What should be avoided in IVF treatment
This is what the timing looks like
The causes are not always found so quickly that treatment can begin immediately. Each treatment must be carefully planned. IVF and ICSI treatments in particular require perfect timing. So if you think more in the medium and long term, you will avoid disappointment and frustration.
The IVF treatment consists of different phases, which we would like to describe to you below. Of course, every treatment is individually tailored to you. Therefore, there may be deviations from the procedure outlined here in individual cases.
In most cases, treatment begins in the second half of the cycle, before the actual start of stimulation. The administration of certain drugs, so-called GnRH analogues, temporarily reduces the body's own production of fertility hormones. We call this process down-regulation. This allows the stimulation cycle to be better controlled. A possible premature ovulation is prevented. In addition, the optimal time for triggering ovulation can be selected. This method has been in use worldwide for many years and has led to a significant decrease in the number of discontinued treatment cycles. Depending on the individual case, there are also other promising stimulation methods; in any case we will choose the best treatment for you.
You need to remember ...
After consulting your doctor, you should contact the practice by telephone at the beginning of the cycle and arrange an appointment for the down-regulation. Down-regulation is usually started between the 18th and 23rd day of the cycle (long protocol) in the previous cycle. Alternatively, a pill can be given in the pre-cycle to regulate the cycle. Please call the practice at the beginning of the stimulation cycle, even if the bleeding stops at the expected time. In order to check the success of the down-regulation, an ultrasound examination or a hormone determination is sometimes necessary.
The actual stimulation of the ovaries with follicle-stimulating hormone (FSH) usually begins on the third day of the cycle. Through the hormonal stimulation, we stimulate several follicles to grow, with the aim of obtaining several egg cells. This increases the chances of treatment. The stimulation lasts about 11 to 13 days. During this time, a certain amount of the hormone is injected every day. With modern stimulation medication used today, you or your partner can do it yourself if you want, instead of having to see a doctor every day.
You have to remember ... The medication must be injected daily, preferably in the evening before going to bed. After about 7 to 9 days of stimulation, we check egg cell maturation using ultrasound and hormones in the blood in order to find the best time to obtain mature, fertile egg cells.
Instructions for using the Puregon pen
Instructions for using the Gonal-F pen (video)
As soon as the tests show that the optimal time to induce ovulation has come, usually after 11 to 13 days of stimulation, the FSH treatment is discontinued. Ovulation is then triggered by a small syringe.
You need to remember ...
In the late evening the ovulation induction injection is "due". You can also inject this syringe under the skin yourself or have it injected by your partner.
35-37 hours later, i.e. the day after the trigger syringe, the follicles are usually obtained through the vagina with the help of ultrasound technology and a fine needle (follicle puncture). To make this procedure easier for you, you will be given either pain relievers and sedatives or a brief general anesthetic.
You need to remember ...
On the day of the puncture, please come to the practice with your partner on an empty stomach at the agreed time. Both partners should bring their identity card with them, as we are legally obliged to determine your identity on the day of the egg retrieval. Your partner will be asked to give a semen sample to the laboratory. Should there be any difficulties here, please speak to us openly. A way will be found that is acceptable to your partner. After the puncture, you will stay in the practice for about 1-2 hours and then you can go home. The next day, depending on the fertilization result, we will make an appointment for the embryo transfer with you by phone.
If at least one embryo has matured in the special nutrient fluid adapted to the human body in the IVF laboratory, it is transferred into the uterine cavity in a thin, flexible catheter. This transfer is generally painless. Two (maximum three) fertilized egg cells are transferred per transfer. You should decide together whether your husband will be present at the embryo transfer.
Yellow body phase / 2nd half of the cycle
Now the time of waiting begins, which is often difficult to bear because it can be associated with great inner tension and restlessness. Even if it is difficult, try to be calm and lead a "normal life". Physically, you should take it easy and avoid excessive temperature increases or circulatory stress; this includes saunas, hot tubs or intensive sunbathing and extreme sporting activities. The second half of the cycle is often medically supported either by hCG injections or by progesterone in the form of suppositories or injections. A pregnancy test will be performed two weeks after the embryo transfer. If this is positive and the period is still missing, an ultrasound examination will be carried out about three weeks later to clinically confirm the pregnancy.
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