This overview summarizes some of the steps an IVF patient undergoes while undergoing an IVF cycle in our program at PFCLA.
After the initial visit with the physician and after all of the testing is completed, the patient is instructed to call with her period to start the IVF cycle. This initial phase can take up to 2-4 weeks to complete.Once the patient calls on the first day of her period, she is typically instructed to start taking birth control pills (BCP), one pill a day, and wait for instructions.
In about 7-10 days, the patient will receive a packet by mail or email, that contains all the information that she needs. At the same time, the Clinical Coordinator would have contacted her to arrange for the delivery of the medications that the patient will use. We can either send a prescription for all the medications or have an associated pharmacy ship all the medications with the syringes and needles.
Once the Calendar packet is with the patient, our office will contact her to make the necessary appointments. These usually include 3 initial appointments:
Calendar review and injection instruction appointment with a nurse. This can be done by telephone if the patient is not local.
A baseline ultrasound or Estradiol test prior to the start of the fertility hormones. Again can be done locally if the patient is not within reasonable driving distance from our office.
The patient is then discharged home an hour later. The day of the ER, the partner has to produce a semen sample. The sperm is washed and prepped and used to fertilize all the eggs on the same day, usually within 4-5 hours after retrieval. The number of eggs produced depends on many factors, including the patient age and her ovarian reserve. In general, women < 35, produce between 10-20 eggs. The younger the woman, the more eggs are produced. Women in their late 30s or early 40s, typically produced < 10 eggs. It is also important to understand that usually, the higher the number of eggs produced, the better the chances of pregnancy.
- Age of the patient producing the eggs
- The quality of the embryos at the hand
- Previous history of failed IVF cycles
- The desire of the patient for multiple births
The grading of embryos varies from one clinic to the next. In our program, we use two criteria to grade embryos:
- The number of cells
- The percentage of fragmentation
An embryo is formed when sperm and egg unite.
Therefore, when we evaluate an embryo, we would label it by its cell number and then it grading. For instance, an excellent embryo would be 8cell GI, a good embryo would be a 7 or 8 cell GII and a poor quality embryo would be any embryo that is less than 5 cells or with GIII grading.