New IVF Patient Information

Dear Patient,

Welcome to our IVF program. We know how important your treatment is to you and our goal is to offer you state of the art medical technology in a comfortable and caring environment. We believe it is important that you understand and participate in the development of your care. We offer this information and instruction for your review. Our specialized staff are dedicated to providing you the highest quality care and are available to answer any of your questions.

Please bring your consent forms to your instruction session. We will discuss the forms in detail at this time or you may call the office with questions. You may sign your forms in advance if you wish. 

Medications for your IVF cycle can be ordered by us through a specialty pharmacy. You will be contacted by the pharmacy regarding your order. The medications will be delivered to your home. Medication costs average around $2000.00. The cost may be higher or lower depending upon your response to the medication.

We will need to schedule an instruction session prior to starting your injectable medications. We offer group or private sessions for your convenience. These sessions typically last about an hour. During this appointment we will:

• Offer instruction in preparing and injecting medication
• Review the treatment cycle step by step
• Question and answer discussion
• Collect your consent forms
• Collect your IVF fees

Please call the office if you prefer a private session. Arrive 15-20 minutes early as we will collect fees prior to the instruction session.

The first medication you will start is birth control pills. Birth control pills decrease androgens (male hormones) in your system and allow us to schedule your cycle effectively. You will start your pills at some point between cycle day three and ten. Please call the office when your period starts and we will give you a start date. When you begin the birth control pills, it is very important that you continue to take only the pills that contain hormones. Typically this is the first three rows of pills in the pack. Do not take the last row of pills but go directly to a new pack. You may experience some spotting while on the birth control pills. If you have heavy bleeding please call the office. Your last day to take birth control pills will be_______________. When you stop the birth control pills you will have a period three to five days later. Usually your first injectable medication will be Lupron. Please follow the Lupron protocol marked below. Lupron injections will continue until you are instructed to stop which may be two or three weeks. 

Begin Lupron injections on __________________________.

Dosage: 10 units once daily. When you start the second injectable ( Bravelle, Follistim, Menapur, Repronex or Gonal F ) the Lupron dose will decrease to 5 units once daily. 

Begin Microdose Lupron injections on _______________________.

Dosage: 20 units twice daily 12 hours apart. 

Your office appointments are scheduled for ___________________, __________________, and

____________________. Please arrive at ____________________ AM. You may require one additional office visit. You will have a vaginal ultrasound and labs drawn at these visits. Allow thirty minutes for these appointments. Our staff will contact you between 2:00 and 4:30 p.m. on these days with your lab results and medication instructions. Please be sure the nursing staff has your preferred contact number. You may call the office if you wish. 

The second injectable medication will be the follicle stimulating hormone. This will be either Bravelle, Follistim, Repronex, Menapur or Gonal F. You will start this injection on the day of your first scheduled office visit. We will confirm your dose that day. You will continue these medications until instructed to stop. Typically this will be eight to ten days. At this point your eggs will be mature. Your retrieval will be one of the following days _______________________.

Your embryo transfer usually will be the third day after your egg retrieval. You will have a blood pregnancy test drawn fourteen days after the egg retrieval. We will schedule your first pregnancy ultrasound two to three weeks after the positive pregnancy test. At that point you will be referred to an obstetrician for the remainder of your pregnancy. Our goal is to help you achieve a successful pregnancy and we thank you for allowing us the opportunity to participate in your care. 

Medication Dosage

Antibiotics: Refer to your medication bottle - Start day before transfer.

Prednisone: 3 pills orally with evening meal - Start day of retrieval.

Progesterone: Starting day before transfer

Tramadol: 1 pill orally every 4 - 6 hours as needed.

Progesterone in Oil: 1 ml injected intramuscularly once daily starting day before transfer. 

Instructions for HCG Injection (Chorionic Gonadotropin or Novarel)

1. Wash hands and gather supplies.
2. You may use a Lupron syringe or a 3cc syringe with a 30-gauge needle.
3. Remove lids of both vials by flipping off the cover.
4. Insert needle into the vial of liquid ( this vial contains no medicine but serves as a diluent only).
5. Turn vial up and draw out .5cc (50 units) of liquid.
6. Insert the needle into the vial of powder, gently swirl the vial to dilute but DO NOT SHAKE
7. After all powder is diluted, turn vial up and draw out ALL of the liquid ( medicine ).
8. Clear the air from the syringe without pushing out medicine.
9. Clean injection site with alcohol. Inject into top of the thigh or anywhere on the stomach that is 1 inch from belly button or the back of the arm can be used.
10. Pinch area and inject at a 90-degree angle.
11. This injection is given subq, not intramuscular as the package instructs. It is not a multi dose vial. It may cause some pelvic cramping. You may also experience redness and itching at the injection site. Apply a topical steroid cream if this occurs.