 or estradiol. This ensures your ovaries have taken restful sleep thanks to Lupron or GnRH antagonist injections.
An ultrasound examination will assess the size and shape of your ovaries. Your provider will look out for ovarian cysts; if any are discovered they will decide how best to deal with them – sometimes just postponing treatment until later (many cysts often resolve themselves over time); other times aspiration may be used (sucking out fluid from within a cyst with a needle).
Ovarian stimulation using fertility drugs is the next step, depending on your treatment protocol this could mean anything from one to four shots every day for up to 10 days – your clinic should teach you how to administer these injections prior to commencing IVF.
As part of ovarian stimulation, your provider will monitor the growth and development of your follicles. At first, this may involve bloodwork and ultrasounds every few days to track estradiol levels; then when monitoring oocyte growth (Oocytes are eggs in your ovaries).
Monitoring your cycle is extremely important to determine how your provider adjusts your medications; once your largest follicle reaches 16-18 mm in size, they’ll likely want to see you daily in their clinic.
For your IVF treatment to be successful, the final stage of maturation for your oocytes must occur successfully before they can be collected from storage for retrieval. In order for them to complete their growth and development before retrieval.
Human Chorionic Gonadotropin (hCG), commonly referred to by its brand names Ovidrel, Novarel, and Pregnyl is used to stimulate this final stage of ovulation growth. Timing this shot correctly is key; otherwise, the eggs won’t have matured enough and it won’t fertilize correctly. If given too early or late it could mean “old eggs” won’t fertilize properly either way.
Daily ultrasounds help in timing this trigger shot just right. Usually, when four or more follicles have grown to 18-20 mm in size and estradiol levels have reached approximately 1,250, an injection of hCG should be given.
Your Infertility Doctors in Lahore should give you an exact hour in which to administer this injection – be sure to follow their instructions!
At this stage, it has been assumed that the ovarian stimulation drugs have worked correctly; however, that may not always be the case; sometimes follicles do not form. Should this occur, healthcare providers may increase dosage; however, if your ovaries fail to respond, your cycle will likely be canceled.