A typical in-vitro fertilization (IVF) schedule lasts approximately 31 days from administration of the first medication to the blood pregnancy test. There are many factors that influence each patient’s individual schedule, so a typical IVF schedule involves a patient who has a normal 28-day menstrual cycle and does not use birth control pills to regulate her cycle. Each schedule includes the use of drugs to suppress ovulation, stimulate egg follicles and encourage egg maturation; egg retrieval and embryo transfer procedures; and finally a pregnancy test.
The IVF schedule begins with a drug used to suppress ovulation so that the doctor can have control over ovulation to ensure a successful result to the IVF treatment. In the United States, a gonadotropin-releasing hormone agonist medication is used to accomplish this; the type of medication might differ depending on the location of the patient. The drug is given by subcutaneous injection daily. The ovulation suppression drug is started during the last seven days of the patient’s menstrual cycle.
One day after the new menstrual cycle starts, follicle stimulation hormone (FSH) injections begin. The purpose of FSH is to stimulate the development of mature follicles with each follicle containing one egg. This also is a daily subcutaneous injection taken for eight days in conjunction with the ovulation suppression drug. These eight days are known as stimulation days, and during this time period several blood and ultrasound screenings are scheduled. Blood is tested to check for appropriate estrogen levels, and the transvaginal ultrasound measures the size of the egg follicles.
Day 16 of the IVF schedule includes the human chorionic gonadotropin (HCG) injection. The HCG injection is used to help the eggs reach maturation. This also is the last day of the ovulation suppression and FSH injections.
Two days after the HCG injection, the egg retrieval procedure is administered. The patient is put under heavy anesthesia, and an ultrasound is used to guide a needle to the ovary and the follicle. The follicle fluid is suctioned through the needle; the eggs detach from the wall of the follicle and are pulled out of the ovary. Four hours later, sperm is added to the eggs, and the eggs are observed to ensure fertilization.
The day after the egg retrieval procedure, progesterone treatment is started. The treatment is given either with daily injections or daily use of a vaginal cream. Progesterone is a female hormone that helps to prepare the uterus for embryo implantation.
Embryo transfer is next on the IVF schedule, but the day that the transfer takes place depends on whether it is a three-day transfer or a five-day transfer. The time period between the egg retrieval and the embryo transfer will depend on the doctor. The embryo transfer procedure does not require anesthetization. Under ultrasound guidance, an embryo transfer catheter is passed through the cervix into the uterus, and the embryos are transferred through the catheter to the uterine lining. The patient lies on her back for one hour before going home.
The final step of the IVF schedule is the blood pregnancy test. The pregnancy test is scheduled about 14 days from the egg retrieval procedure. If the pregnancy test is positive, additional follow-up steps will be taken to ensure a healthy pregnancy.