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 can resume normal
activities. At 12 and 14 days later, Barbados Fertility Centre
will take a blood test to see if you are pregnant. If you are
not pregnant, we will review your cycle and discuss plans for
future treatment.
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 the embryos will be timed for two, or three
days after ovulation depending on the age and development of
your frozen embryos. On average 2 out of 3 embryos successfully
thaw.
On the day of transfer phone the clinic to check if the embryo/s
have survived the thawing process before being admitted to hospital.
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 embryo transfer. DO NOT stop the medication
unless instructed by a patient coordinator.
A pregnancy test will be performed approximately 14 days after
transfer. It is important that this test is performed even if
you experience bleeding suggestive of a period.
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.
On the day of transfer contact the clinic, an hour before the
procedure, to confirm that your embryo/s have survived the thawing
process.
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.
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