Brief synopsis of what happens during an ivf cycle

This Is What Happens During IVF Treatment:

 Birth Control Pills Phase

 This is the first possible phase, it lasts for approximately 14-21 days. At the beginning of your IVF cycle you may be on birth control pills for this 2 to 3 week period of time.

Down Regulation Phase

The aim of the medications during this phase is to calm down your ovarian function. The down regulation medications work by suppressing the production of hormones from the pituitary gland. You may be on a nasal spray of Synarel/Lupron or Buserelin for approximately 10-15 days. You will usually begin these medications at around day 21 of your menstrual cycle or 7 days post LH surge.

Side effects: Some women experience side effects such as headaches, night sweats, irritability, feelings of depression.

Baseline Ultrasound and Blood Test

This is usually about an hour appointment. You will be be asked to go to the IVF clinic for an ultrasound examination and blood test for your estradiol value. If these test results are in the normal range, you will be cleared to enter into the next phase of your IVF cycle: Stimulation.

Stimulation Phase

This phase of the IVF cycle lasts for approximately 10-12 days. You will begin Gonadotropin injections. The purpose of administering gonadotropin is to stimulate the ovaries to produce more than one egg. Bravelle, Repronex, Pergonal (hMG), Follistim and Gonal-F (FSH) are some of the medications given as an injection once or twice a day to recruit multiple eggs which develop inside follicles. You will also be given another injection ( such as Antagon and Cetrotide) to prevent a premature release of the stimulated eggs before the egg retrieval procedure. After reviewing your blood test results, your physician will determine (on or about the 6th through 8th day of gonadotropin injections) when to begin Antagon or Cetrotide injections. During this stimulation phase you will probably be asked back to the IVF clinic several times for vaginal ultrasound scans. These scans track how many follicles are developing as well as the thickness of your uterine lining. These scans are valuable because it gives the IVF clinic information on how things are progressing for you and they may change your medication levels accordingly, tweaking and fine tuning the medications to get the desired results.

Side effects:  some women experience breast tenderness, abdominal distention and skin irritation (at the site of the injection).

Risk: Occasionally the ovaries are over stimulated and there is a risk of developing OHSS-Ovarian Hyper Stimulation Syndrome. This when there are a large number of follicles present and the ovaries might possibly enlarge and release chemicals into the bloodstream that make blood vessels leak fluid into the body. OHSS can be classified as Mild, Moderate or Severe.  Most instances are mild or moderate with the enlarged ovaries developing cysts and fluid filling up the abdominal cavity. Your IVF cycle may be cancelled.  The most severe occurs in only 1%-1.5% and requires in hospitalisation and treatment to recover, (symptoms are nausea, vomiting, abdominal distention and pain, breathlessness, feeling weak, reduced urine output, heartburn or indigestion).

Trigger Shot

Once the IVF clinic has determined that you are ready for the next phase of the IVF cycle (egg retrieval /egg collection), you will take an injection of hCG (Pregnyl, Novarel). This injection is usually administered late in the evening, approximately 37 hours prior to egg retrieval. This medication “ripens”/ “matures” the developing eggs and initiates the ovulation process. If you were to not have the egg retrieval procedure then ovulation would occur about 42 to 48 hours from the time of your injection. Many women can experience abdominal discomfort after the injection of hCG and may be worried that they are ovulating. However, this discomfort is due to ovarian enlargement because of the stimulation medications.  You can rest assured that your clinic is monitoring you very closely and the chance of you ovulating prior to egg collection is extremely slim, and almost zero if you are receiving the medication to prohibit ovulation such as Lupron, Synarel, Antagon or Cetrotide.

 Egg Retrieval/ Egg Collection

This procedure is usually performed 36-37 hours after you take the trigger shot of hCG. Before the egg collection procedure you may receive small doses of medication given intravenously, which will make you feel relaxed and sleepy during the procedure. During the procedure your eggs will be retrieved with a needle inserted through the vaginal wall under the visual guidance of ultrasound. No abdominal incisions are required. Your partner will be asked to provide a semen specimen either before or immediately after the time of your egg collection procedure.

Side effects: Following this egg retrieval procedure you may experience some pelvic area tenderness and feel tired or sleepy from the medications you have received during the procedure. You may also experience some light vaginal spotting. This bleeding may be red to brown in color and should be scanty. The medications given during your egg retrieval to calm you may not be eliminated by your body for up to 24 hours, so you may feel “hung over” or just not your normal self for a little while afterwards.

Risk: Pelvic infection 

Fertilisation and Incubation

This can last from 3-5 days after egg retrieval.  This is the time when sperm is introduced to the egg/s and fertilisation should occur to create embryos.  The resulting embryos are put into an incubator to develop and grow for 3 to 5 days.

The lack of control and lack of information at this time can be very stressful for couples as they will not know how things are progressing and their embryos are in the care of someone else, in another location. 

Embryo Transfer and Embryo Freezing

This procedure is usually performed 3-5 days after egg retrieval.  The best quality embryos are chosen by the Embryologist to be transferred back in to your womb.  Usually 2 embryos is the maximum number that will be returned to your womb.  If you have more than 2 embryos the “extra” embryos will be allowed to progress to a state that is desirable for freezing.  Embryos can be frozen so that they can be transferred back in to you at another date during another IVF cycle.

This can be a very exciting day for couples to have reached this point of Embryo Transfer.

The Two Week Wait ( 2WW )

This is the time period after embryo transfer and before your pregnancy test. It may not be a full 2 weeks, the amount of days waiting depends on how many days your embryo was transferred back after egg collection. You may be prescribed progesterone for this time period.

This again can be a very stressful time for couples as they do not know if their embryo/s are implanting.

IVF success rates: About 1 in 3 IVF cycles are successful and result in pregnancy. Factors such as age, pre-existing conditions like PCOS or low AMH or high FSH or sperm issues can have an impact on your chances of success.

Pregnancy Test

This is usually performed about 14 days after retrieval, the timing of the test depends on how many days after egg collection your embryo was transferred back. Depending on the medication you are on, you may need a blood test instead of a urine test to confirm whether or not you are pregnant.

Source Link: http://www.fertilityacupuncture.ie/fertility-information/brief-synopsis-of-what-happens-during-an-ivf-cycle/