In Vitro Fertilization (IVF)

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In-Vitro Fertilization

  • Use oral and/or injectable drugs to grow extra eggs​
  • Retrieve eggs with ultrasound guidance​
  • Fertilize in the Petri Dish​
  • Transfer embryo into uterus

Egg Retrieval

  • On day 1 of your menstrual cycle, call WFI to schedule your day 3 baseline visit ​
    • Day 1 consists of the first day of bright red, full flow​
    • Your day 3 baseline visit will consist of the following:​
      • Blood work ​
      • Transvaginal ultrasound

Letrozole or Gonal F or Follistim​

  • Injected days 3-14 of cycle in the lower abdomen​
  • Allows the ovaries to grow extra eggs​
  • Gonal-F and Follistim are refrigerated

Menopur

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  • 75-150 IU injected days 3-14 of cycle in the lower abdomen​
  • Allows the ovaries to grow extra eggs​
  • Refrigerate after mixing

Omnitrope

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  • Injected days 3-14 of cycle in the lower abdomen​
  • Allows the ovaries to grow extra eggs​
  • Gonal-F and Follistim are refrigerated

Omnitrope Mixing Instructions

  • Supplies
    • 5ml syringe
    • 18g 1½ inch needle
    • Insulin syringe with needle attached
    • Vial of powder
    • Vial of fluid
  • To Mix:
    • Use 5ml syringe and 18g needle to draw up all fluid.
    • Inject fluid into vial of powder. Gently swirl to mix.
    • With insulin syringe draw up 38 units of mixture for a subcutaneous injection.
    • Refrigerate after mixing.

Ganirelix or Cetrotide​​

  • Injected in the lower abdomen​
  • SAME EXACT time in the morning​
  • Stops early ovulation​
  • Cetrotide is refrigerated​

Novarel

  • ​Usually need to mix with 5 ml of diluent​
  • Injected in the lower abdomen​
  • Improves egg quality​
  • Can also be used for as a “trigger” medication​
  • Refrigerate after mixing ​

Novarel Mixing Instructions (low dose Hcg):

  • Supplies
    • 5ml syringe
    • 18g 1½ inch needle
    • Insulin syringe with needle attached
    • Vial of powder
    • Vial of fluid
  • To Mix:
    • Use 5ml syringe and 18g needle to draw up 5ml of fluid.
    • Inject fluid into vial of powder. Gently swirl to mix.
    • With insulin syringe draw up dose indicated on medication calendar for a subcutaneous injection.
    • Refrigerate after mixing.

Follicles Near Trigger Day

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Triggers:

Lupron, Novarel, Ovidrel or a combo!

leupron packaging
Novarel packaging
ovidrel packaging
  • ​Injected to prepare the follicles for egg retrieval​ (day 12 of the cycle)​
  • We will tell you how much to inject and EXACT timing​

Novarel Mixing Instructions (trigger):

  • Supplies
    • 5ml syringe
    • 18g 1½ inch needle
    • Syringe with subcutaneous needle attached
    • Vial of powder
    • Vial of fluid
  • To Mix:
    • Use 5ml syringe and 18g needle to draw up 1ml of fluid.
    • Inject fluid into vial of powder. Gently swirl to mix.
    • With separate syringe with subcutaneous needle attached draw up dose indicated on medication calendar for a subcutaneous injection

Cabergoline

  • Vaginally: once or twice per day, starting the night of trigger​
  • 8 days total
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Egg Aspiration

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Don’t worry, you are asleep and comfortable during this part!​

Antibiotics

  • Taken orally, twice per day for 5 days​
  • Starting with your first meal after egg retrieval​
  • Take with meals!

Egg

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Egg & Sperm

ICSI (Inject Sperm Into Egg)

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The Embryo Grows

Fertilized Egg = Embryo

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Day 3 Embryos

Day 5/6 Embryos: Blastocysts

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Assisted Hatching

  • Taken orally, twice per day for 5 days​
  • Starting with your first meal after egg retrieval​
  • Take with meals!
Screenshot 2023-04-24 at 10.54.55 AM

Pre-Implantation Genetic Screening/ Diagnosis

  • Look at chromosome number and XX or XY​
    • (Example: Down’s syndrome and gender)​
  •  Look at a single gene disorder​
    • (Example: Cystic Fibrosis)

Pre-Implantation Genetic Screening

  • Looks for normal chromosome number, ensures no extra pieces, & gender​

Pre-Implantation Genetic Diagnosis

  • Look for specific single gene defect​
    • Example: Cystic Fibrosis

Embyro Freezing

  • Happens on embryo day of life 3 or 5/6 after retrieval​
  • If doing genetic testing? Tissue removed then embryos frozen at WFI​
  • The next month, transfer happens

Embyro Transfer

  • On day 1 of your menstrual cycle, call WFI to schedule your day 3 baseline visit ​
    • Day 1 consists of the first day of bright red, full flow​
      • This will likely occur 5-10 days following your retrieval ​
  • Your day 3 baseline visit will consist of the following:​
    • Blood work ​
    • Transvaginal ultrasound ​
    • Mock embryo transfer ​
      • Please arrive with a full bladder for this appointment

Embryo Transfer

  • Estrogen for 10 of days​
  • Once lining is ready, add IM Progesterone​
  • Also need antibiotic & prednisone

Embryo Transfer

Empty Bladder

Full Bladder

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Full Bladder

Pregnancy Test

  • Blood test to confirm​
  • (Might repeat test each few days)​
  • Vaginal ultrasound for head count​

Nine Months Later:

Additional medication instructional videos can be found here:

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