Explanation of Timelines
Minimal Stimulation Cycles (Clomid and Letrozole)
Once you’ve chosen this path of treatment, the following events will occur:
- Your menstrual cycle begins and you call the nurse.
- The nurse will instruct you to begin your medication, usually day three.
- You will start using ovulation predictor kits on day 11.
- If you are planning to use ovidrel, you will also have an ultrasound at the clinic on day 12 or 13.
The next step is either intercourse or insemination. If you have chosen to have intercourse, you will do so on the day and the day after you have a positive surge on the ovulation kit. If you have chosen to have an insemination, a nurse will schedule you a time to come to the clinic 36 hours after ovidrel for the insemination. Then you will wait two weeks and take a urine pregnancy test. If it is positive, we ask that you come to the clinic for a blood test.
Controlled Ovarian Hyperstimulation (COH) also known as Gonadotropin Therapy
If this is your chosen path of treatment, the following events will occur:
Gonadatropin therapy begins on day two of the menstrual cycle and requires daily dosing for approximately eight to 12 days.
If your physician has recommended lupron, you will begin this daily injection prior to your menses after a baseline ultrasound and pregnancy test.
It is important to inform your physician or nurse clinician of your intentions to begin a treatment cycle prior to your menstrual period so you can have the appropriate medications on hand.
Ovidrel is then given to trigger the maturation and release of the egg from the ovary. After ovulation is triggered, prometrium is given to maintain progesterone secretion in the luteal phase (the two-week interval after ovulation).
Approximately one week after therapy is begun frequent monitoring by ultrasound and estrogen measurements begins.
Estrogen monitoring involves obtaining a blood sample. This will be performed if necessary to adjust medications.
When monitoring begins, clinic visits may be every few days or daily, depending on your particular cycle progression. The dosages of your medication are individualized based on your particular situation.
Dosage (number of amps/vials of gonadatropin) may vary from day to day and cycle to cycle. You will receive instructions regarding your dosage at each monitoring visit.
Occasionally the schedule may have to be changed after additional information (estrogen level) is obtained. Ultrasounds and estrdiol tests will determine when you are to take ovidrel to release the eggs.
The next step is either intercourse or insemination. If you have chosen to have intercourse, you will do so 12 and 36 hours after the ovidrel. If you have chosen to have an insemination, a nurse will schedule you a time to come to the clinic 36 hours after ovidrel for the insemination.
Then you will wait two weeks and come to the clinic for a blood test.
