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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