For IVF/ICSI treatment to be successful the ovaries should be stimulated to produce more than a single egg. In order to achieve this goal potent drugs called gonadotropins are administered in a controlled manner. Gonadotropin treatment is self administered as most of the medications used today can be received subcutaneously.

How the treatment is initiated?

An ultrasound examination is performed when the patient arrives in the IVF unit. This examination should coincide with the 3^rd or the 4^th of the period following prior down regulation (the nasal sniff or subcutaneously administered Leuprolide acetate).

If you don’t have any cysts and the inner lining of the uterus is thin than treatment is initiated. Alternatively treatment can be started directly on the 2^nd or 3^rd of a normal menstrual cycle without a prior down regulation. The later is called the short protocol.

How long does the treatment last?

The treatment usually lasts for 10-12 days. During this phase you will be asked to come periodic ultrasound examination. The frequency of these examinations will increase as the treatment progresses. When the eggs are deemed to be mature a final injection will be given at a specific time and the eggs collected after approximately 36 hours.

How much medication am I going use?

The amount medications used to stimulate the ovaries depends on the age of the woman and her ovarian reserve. While younger women with normal ovarian reserve use lesser amounts, older women and women with diminished ovarian reserve necessitate larger doses to stimulate the ovaries. Variation in drug dosage may be up to two-fold.

Can my treatment be cancelled?

If there is inadequate response form the ovaries (poor response) meaning that the ovaries did not produce enough eggs to be successful than the treatment may be cancelled and reinitiated with another protocol. Sometimes only one egg gains dominance and prevents other eggs from growing (asynchronous growth). This is another reason for canceling the treatment. Sometimes there will be too many eggs stimulated (hyper response) which may result in ovarian hyperstimulation syndrome if the treatment is continued. There are several options that may be exercised in this instance. The treatment may be cancelled altogether. The other option is to proceed to egg pick-up, but to freeze all the resulting embryos and not do an embryo transfer. During this period we can administer some medications to prevent hyperstimulation syndrome.