This is the page linked from the third circle image on the front page.

This page is dedicated to supporting you while you are going through an IVF treatment cycle. It lays out the IVF treatment process, step by step, for the different IVF treatment plans (also called ‘protocols’). It explains what we do at each step, why we do it, and what you can expect in terms of outcomes and potential adverse effects; this means you will be fully armed with the knowledge to help you through a typical IVF cycle. For the three commonest protocols (long protocol, short antagonist and short agonist protocol) we provide our unique ‘IVF calendar’, the app that allows you to estimate your expected date of egg collection, embryo transfer and pregnancy test date. Sometimes certain steps in your IVF plan take a little longer than anticipated; that is no problem! You can move the date adjuster slider on the IVF calendar to take account of this. Please note that the advice on our pages and information from our IVF calendar are for general guidance only. Your IVF clinic will tell you what IVF protocol is planned for you and any tweaks they have made considering your specific circumstances. You should not rely on our IVF calendar to help you with treatment decisions, that is when to take medicines, but obtain specific information from your clinic.

So, let’s look at the steps of a typical IVF (or ICSI) treatment cycle.

Treatment start

The start of the treatment will normally depend on the treatment ‘protocol’ (a fancy name for your specific treatment plan!) as well as the first day of the menstrual cycle in which your treatment is scheduled to start. Our IVF calendar can help calculate treatment start date and other key event dates, but you must ensure you have selected the correct treatment protocol with the help of your IVF clinic.

If you don’t have regular menstrual bleeds, your IVF clinic will let you know when you should start the treatment.

Down-regulation or pituitary suppression

Down-regulation, also known as pituitary suppression, is given to ensure that you don’t release the eggs too early before the actual date of egg collection. Down-regulation can be achieved with a GnRH agonist injection (e.g. Buserelin) or a GnRH antagonist injection (e.g. Cetrotide). The injections are normally given daily.

You will have a scan to confirm that you have achieved down-regulation (when the lining of the womb is expected to be thin and the ovaries to be inactive without any large follicles). You may also have an oestrogen blood test to confirm down-regulation.

<add something very brief about what to do if not down-regulated; side effects; how to manage them> Abey, please help.

Ovarian stimulation

Stimulation medicines are given to stimulate your ovaries to produce many follicles, which are fluid filled sacs containing eggs. All stimulation medicines contain the hormone, FSH, which stands for Follicle Stimulating Hormone. There are many different stimulation medicines, including Menopur, Gonal F, Meriofert, Follitropin and Bemfola. Sometimes your doctors may suggest using a combination of these medicines. These injections are normally given daily.

During the stimulation phase you will have several scans to ensure the follicles are growing and the lining of the womb is thickening appropriately.

<add something very brief about what to do if too little or too much stimulation, side effects; how to manage them> Abey, please help.

Egg maturation or ‘trigger’ injection

This is a very important injection. It is given to achieve final maturation of the eggs before eggs are collected. The hormone hCG is normally used for this purpose. It is very important to time this injection right. It is really important that you get specific advice from your clinic about the timing of this injection.

Egg collection

Eggs collection operation is performed under sedation or anaesthesia. It is normally performed 34 to 36 hours after the ‘trigger’ injection. A needle is passed into the ovaries through the vagina, and the follicular fluid containing the eggs is aspirated and given to the embryologists in the IVF laboratory.  It is really important to get specific instructions about the exact time of your egg collection from your clinic. It is also important for you to follow your clinic’s advice on how long you should avoid food and drinks before the egg collection procedure.

Progesterone pessaries or injections are also started on the same day or within 2 days of egg collection. You should obtain specific information from your IVF clinic.

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Embryo Transfer

The embryo transfer date will depend on embryo development and quality. After the egg collection, your embryologist will keep in contact with you to let you know about embryo development. Embryo transfer may be 2 or 3 days after egg collection (cleavage stage embryo transfer) or 4 or 5 days after egg collection (blastocyst transfer). <<ultrasound guidance and evidence>>

Pregnancy test

We advise that you do a pregnancy test 16 days after egg collection.

<<Abey, please add something about the ‘2 week wait’ here and how to cope with it.>>

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You can find answers to common IVF questions on the ‘Fertility Questions’ page. A common question we get asked is: When should the male partner attend clinic during an IVF treatment cycle?

Your partner can attend all of the appointments with you, but the absolutely mandatory date to attend is on the day of egg collection. Your partner will need to produce a semen sample on that day as well as take you home after the operation and look after you for at least 24 hours following the egg collection operation. We will also advise attending on the day of embryo transfer.

<<link to fertility fora and counselling advice>>