| What
to Expect
All couples that come
to Barbados Fertility Centre are given an individual
treatment program according to the causes of their
infertility. Specific treatment options will be discussed
on an individual basis.
Key steps in a typical IVF cycle may include:
Follicle stimulation
Follicles are tiny sacs on the ovaries that contain
the eggs. By giving you injections, nasal sprays or
tablets, we increase the number of follicles that
"ripen" each menstrual cycle. This enables
us to collect and fertilise several eggs, thereby
giving you a better chance of achieving a pregnancy.
Timing your ovulation
Through blood tests and ultrasound we monitor the
growth of your follicles. When they are "mature",
an injection of hCG will be prescribed. This injection
stimulates the eggs to be released.
Egg collection
About 36 hours after the hCG injection, we collect
the eggs by inserting a fine needle into the ripe
follicles and aspirating the contents. The needle
is passed through the vaginal wall to the follicles
using ultrasound guidance. Only a light anaesthetic
is required.
Semen sample
Around the time your eggs are collected, your partner
will need to produce a semen sample.
Fertilisation procedure
If you are having standard IVF treatment, your eggs
are mixed with the sperm in a culture dish. If you
are having ICSI (intra cytoplasmic sperm injection)
one sperm is injected directly into the cytoplasm
of each egg. Following fertilisation, up to three
embryos will be transferred to your uterus using a
fine catheter.
Pregnancy test results
Once the embryos have been transferred, you will resume
light activities. Either 12 or 14 days later you will
take a pregnancy test and a Nurse from Barbados Fertility
Centre will call you to review the results.
Typical Treatment Cycles
Frozen Embryo Cycle
A treatment cycle in which frozen embryos are to be
thawed and transferred can be undertaken in several
different ways. The most traditional methods have
been to allow women to ovulate naturally or with Clomiphene
Citrate followed by the transfer of embryos when the
uterus is prepared to accept embryos.
Alternatively, Hormone Replacement
Therapy (HRT) can be used to prepare the uterus to
accept embryos. Our Fertility Specialist needs to
recommend what is appropriate for you.
Natural Cycle
The natural cycle method involves telephoning your
patient coordinator on the first working day after
Day 1 of your period.
Your patient coordinator will advise
you when to commence the Clearplan Urine Kit or daily
blood tests to detect ovulation. You will have an
ultrasound to confirm follicular development.
The transfer of your embryos will be
timed between 3 – 6 days after your positive
LH Surge depending on the development of your embryos.
On average 2 out of 3 embryos successfully thaw but
we have seen this rate increase substantially since
moving to Vitrification. 70% of our couples get 100%
survival rate with this technique. The embryos will
be transferred to the uterus in the same way as a
fresh transfer. You will be required to use progesterone
medication after your transfer. Do NOT stop this medication
unless instructed by your Nurse coordinator. Either
12 or 14 days later you will take a pregnancy test
and a Nurse from Barbados Fertility Centre will call
you to review the results.
Clomiphene Citrate Cycle
This type of cycle is the same as the Natural Cycle
above but with the addition of Clomiphene Citrate
as prescribed (usually Day 2 to Day 6).
Hormone Replacement Therapy (HRT)
Cycle
You will be asked to phone your patient
coordinator prior to your expected period when she
will explain the proposed treatment regime.
You will be required to use the Oral Contraceptive
Pill and Buserelin or Lupron followed by a blood test
similar to the Down Regulation phase of a Stimulated
Cycle.
If the result of the blood test is satisfactory,
you will commence taking oestrogen tablets morning
and night (Day 1 of cycle).
You will have two ultrasound appointments between
8 and 14 days after commencing the oestrogen tablets.
If the ultrasound result shows that
the lining of the uterus is adequately prepared you
will be advised to stop the Buserelin or Lupron, continue
oestrogen and commence Progesterone vaginal pessaries
and any other medications prescribed by your Fertility
Specialist. Your embryo transfer will take place in
two or three days' time. Continue to take all medications
as instructed until the result of your pregnancy test
is known.
The embryos will be transferred in the
same way as a fresh embryo transfer.
A pregnancy test will be performed 14
days after transfer. (The medications prescribed by
your Fertility Specialist may prevent a period even
if you are not pregnant.)
If the pregnancy test is POSITIVE the
medications will need to be continued until your Fertility
Specialist advises otherwise. If the result is NEGATIVE
the medications can stop. It is important that this
test is performed even if you experience bleeding
suggestive of a period. |