The IVF treatment cycle includes the following stages:
- Investigation and diagnosis of infertility
- Preliminary tests
- Stimulation of the ovary with drugs (12-14 days) for the development of multiple follicles
- Monitoring using a series of ultrasounds and hormone tests
- Induction of final oocyte maturation (a single evening injection)
- Egg collection
- Fertilization and culture outside the woman's body (2-6 days)
- Embryo transfer
- Pregnancy test (13 days after the embryo transfer, measurement of blood levels of β-human chorionic gonadotrophin (β-hCG)
- Test of clinical pregnancy using transvaginal ultrasound (4 weeks after embryo transfer)
- Test of ongoing pregnancy on 12th week of gestation (10 weeks after embryo transfer).
What must I do first?
You must first book an appointment either yourselves or via one of our collaborating doctors who referred you to our unit. It is also useful that you gather any previous related tests (semen analysis, hysterosalpingography, blood tests, hormone levels, photographs or videos from previous hysteroscopies or laparoscopies), reports from previous IVF attempts, operations, laparoscopies etc.
What tests are necessary?
The preliminary tests before the onset of an IVF program include:
- Sperm tests (semen analysis, sperm preparation, semen culture)
- Hormone profiling and transvaginal ultrasound on the 3rd day of the cycle
- Blood tests for hepatitis, HIV I-II, VDRL (necessary)
- Pap-test, breast examination in women over 35, heart check up
- Special examinations, such as laparoscopy or hysteroscopy, which may be recommended by the Medical Director of the unit, based on the assessment of the medical history and other tests (information on laparoscopy-hysteroscopy can be found in a following section).
The tests of prenatal diagnosis are also recommended. These tests usually include haemoglobin electrophoresis (helpful for diagnosis of haemoglobin disorders), blood group, Rhesus factor, rubella, toxoplasm and cytomegalovirus antibodies, complete blood count, complete urine testing, blood urea and sugar, cystic fibrosis etc.
Although these tests are usually performed in the first weeks of pregnancy, it is preferable to complete them prior to embarking on in vitro fertilization treatment.
In very rare circumstances, a karyotype may be requested, along with a check for thrombophilia and special immunological testing.
Where can I have my tests?
Eugonia covers the entire spectrum of the necessary examinations and collaborates with many national insurance organisations.
It is necessary that the ultrasound, hormone tests and sperm tests are performed in our unit so that the results can be assessed by the scientific team of Eugonia and be compared with similar other cases. This provides an additional level of quality control of the whole process.
However, if this is not possible, these tests can be performed elsewhere and be brought or delivered to our unit. It is preferable that all the tests have been completed before the start of the treatment program.
Monitoring
The monitoring is performed in our unit and involves a series of ultrasounds and hormone tests. You may find a detailed description in the section: Treatment course.
Your first visit at Eugonia
At your first appointment, you will be welcomed by the coordinator of the unit (sister or midwife). The interview will be conducted in three phases:
First, the midwife will take a detailed record of your medical history and information from any previous attempts.
Then, you will meet the Medical Director of the unit, with whom you will discuss extensively the diagnostic and therapeutic strategy recommended. The Doctor will note in your history sheet all the necessary tests that need to be done, the treatment protocol, doses of drugs and details about the treatment program you will follow.
In a third phase, the midwife will explain and give you written instructions for any further tests, if necessary, as well as details about when and how these will be conducted. You will also be given the prescriptions for the necessary drugs, instructions about the treatment protocol, dosage, time and manner to take your drugs, and also medical notes, forms and instructions about your next appointment with us.
You must remember that this first appointment may last a while, depending on the information that need to be recorded and the extent to which you wish to discuss your treatment with the Doctor (usually 1-2 hours).
Finally, you will be given official information brochures and consent forms required by the law, so you have enough time to peruse them. Consent forms must have been signed and filed in your medical folder before the onset of the treatment.
Your visits to the unit during the treatment program
You will be informed about your visits to the unit during the treatment for hormone tests and ultrasounds. Should you have any questions or problems feel free to contact the units midwife, who, in turn, will inform the Doctor.
In each phase of the program, the results of your tests will be assessed by the Medical Director and his colleagues, aiming to decide on the way forward regarding your drug dosage and treatment continuation. Each organism responds differently to the treatment so each case is judged on its own merits. Perhaps it may be possible to re-assess the dosage of the drugs, or modify some timing aspects of the program. Our principle in your monitoring is always the best outcome of your attempt and your final success.
