03 Jan Monitoring Your IVF Cycle
If you’ve done your homework researching fertility treatment centers and treatment options, odds are you’ve come across phrases that read something like, “we provide continuous monitoring during your IVF cycle.” You’ve also read that patients need to clear their calendars to accommodate the daily appointments during ovarian stimulation leading up to the egg retrieval date.
But what does closely monitoring your IVF cycle actually mean? Why does the ovarian stimulation phase of an IVF cycle require such close monitoring? And what are we actually monitoring?
IVF Monitoring Explained: Steps Two & Three Of The IVF Cycle
We outline the typical IVF Timeline in five separate steps:
- Syncing your cycle for IVF and egg retrieval
- Ovarian follicle stimulation
- Egg Retrieval
- Embryo transfer and the beginning of your TWW
Patients and their fertility specialists constantly communicate throughout the IVF journey. However, Steps 2 and 3 – ovarian follicle stimulation and egg retrieval – require continuous, careful monitoring. Here’s why.
1. Confirmation you’re ready to begin the ovarian stimulation phase
Before officially starting you on injectable fertility medications, we do extra testing to ensure you’re ready. This is called “IVF baseline monitoring,” which includes:
- Imaging tests. We’ll use transvaginal ultrasound to confirm the number of antral follicles available and to make sure there are no anatomical abnormalities such as ovarian cysts or other things that could cause compilations. We also verify the uterine lining is thin and ready.
- Blood tests. We take your blood to confirm you aren’t pregnant (although rare, we have had cases where women were unknowingly pregnant. You’d never want to take fertility meds if that is the case!). We also use blood tests to get a baseline read on FSH, LH, and estrogen levels – which should be low at this point.
Assuming you get the green light to move forward, the IVF cycle monitoring continues.
2. Fertility medication and ovarian stimulation
The injectable fertility medications are more potent than their oral counterparts, so we pay close attention to patients during this phase. Your doctor determines medication dosage based on your medical history, fertility treatment history, and diagnosis. However, doses may need to be adjusted based on how your body responds.
Depending on your situation, you’ll return to the clinic between days 2 and 5 of the fertility medication cycle. Some patients have to come every day depending on how their bodies respond to the meds. At these monitoring appointments, we:
- Perform another vaginal ultrasound to count how many antral follicles are responding. We also measure the maturing eggs. The combination of high numbers of maturing follicles combined with elevated F2 levels elevates fluid levels in the abdomen. So, we also keep an eye on abdominal fluid levels. Higher than normal levels are a sign of Ovarian Hyperstimulation Syndrome.
- Measure FSH, LH, and E2 (estrogen) levels – still looking for lower levels since the LH surge shouldn’t happen just yet.
Depending on what we see, we may adjust your dosage to support optimal egg follicle stimulation while reducing any risk of OHSS. You may come back every day for the next few days, or we might have you skip a day. This is decided on a patient-by-patient basis.
NOTE: Patients showing signs of OHSS or experiencing extreme discomfort cease treatment immediately.
3. Final monitoring visits
The average ovarian stimulation cycle lasts between 10 to 14 days. Monitoring continues through that second week until we see that the eggs are the “perfect size” (measured in millimeters) – between 18mm and 22mm. We also pay close attention to those hormone levels. We want to see E2 levels that are high but correspond to the number of mature eggs we plan to retrieve, relatively high FSH levels, and lower LH levels (we don’t want that LH surge to happen until we call the (literal) shots.
The goal in these final visits is to time things, so everything’s just at the tipping point. We sync the trigger shot to correspond with an appointment 36 hours later – the perfect window for us to retrieve your eggs. Sometimes, patients already have a monitoring visit scheduled for that same day. If not, we set one.
Fertility Center of Dallas Answers Any Questions About Monitoring Your IVF Cycle
Do you have more questions about IVF cycle monitoring? Contact the Fertility Center of Dallas. We understand it’s a lot of information to take in all at once, and we’re here to make the process as simple and straightforward as possible.