Patient Education
Patient Education: In Vitro Fertilization (IVF) Fresh Cycle, Using Standard Lupron Protocol
CHR's patient education for IVF with Standard Lupron consists of the following components:
- What is an IVF? - a brief description of the procedure
- Pre-cycle checklist - a list of pre-cycle tests and preparations
- Timeline of IVF at CHR - what needs to be done and when
- Medications - pharmaceutical company's instructions and information on medications used
- Consent Forms
- FAQs
- Completion/Question Form - let CHR know you've read it, and ask questions
Please read each item carefully, and make a list of questions you might want to ask. This way, you will be more prepared when you meet with your nurse coordinator for your training session. When you are unsure about something along the way, you can always come back to this page to refresh your memory.
Every cycle stimulation may have to be individualized and, therefore, may end up deviating from the here described routine. Please always follow the instructions, given by the CHR staff. When in doubt, call CHR at 212-994-4400, rather than taking the wrong step. Our staff is available for inquiries 24 hours a day, 7 days a week.
Once you have read through all the relevant material according to the type of IVF you will be going through, please complete the Completion/Question Form.
1. What is IVF?
IVF is a procedure that can offer women who have blocked or absent fallopian tubes or men with low sperm counts a chance of parenthood. In an IVF cycle, you will take hormone injections/medications to encourage your ovaries to produce more than one mature egg. You will be closely monitored using ultrasound and blood tests while you take your medications to determine when your eggs are mature. Once your doctors have determined that your eggs are almost ready, you will use additional medication to allow their full development and your retrieval will be scheduled. Retrieval is a short in-office procedure for which you will be given light sedation. After your eggs are retrieved, they will be mixed with sperm (inseminated). The following day, our embryologists will check to see if the eggs accepted the sperm and are fertilized. Three to five days later, some of the resulting embryos will be placed in your uterus (embryo transfer), bypassing the fallopian tubes. Two weeks after the embryo transfer, you will find out if you have achieved pregnancy by having a blood test for pregnancy.
OPTIONAL: If you need more general information for IVF, you can continue on to read about IVF. (A new window or tab will open.)
2. Pre-Cycle Checklist
A series of tests are required before an IVF cycle can take place, on both female and male partners. You should discuss your specific checklist requirements with your clinical-coordinator who will be responsible for guiding through this process.
Download the Pre-Cycle Checklist. (A downloadable PDF will open in a new window or tab.)
3. Timeline of IVF Using Standard Lupron Protocol
After the initial consultation with a physician (which determines the type of treatment you will be undergoing), you will need to complete all the required pre-cycle tests (please refer to the Pre-Cycle Checklist). After this step is complete, you will be ready to start your cycle. After your checklist is complete and before starting a cycle of treatment, you should carefully review the material on this web page and schedule an appointment with one of our clinical nurse coordinators to review instructions for preparing and injecting your medications, in a step we call a "Teach."
This appointment will be an opportunity for you to address any questions that you may have after studying the information provided on this page. For this appointment, please bring a copy of the completed questionnaire provided at the end of this material. This visit will also provide an opportunity for you to receive necessary prescriptions and to initiate any required pre-authorization from your insurance carrier, if applicable.
At CHR, if you are using a "Standard Lupron Protocol," you will return for a blood test and sonogram about 10 days before your next anticipated menstrual period (about day 18 to 19 of a normal 28 day cycle). If your tests confirm that you have ovulated, you will begin using Lupron (see the medication list for more detail).
| Standard Lupron Cycles | ||
Click on the image for a larger version of the cycle card.  | ||
| Step 1 | 10 days before your next period |
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| Step 2 | Day 1 of your next period |
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| Step 3 | Day 2 or 3of your next period in the in the morning: |
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| Step 4 | Later the same day: |
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| Step 5 | Day 7 of your cycle (After 5 days of hMG and FSH injections) |
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| Step 6 | 6-10 days after the start of FSH and hMG |
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| Step 7 | 8-14 days after the start of FSH and hMG |
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| Step 8 | Approximately 34 hours after hCG injection |
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| Step 9 | 3 days after egg retrieval |
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| Step 10 | 14 days after the embryo transfer |
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4. Medications
For IVF cycles using the Standard Lupron Protocol, there are five main medications. The five main medications are followed by six support medications that you may be instructed to take. Brand names of the medications you use will vary, so we've listed the generic name on the left-hand column, with general information on each medication at the top of the right-hand columns. For usage instructions of the specific brand-name medication you will be using, click on the icons below (
& 
).
| Leuprolide Acetate | In IVF cycles, Leuprolide Acetate (often called Lupron, even though it's a brand name--a bit like Band Aid and Hoover) is used to prevent premature ovulation. Because Leuprolide Acetate does this by suppressing the estrogen production in your body, you will need Follicle Stimulating Hormone (FHS) and/or Human Menopausal Gonadotropin (hMG) to encourage follicular development.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Lupron | |
N/A | |
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Follicle Stimulating Hormone (FSH) |
Follicle Stimulating Hormone (FSH) is used in IVF cycles to stimulate your ovaries to produce multiple mature eggs.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Bravelle® | N/A | |
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| Follistim® | |
N/A | |
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| Gonal-f® | |
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Human Menopausal Gonadotropin (hMG) | hMG contains natural follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In IVF cycles, hMG is used to regulate ovulation and encourage growth of multiple eggs when clomiphene citrate did not work well.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Repronex® | |
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| Menopur® | N/A | |
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| Human Chorionic Gonadotropin (hCG) | hCG is similar to LH. In an IVF cycle, one-time injection of hCG is used to trigger ovulation to get your mature eggs ready for insemination. You should wait until you are instructed specifically to administer this injection.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Novarel™ | N/A |
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| Pregnyl | N/A | N/A | |
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| Profasi | N/A |
N/A |
N/A | |
| Ovidrel® | | | | |
| Progesterone | Progesterone is used to thicken your endometrium (lining of the uterus) so that the implantation of fertilized egg(s) will be easier. Medications used in ovarian stimulation can suppress progesterone levels in your body, so it is important to supplement it with exogenous progesterone. You will be taking both Progesterone injections and Prometrium vaginally.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Prometrium® | |
N/A | |
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| Progesterone | |
N/A | N/A | |
| Micronized Estradiol | Micronized estradiol helps maintain and build your uterine lining so that the transferred embryos will find a comfortable environment there.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Estrace | N/A | N/A | |
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| Micronized DHEA | DHEA improvers the quality of eggs and embryos.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| FERTINATAL® | | N/A | N/A | |
| Baby Aspirin | Aspirin helps increases blood supply to your uterus and ovary. It also prevents clotting.
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| Prenatal Vitamins | Prenatal vitamins, such as Folate, will help prevent neural tube defects. Iron will build up your blood count. Calcium helps build your babies' bones and will help you maintain yours.
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| Prednisone | Prednisone suppresses male hormones and immune function.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Prednisone | N/A | N/A | |
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| Doxycycline | Doxycycline is an antibiotic used to prevent infection after the egg retrieval.
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5. Consent Forms
All signed informed consent documents are required prior to any procedures performed at CHR. Please read through the following informed consent forms according to your planned treatment(s) so that you are well informed by the time you meet with your nurse coordinator for further explanation and signing of the form(s). You should NOT sign the consent form(s) until you meet with your nurse coordinator.
- Download the Affirmation of Sexual Intimacy Form.
- Download the Comprehehsive Informed Consent for IVF, ICSI, AZH and Embryo Cryopreservation.
If you are using donor sperm:
- Download the Informed Consent for Sperm Donor Inseminaton.
6. FAQs
What is IVF?
-- IVF is a procedure that can offer a chance of parenthood to women who have blocked or absent fallopian tubes, or men with low sperm counts. In an IVF cycle, you will take hormone injections/medications to encourage your ovaries to produce more than one mature egg. You will be closely monitored using ultrasound and blood tests while you take your medications to determine when your eggs are mature. Once your doctors have determined that your eggs are almost ready, you will use additional medication to allow their full development and your retrieval will be scheduled. Retrieval is a short in-office procedure for which you will be given light sedation. After your eggs are retrieved, they will be mixed with sperm (inseminated). The following day, our embryologists will check to see if the eggs accepted the sperm and are fertilized. Three to five days later, some of the resulting embryos will be placed in your uterus (embryo transfer), bypassing the fallopian tubes. Two weeks after the embryo transfer, you will find out if you have achieved pregnancy by having a blood test for pregnancy.
Why am I using the Standard Lupron protocol?
-- If you are a woman with evidence of normal ovarian function, then you will most likely use standard Lupron. Lupron is a injectable medication which will protect you from ovulating until your eggs are mature.
How long will my standard Lupron cycle take from start to finish?
-- In most cases, you will begin using Lupron about 8 to 10 days before your next menstrual period (see Timeline section above). Your ovulation induction will begin on the second day of your menstrual cycle with additional injectable medications. From the time you begin the additional medications until your egg retrieval, it will be 8 to 14 days. Your embryo transfer will occur 3 to 5 days after your retrieval. Thus, from the time you begin using Lupron until the time of your transfer, it will be about 4 to 5 weeks.
How many visits should I expect to make?
-- Approximately 5-8 visits.
What if my husband/partner will be out of town during the treatment?
-- We can freeze his sperm for back-up, in case he is not in town on the day of your IVF procedure. If he turns out to be in town on the day of the procedure, he can always provide fresh sample.
What are the most common side effects of the hormone medications?
-- Symptoms similar to PMS (Premenstrual Syndrome) are the most common. You may experience bloating, mood swings, cramping and headache. It is okay to take Tylenol as needed. Symptoms from these medications may continue for up to two weeks after your last dose. In fact, some women continue to experience symptoms for the first few weeks of pregnancy.
7. Completion/Question Form
For future reference, we recommend printing this page (a printer-friendly version is here. Please click here for the Completion/Question Form where you will be asked to answer a few questions on this IVF training material, as well as have an opportunity to ask additional questions, if you have any. After you have submitted the Completion/Question Form, you will be asked to print out a certificate, so that you can bring it in with you the next time you have an appointment with CHR.
Written by David Barad, MD
Last updated: April 9, 2013
