Although protocols can vary, typically the process is two weeks involving:
Some patients may additionally benefit from two weeks of hormonal preparation prior to beginning stimulation. The addition of these medications helps follicles grow at the same rate to optimize the number of eggs retrieved.
Our goal is to obtain the greatest numbers of healthy eggs from your ovaries. The eggs begin in a small “antral” follicle in your ovary. Ovarian stimulation gently prompts these follicles to grow or “mature” a cohort of eggs. You will follow this process and can see how we measure your follicles during your monitoring appointments, which are usually 20-30 minute morning visits leading up to your retrieval. Based on the growth of your follicles (assessed by ultrasound), and hormone levels (assessed by blood tests), we adjust your medications and time your final injection, the “trigger shot” which causes the eggs to complete maturation for retrieval.
Some patients report bloating and may feel tired from the hormones. These effects are usually well tolerated and do not require treatment. While the injections can cause minor irritation and discomfort, our patients make it through just fine. We’ll provide instructions and tips to make it easier.
During the retrieval, you’ll be under anesthesia for 20 minutes. Most patients wake up with minimal discomfort or cramping that does not require additional medication. For the few patients who experience more severe cramping, rarely do they need more than Tylenol.
The idea of giving yourself injections can be intimidating. While many people feel anxious the first or second time, hundreds of thousands of women have safely undergone hormone stimulation and find that they quickly get used to administering their own medications. Some patients have a friend or partner help with the injections. We also work with several nurses who offer home visits to administer nightly injections.
The night before, you’ll have a hearty dinner and then abstain from any food or drink after midnight. The morning of your retrieval, you’ll check in about an hour before the procedure. Your nurse will guide you over to the lab where you’ll change into a warm robe and place your belongings in a secure locker. You’ll meet the anesthesiologist and embryologist who will be caring for you and your eggs. Under their watchful eye, you’ll fall asleep under anesthesia, while our specialists aspirate your eggs using a very fine needle. 20 minutes later, you’ll awaken in our recovery area.
If a fresh semen sample is used, your partner will produce the sample while your eggs are being retrieved. Otherwise, we will thaw a frozen sample.
Our care team will be there to look after you and ply you with juice and snacks. Most patients walk out the door about 45 minutes later. Most patients take the rest of the day off to rest.
The transfer itself takes a few minutes and is not painful. The primary discomfort you may experience will likely be from having a full bladder. A full bladder will help your organs stay in the right place so our team can have the best images for transfer.
You’ll arrive early to change and get ready. There’s no anesthesia required, but we recommend Valium to minimize uterine contractions. You’ll watch us on a closed circuit television as we gently draw your embryo into a thin soft catheter for transfer. You’ll then watch by ultrasound as the embryos are returned to your uterus.