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Infertility Evaluation
After this consultation, you will
need to have blood work done to evaluate your day 3 hormone levels, including
FSH, LH, and estrodial levels. The results of these tests will help your
doctor assess your level of ovarian function as well as to identify other
potential obstacles that may interfere with the IVF cycle. You may also need
a semen analysis, blood tests for infectious disease, and a hysterosalpingagram
(HSG) if these have not already been performed. We will help you coordinate
the testing in your own town.
Many patients are asked to start birth
control pills in anticipation of treatment. BC pills improve the timing and
egg development during your IVF cycle.
Additional Testing
Women who are over 38 will need an
additional test called the Clomid Challenge Test. This CCT test is performed
to give your doctor a preliminary indication of the ovaries response to
fertility medications. It can be done in your hometown. To perform the CCT,
blood will be drawn on Day 3 of your menstrual cycle to measure your FSH,
LH, and estrodial levels. Next, you will take 100mg of Clomid or Serophene
on menstrual cycle days 5-9, on day 10 the same hormone levels will be
evaluated again. The results will be faxed to our Center for interpretation.
One Day Visit
Next you will travel to Washington, DC for a
comprehensive one-day evaluation. You will meet with a nurse coordinator
for an extensive educational overview of IVF and the injectable medications
you’ll be using during your IVF cycle. You’ll also meet with your
doctor to review your evaluation, the treatment plan, and answer any questions
you may have. We will also perform a Mock Embry Transfer to evaluate the uterus
and diagnosis and problems prior to your cycle. Couple really benefit from this
one-day visit as it allow us to tailor the treatment plan to meet your specific
needs, maximizing your chances of success. You will also become familiar with
your medical care team and our facility before your IVF procedure.
Purchasing Medications
You will next be asked to purchase
the medication required during your IVF cycle. You can purchase the medication
form your local pharmacy or they can be sent to your from a discount mail order
pharmacy.
Initiating the IVF Cycle
Once your IVF cycle begins and you
start taking your medications, we will help you coordinate your medical care
with a local physician. This doctor will arrange early ultrasound and blood
work (usually referred to as monitoring) to monitor your response to the
fertility medications. These monitoring results will be faxed to us on the
day they are completed and evaluated by our physicians. You will receive a
call that afternoon from a nurse coordinator from our Center who will provide
you with medication instructions. Most patients from outside Washington, DC
can begin taking their fertility medications at home when using a local
physician is involved.
Egg Retrieval and Embryo Transfer
You will travel back to
Washington, DC approximately 4-6 days prior to egg retrieval. Final ultrasound
studies and blood hormone evaluation will be performed during this period to
pinpoint the exact time of optimal egg development. When your eggs are ready,
you will be scheduled for an egg retrieval in our own Joint Commission
accredited Surgical Center. Your husband/partner should be present on the day
of egg retrieval to provide a semen specimen that will be used to fertilize
the eggs.
Embryo Transfer
After 3-5 days of growth in the laboratory
following your egg retrieval, you will return to our Center for your embryo
transfer. Bed rest is necessary for 24 hours after embryo transfer and then
you can return home. At this time you will receive instruction about which
medications you may need to begin or continue taking. Our nurse coordinators
will work closely with you to provide as much advance notice as possible about
your travel dates. If you live close to Washington, DC, you may choose to return
home prior to the embryo transfer.
Pregnancy Test
Approximately 14 days after embryo transfer,
you will have a blood pregnancy test performed by your local doctor. These
tests will be sent to us the same day, so we can inform you of the results.
If you are pregnant we will continue to work with you and your local doctor
to coordinate the ultrasounds, lab work, and medications that are necessary
to maximize your chance of maintaining a successful pregnancy.
Traveling to Washington, DC
There is a wide range of
accommodations in the Washington, DC area to meet your travel needs. Many are
located only a short driving distance from our Center. These include hotels,
motels, and even suites with cooking facilities. The Washington, DC area is
known for its museums, fine restaurants, and other cultural activities…
so you will be able to find lots to do while you are visiting with us for
treatment.
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