good news, i don't have hiv or any other infectious diseases and my cystic fibrosis screening was negative. i was confused when i previously posted that we could start whenever we want, it actually does depend on my cycle. so, we have to wait approximately three weeks before we begin. i was bummed for a minute but now think it will be nice to have a few more weeks to prepare. i have posted the ivf calender from my doctor below, i am not sure if it will make things more or less confusing but its there for anyone who would like to take a look. omg, i am officially nervous.
IVF Calendar
• We often plan this calendar based on an estimated period start date. If your period is a few days early or late (and sometimes even a week early or late), this calendar will not change. We will let you know if it changes.
Getting “started!” Period start date: ~3-25
• Call or email your IVF coordinator with your period start date to confirm IVF cycle dates, schedule labs, etc.
•If you start on a weekend, please wait to call until the next business day.
•Please do not call the physician after normal office hours with a period start date!
• If you are considering PGD (embryo biopsy/genetic testing)…or Attain IVF through Integramed, you MUST let us know at this point. You CANNOT add it later in your cycle, it must be planned from the beginning.
• Take a home pregnancy test. Yes, we’re serious! It is actually quite common to mistake early pregnancy bleeding for a period. Unless you’ve had your tubes tied or removed, or your husband has had a vasectomy…humor us and take one before you start any medications. Thank you!
• You and your husband should start the Z-Paks (antibiotics): 2 days before HSG. Your husband’s prescription will be under his name at the pharmacy.
• Use a non-spermicidal condom throughout your IVF cycle to prevent accidental pregnancy (not necessary for tubal ligation or vasectomy patients).
• Continue taking or start taking a prenatal vitamin daily. It is also acceptable to take an over-the-counter multivitamin with 1-2 additional folic acid tablets.
Begin birth control pills:
• Please start birth control pills on day 1, 2, or 3 of your cycle; it doesn’t matter which day.
• Take one active pill daily until the stop date listed below. It doesn’t matter if you take them morning or night.
• Warning! You will likely take an odd number of pills; it may be more or less than one pack. You already have refills on your prescription at the pharmacy. Make sure you take only the ACTIVE pills, do NOT take the placebo / sugar pills! If you are scheduled for more than one pack, take the first 21 pills and then go straight into a new pack.
• Breakthrough bleeding is annoying but normal.
• If you have any questions about how to take pills, please let us know.
Uterus evaluation appointment: Mar 29, 31, or Apr 5 or 7, email Brandi to schedule
• Trial embryo catheter measurement
• HSG (hysterosalpingogram or dye x-ray)
• Check in at the main entrance of Overland Park Regional Medical Center at 7:00am. You can park at the main entrance...or you can also park at our building and just walk down the hall. It's not far from our office. Your doctor will then meet you in radiology to do the HSG and embryo catheter measurement (very crampy, but quick). Please eat something for breakfast, and take 800mg of ibuprofen at about 6:30am.
Getting closer! Begin the following medications on: 4-8
• Aspirin --Take one low-dose 80 or 81mg aspirin tablet once daily until 20 weeks of pregnancy. It does not matter what time of day you take it. Avoid additional aspirin-type products like ibuprofen, Excedrin, and Aleve. Tylenol products are OK to take for headaches or muscle aches.
• Dexamethasone --Take one dexamethasone tablet daily at bedtime, until your coordinator tells you to stop. It will be approximately 1 month.
• Lupron --Start taking Lupron (leuprolide acetate) injections daily.
• Draw up 10 units on the syringe.
• Administer in the abdomen or thigh.
• Give injection at the same time every evening (between 5-11pm).
• Do NOT stop taking Lupron until your coordinator tells you stop. It will be approximately 1 month.
• Even though the box says “14 days” and it looks like a tiny amount in the bottle…it will last for your
whole IVF cycle. You will need more needles than are in the box; the pharmacy should have given
them to you.
• Make sure you follow these instructions and NOT the dosing instructions on the box.
$ If you are doing Attain IVF through Integramed, your payment of _________is due TO Integramed by today.
Take your LAST birth control pill on: 4-13
• You will likely have another period in 2-6 days. You do not have to call.
Halfway there! Suppression appointment: 4-20 or 4-21 or 4-22
• This appointment will take approximately 1 hour. Your husband does not have to be present unless you choose.
• Report to the lab (Suite 125) for blood draw FIRST.
• You will then have an ultrasound (suppression scan) to confirm the ovaries are suppressed.
• Notarized consent forms are due. You have 2 stapled sets of consent forms, one set for IVF, one set for frozen/cryopreserved embryos. You must fill them both out, even if you don’t end up with any embryos to freeze. You can take them to a bank notary, or any notary that you know; or we usually have a notary here in our office and we can witness them if your spouse is with you today. The forms MUST be signed in front of a notary.
• Your IVF coordinator will review the next phase of your protocol, give you lots of new instructions, and order your injectable medications from a specialty mail-order pharmacy. The meds are usually shipped overnight and will arrive in time to begin stimulation. You should also receive a needle box from the pharmacy; you can return it to our office for disposal at the end of your cycle.
$ Payment is required today. MultiCycle Plan ___________, or Attain ___________ , or insurance __________.
Call or email Toni or Carol (Carol@RRC.com) with financial questions.
Time to make eggs!
• Stimulation shots (Gonal F, Follistim, other) to make eggs will begin approx: 4-25
• You will need blood draw in the morning to check estradiol (estrogen) level on approx: 4-27
• First office visit for a morning blood draw and scan to check the ovaries on:4-30.
• You will have ~1-3 additional scans to monitor follicle growth the following week. Usually on Monday and/or Tuesday: 5-3 / 5-4. These scans will determine the retrieval date.
Retrieve the eggs!
• Egg retrieval will be tentatively: 5-6 (give or take a day depending on follicle growth)
$ You will be instructed when it is time to pre-register and make payment to the hospital ($1000) and anesthesia ($440), or file to insurance per Carol’s instruction, if applicable.
• If you live more than 1 hour from our office, we ask that you stay in Kansas City the night before your retrieval (if you are late to retrieval due to traffic or weather, you could ovulate, and the eggs will be gone).
Embryo transfer!
• Embryo transfer will be 5 days after retrieval, tentatively: 5-11 (give or take a day based on retrieval date)
$ If you did PGD (genetic testing on the embryos, $1500 payment is due today, shipping will be billed to you later).
• You will need 2 days off work, the day of transfer and the day after, at home resting.
• Pregnancy test will be the week following embryo transfer (approx 8 LONG days later)!!
Good luck! Please follow these instructions very carefully.
Do not hesitate to ask questions…we are with you all the way!
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