In Vitro Fertilization (IVF)
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Letrozole or Gonal F or Follistim
- Allows the ovaries to grow extra eggs
- Gonal-F and Follistim are refrigerated
Menopur
- Allows the ovaries to grow extra eggs
- Refrigerate after mixing
Omnitrope
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 1.14 ml of fluid (or all of the contents from the fluid vial).
- 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
Triggers:
Lupron, Novarel, Ovidrel or a combo!
- Injected to prepare the follicles for egg retrieval
- 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
Egg Aspiration
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
Egg & Sperm
ICSI (Inject Sperm Into Egg)
The Embryo Grows
Fertilized Egg = Embryo
Day 3 Embryos
Day 5/6 Embryos: Blastocysts
Assisted Hatching
- Taken orally, twice per day for 5 days
- Starting with your first meal after egg retrieval
- Take with meals!
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
Embryo Transfer
- Estrogen for 10 of days
- Once lining is ready, add IM Progesterone
- Also need antibiotic & prednisone
Embryo Transfer
Empty Bladder
Full Bladder
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:
- MDR: https://mdrmedcoach.com/
- Freedom Fertility: https://www.freedomfertility.com/resources-support/freedom-medteach/