In preparation for an IVF stimulation cycle, you should have gone through your initial infertility testing and diagnosis. 

The results will help your RE determine the stimulation protocol that’s best for your situation. This is a critical piece to your IVF success as too little or too much medication can significantly impact your egg quality. 

Your clinic will provide you with a list of medication, dosages and calendar for your key dates and monitoring appointments for your IVF stimulation cycle. Make sure to enter this info in the Embie app to keep track and set reminders of your daily protocol activities. 

Taking your medications on time is crucial during IVF. If you’re a few hours off, you can experience premature ovulation or miss your egg retrieval window. 

In most cases, an IVF stimulation cycle begins with a baseline monitoring appointment. This is done on day 2 or 3 of your period or on day 21 (post ovulation), depending on your protocol. 

If everything checks out during your baseline appointment, you are given the green light to begin your cycle. 

Ovarian Suppression/Down Regulation:

The process starts with ovarian suppression through the use of birth control pills and/or Lupron/Decapeptyl, which usually lasts around 12 to 14 days. This is done to allow your clinic more control and the even growth of your follicles (pockets of fluid which typically contains eggs). 

Ovarian Stimulation & Monitoring:

Once ovarian suppression is achieved you then start ovarian stimulation with recombinant follicle-stimulating hormone (FSH) and/or Human menopausal gonadotropin (hMG, combines LH and FSH) medication. The stimulation is monitored through ultrasounds performed every 3 to 4 days along with blood hormone measurements including estradiol and progesterone.

Gonadotropin-releasing hormone antagonist (GnRH antagonist) drugs such as Cetrotide may be introduced 5 to 7 days into your stimulation phase to prevent you from ovulating prematurely. 

Once the majority of the follicles are in the 16 to 20mm size, ovulation is triggered with human chorionic gonadotropin (hCG) or Gonadotropin-releasing hormone agonist (GnRH agonist) depending on your protocol. The trigger shot starts the ovulatory process which is required for egg maturation. 

Egg Retrieval:

The egg retrieval procedure is then typically performed under anesthesia, 34 to 38 hours after the trigger is administered.

While you’re asleep, an ultrasound wand is put in the vagina. A needle is guided along the ultrasound into each follicle on the ovary and an egg is removed with a low grade suction.

The fluid is handed to the embryologist who then searches through the fluid to identify the mature eggs and prepare them for freezing or fertilization.