Oocyte retrieval and embryo transfer

Day of hCG Administration

1. Lupron® is discontinued when hCG is given.
2. hCG is given when three or more follicle are 20 mm or greater in diameter.
3. 5,000 or 10,000 units hCG are given intramuscularly at the time indicated by the nurse, depending on the time of retrieval.
   

Day After hCG (Day Before Retrieval)

1. The morning after hCG an estradiol level is drawn.
2. Nothing to eat or drink after midnight.
3. Husband will receive instructions regarding collection of a semen specimen, usually one hour prior to or following the retrieval. Most specimens are collected in the fertility office. Please review the information sheet for semen collection.

Day of Retrieval

1. Wear loose clothing.
2. Avoid jewelry, makeup, perfume and cologne.
3. Report as instructed at the appointed time.
4. Someone should accompany you to the IVF Center. This person will keep your belongings during the procedure and must escort you home after you are discharged.
5. An IV will be started and the procedure will be performed on site at the IVF center.

Following Retrieval

1. Following oocyte retrieval, you will be discharged home within approximately 1-2 hours.
2. You may not be fully alert for several hours after discharge. Do not drive after being discharged on the day of retrieval.
3. Limit your activity for 24 hours after the procedure.
4. Medications
   A. Medrol 16 mg once a day for four days will be started on the night of retrieval.
   B. Tetracycline 250 mg four times a day for four days will be started on the night of retrieval.
   
5. Call the office if you experience any of the following problems:
   A. Difficulty breathing
   B. Excessive bleeding
   C. Severe pain
   D. Fever
   E. Any other disturbing problems
   

Day After Retrieval

1. A report concerning fertilization of the oocytes will be given by telephone about 24 hours after the insemination has occurred.

Embryo Transfer

1. Embryo transfer is performed at the IVF Center 3 days or 5 days (blastocyst) after oocyte retrieval.
2. Valium 10 mg should be taken approximately one hour prior to transfer.
3. Avoid jewelry, makeup, perfume and cologne.
4. Following embryo transfer you will be discharged home within approximately 1-2 hours.

Progesterone Supplementation

1. Progesterone may be administered intramuscularly, orally, and/or vaginally depending upon your physician's instructions.
2. Progesterone 50 mg intramuscularly (IM) is given on the day after oocyte retrieval and the next day 50mg, depending on the IVF Protocal.
3. Progesterone stays 50 mg IM, and is maintained until a negative beta hCG or until 10 weeks with a viable pregnancy.
4. The dosage of progesterone may vary in some instances based on the patient's history.

Pregnancy Follow-up

1. An initial pregnancy test is obtained 10-12 days after the embryo transfer and is repeated as necessary.
2. If pregnant, an ultrasound scan is recommended approximately 3½ weeks after embryo transfer to assess the pregnancy.
3. Patient will return to her obstetrician after ultrasound confirmation of a viable pregnancy to continue prenatal care. Non-local patients should report pregnancy results from their local obstetrician.