IVF programs typically take 31 days and involve ovulation suppression, egg stimulation, retrieval, embryo transfer, and a pregnancy test. Medications are used throughout, including FSH, HCG, and progesterone. The final stage is a blood pregnancy test taken 14 days after egg retrieval.
A typical in vitro fertilization (IVF) program takes approximately 31 days from administration of the first drug to a blood pregnancy test. There are many factors that influence each patient’s individual schedule, so a typical IVF program involves a patient who has a normal 28-day menstrual cycle and does not use birth control pills to regulate her cycle. Each program includes the use of medications to suppress ovulation, stimulate egg follicles, and encourage egg maturation; egg retrieval and embryo transfer procedures; and finally a pregnancy test.
The IVF program begins with a drug used to suppress ovulation so that the doctor can have control over ovulation to ensure a successful outcome to the IVF treatment. In the United States, a gonadotropin-releasing hormone agonist drug is used to achieve this goal; the type of medication might vary depending on the patient’s location. The drug is administered daily by subcutaneous injection. The ovulation suppressant drug is started during the last seven days of the patient’s menstrual cycle.
One day after the start of the new menstrual cycle, injections of follicle stimulating hormone (FSH) begin. The purpose of FSH is to stimulate the development of mature follicles with each follicle containing an egg. This is also a daily subcutaneous injection taken for eight days in combination with ovulation-suppressing medication. These eight days are known as pacing days, and several blood tests and ultrasounds are scheduled during this time. Blood is tested for appropriate estrogen levels, and transvaginal ultrasound measures the size of the egg follicles.
Day 16 of the IVF program includes the injection of human chorionic gonadotropin (HCG). HCG injection is used to help eggs reach maturity. This is also the last day of ovulation suppression and FSH injections.
Two days after the HCG injection, the egg retrieval procedure is administered. The patient is placed under heavy anesthesia and an ultrasound is used to guide a needle into the ovary and follicle. The follicular fluid is aspirated through the needle; the eggs detach from the follicle wall and are extracted from the ovary. Four hours later, sperm is added to the eggs and the eggs are observed to ensure fertilisation.
The day after the egg retrieval procedure, progesterone treatment is started. The treatment is given with daily injections or with the daily use of a vaginal cream. Progesterone is a female hormone that helps prepare the uterus for implantation of the embryo.
Embryo transfer is next on the IVF schedule, but the day the transfer takes place depends on whether it’s a three-day transfer or a five-day transfer. The length of time between egg retrieval and embryo transfer will depend on your doctor. The embryo transfer procedure does not require anesthesia. Under ultrasound guidance, an embryo transfer catheter is passed through the cervix into the uterus, and the embryos are transferred through the catheter to the uterine lining. The patient lies supine for one hour before returning home.
The final stage of the IVF program is the blood pregnancy test. The pregnancy test is expected approximately 14 days after the egg retrieval procedure. If the pregnancy test is positive, further follow-up steps will be taken to ensure a healthy pregnancy.
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