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IVF Standard Lupron


 

Patient Education

Medically reviewed by Dr. David H. Barad - Written by CHR Staff - Updated on Oct 04, 2018

Pre-Cycle Training

In Vitro Fertilization (IVF) Fresh Cycle, Using Standard Lupron Protocol

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 IUI you will be going through, print this page for future reference, then please complete the Completion/Question Form.

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.

1. 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 an 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 on IVF, you can continue on to read about IVF.

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.

3. Informed Consents

Typically, your initial consultation with a physician determines the type of treatment you will be undergoing. (Some patients may not have a formal treatment plan until they have their follow-up consultation to review some information that was unavailable at the time of the initial consulstation.). Once you and your physician determine the type of treatment for you, you will receive a packet of informed consent forms from your clinical coordinator. CHR's comprehensive informed consent for IVF is also posted below.

All signed informed consent documents are required prior to any procedures performed at CHR. Please read through the informed consent forms you receive 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 to go over the consent forms.

If applicable, your partner will also have to sign the consent forms. If you are siging the forms outside of CHR without a CHR employee to witness your signature, consent forms need to be notarized.

Download the Comprehensive Informed Consent for IVF, ICSI, AZH and Embryo Cryopreservation.

4. Billing Clearance

A full payment for your treatment cycle is also due at this time. Our front desk staff can help you with cost questions and payment. With pre-cycle checklist completed (or waivers signed), informed consent forms executed and billing clearance in place, you are ready to start your cycle.

5. 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

Standard Lupron Cycles

 

STEPS

0

Before your treatment cycle

  • Complete the pre-cycle checklist.
  • Review the informed consent forms, ask your coordinator any questions and sign the informed consent forms. (The forms need to be notarized unless you sign the forms in front of a CHR employee.)
  • Get billing clearance.

1

10 days before the start of your next period

  • Visit CHR for a blood test and ultrasound to confirm that you have ovulated. If you don't have regular menstrual cycles, we will give you specific instructions.
  • Start Lupron injections (see the medication list for more detail).

2

Day 1 of your next period

  • If your menstrual period does not start within two weeks of the start of your Lupron injections, please call us ASAP.
  • Call 212-994-4400 to make an appointment for baseline tests (ultrasound and blood work) the next day.

3

Day 2 or 3 of your next period in the morning:

  • Visit CHR for baseline ultrasound and blood work.
  • You will meet with your nurse coordinator to go over the medications. We call this a "Teach."

4

Later the same day:

  • When the results of your morning tests are available, your physician will determine the dosage of medications you will use.

5

Day 7 of your cycle (After 5 days of hMG and FSH injections)

  • Visit CHR for ultrasound and blood work.
  • After this day, your physician will adjust the dosage depending on your response to the medications.

6

6-10 days after the start of FSH and hMG

  • You will visit CHR one or more times (as instructed), for monitoring (blood work and ultrasound).

7

8-14 days after the start of FSH and hMG

  • You will be instructed to trigger ovulation with an hCG injection (see the medication list for more detail). It is crucial that you administer this injection at the precise time that your nurse coordinator instructed you.

8

Approximately 34 hours after hCG injection

  • Visit CHR one hour before the scheduled time for egg retrieval.
  • Your husband (who will accompany you) will produce semen sample.
  • Your eggs will be retrieved through ultrasound-guided needles.
  • Retrieved eggs will be fertilized with the semen sample.
  • Appointment for embryo transfer is given at this time.
  • You will need to rest for 1-2 hours at CHR, then 2 days at home.
  • Start Prometrium capsules twice daily (in your vagina).

9

3 days after egg retrieval

  • Visit CHR for embryo transfer at the scheduled time, usually between 10 am and 2 pm.
  • You will need to be accompanied by your partner or friend.
  • Embryos will be transferred to your uterus through a catheter.
  • You will need to rest for 1 hour at CHR, then 2 days at home.
  • Appointment for pregnancy test, two weeks later, is given at this time.
  • Start Progesterone injections today.
  • Continue Prometrium and start Estrace pills (both vaginally) today.

10

14 days after the embryo transfer

  • Visit CHR for pregnancy test.

Pre-cycle checklist and medication list

Read More →

 

Location
Center for Human Reproduction
21 E 69th Street
Upper East Side

New York, NY 10021
Phone: 626-385-7918
Fax: 212-994-4499
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626-385-7918