QUICK START Introduction to IVF Embryology Transfer Oocyte

QUICK START: Introduction to IVF

Embryology & Transfer Oocyte Retrieval Everyone at RMA wishes you success. Stimulation & Trigger Congratulations on your cycle start! In Vitro Fertilization Introduction to In-Vitro Fertilization (IVF) Cycle

In Vitro Fertilization Introduction In Vivo In Vitro Embryology & Transfer Oocyte Retrieval Stimulation & Trigger Introduction to In-Vitro Fertilization (IVF) Cycle

In Vitro Fertilization Introduction to In-Vitro Fertilization (IVF) Cycle • In Vitro Fertilization, or IVF involves bringing sperm and egg together in a laboratory dish. • Embryos are made and the best embryos are used to help couples conceive.

Introduction to In-Vitro Fertilization (IVF) Cycle • Reasons for IVF: – Tubal factor – Severe Male Factor – Endometriosis – Ovulatory dysfunction – Ovarian failure – Diminished ovarian reserve – Fertility preservation – Unexplained infertility

Introduction to In-Vitro Fertilization (IVF) Cycle Please confirm the following is complete prior to starting your IVF cycle: ü Checklist Blood Work ü Consents are signed ü Cleared by Finance ü Cycle medications from specialty pharmacy

Your physician may prescribe estrogen pills or birth control pills for pretreatment prior. These medications help to synchronize your follicles prior to starting your stimulation injections. Embryology & Transfer There are many IVF protocols which are tailored to each patient specific diagnosis, age, diagnosis and prior responses to stimulation medications. Oocyte Retrieval Stimulation & Trigger Introduction to In-Vitro Fertilization (IVF) Cycle

Introduction to In-Vitro Fertilization (IVF) Cycle Injection Training • Take the time to watch RMA’s injection training videos • Hormonal injections are administered for 8 to 12 days in order to grow the ovarian follicles and allow the eggs to mature • Expect to administer approximately 2 -4 injections daily Click here to view our Injectable Medication Training Videos *Ask your nurse what injections your physician will be prescribing.

Introduction to In-Vitro Fertilization (IVF) Cycle • Frequent ultrasounds and blood work will be needed every 1 to 3 days through this time to monitor progress. • Your Nurse will call you with results and medication instructions by 7 pm. • Please only page if you have not received a call by 7 pm

Introduction to In-Vitro Fertilization (IVF) Cycle –Morning Monitoring Location Weekday Monitoring Hours Weekend/Holiday Monitoring Hours Basking Ridge Mon-Fri 6: 00 am – 7: 30 am Sat/Sun 6: 00 am – 10: 00 am open every day Eatontown Mon-Fri 6: 00 am – 7: 30 am Sat/Sun 6: 00 am – 8: 00 am open on holidays Marlton Mon-Fri 6: 00 am – 7: 30 am Sat/Sun 6: 00 am – 8: 00 am open on holidays except Christmas Day Morristown West Orange Somerset Springfield Englewood Princeton Freehold Mon-Fri 6: 00 am – 7: 30 am Closed Lehigh Valley, PA Daily 7: 00 am-8: 30 am Please make sure you arrive within designated monitoring hours in order to obtain same-day results. You can monitor at the office of your choice, but please let your Nurse know which office you plan to visit There is a Nurse available beginning at 7 am to meet with patients that have questions or need to review trigger instructions. Please be aware that many patients need to get to work, so time is limited in the morning. If you have more complex questions, please ask your Nurse about scheduling a meeting time.

Introduction to In-Vitro Fertilization (IVF) Cycle Injections Pre. Treatment Ultrasounds Stimulation 8 -12 Days Blood work Trigger

Introduction to In-Vitro Fertilization (IVF) Cycle • Trigger Injection – Novarel/Pregnyl/Ovidrel/Lupron Trigger – Stimulate ovulation (releasing of eggs) – ***Time specific injection – Retrieval 36 hrs. later (i. e. 7 pm trigger time on Monday results in 7 am egg retrieval on Wednesday) • Egg Retrievals take place in our Basking Ridge office

Day of Egg Retrieval: • Nothing to eat or drink after midnight the day prior to retrieval • Partners are not allowed in the Operating Room • No children allowed • You will not be able to drive day of retrieval. A responsible adult must accompany you home. Embryology & Transfer Oocyte Retrieval Stimulation & Trigger Introduction to In-Vitro Fertilization (IVF) Cycle

Introduction to In-Vitro Fertilization (IVF) Cycle Male Partner (if applicable) • 2 -5 days of abstinence if producing a fresh semen specimen on the day of oocyte retrieval

Introduction to In-Vitro Fertilization (IVF) Cycle Egg retrievals are performed approximately 36 hours after the scheduled trigger injection.

What to Expect on the Day of Your Egg Retrieval • IV Sedation • Egg retrievals are an ultrasound guided procedure, which takes approximately 10 -20 minutes • Learn how many eggs are retrieved that day

Introduction to In-Vitro Fertilization (IVF) Cycle Night of the Procedure Call the office if you experience: • Temperature above 101 • Persistent nausea or vomiting • Severe abdominal pain or swelling • Heavy vaginal bleeding • Shortness of breath • Fainting • Pain, burning, redness and or swelling in area around IV site Vaginal spotting and/or mild abdominal cramping may occur and is normal.

Embryology Oocyte Retrieval Stimulation & Trigger Introduction to In-Vitro Fertilization (IVF) Cycle The Next Day = Day 1 Fertilization Check

Introduction to In-Vitro Fertilization (IVF) Cycle - Embryology Oocyte (egg) Zygote Cleavage Stage Day of Retrieval Day 1 Days 2, 3 & 4 Blastocyst 80+ cells Days 5, 6 & 7

Introduction to In-Vitro Fertilization (IVF) Cycle • The day after your egg retrieval, a nurse will call you with fertilization results or number of eggs we were able to freeze. • The next embryology update will be 7 days following your egg retrieval with how many embryos were available to freeze.

Introduction to In-Vitro Fertilization (IVF) Cycle Post Egg Retrieval • Please call your nurse with day 1 of your period following your egg retrieval • If your treatment plan involves screening your embryos for chromosomal abnormalities please expect results in approximately 2 weeks from the day of embryo biopsy.

Introduction to In-Vitro Fertilization (IVF) Cycle Please contact your nurse with any questions or concerns.