After your initial new patient consultation and diagnostic testing, most patients will visit our office for IVF cycle monitoring 3-5 times. Cycle monitoring consists of ultrasounds and blood work leading to the culmination of your egg retrieval. You will see a provider at each of these IVF monitoring visits.Your IVF nurse coordinator will discuss required office visits with you when walking you through your IVF calendar and treatment plan. Each visit will last about 30 minutes and we at STL Fertility feel strongly about your experience which is why our physicians perform your IVF ultrasounds and cycle monitoring. For our traveling patients who live 2+ hours away, initial monitoring can be provided locally through your primary OBGYN.

When you have selected a two week timeframe that works best with your life and allows you to be available for frequent cycle monitoring appointments, it is important to touch base with our financial team. Once cleared with our financial team, your IVF nurse coordinator will discuss required office visits with you and walk you through your IVF calendar and treatment plan. Therefore, it is always best to alert your clinical team of the first day of your period at least 1 month prior to your selected treatment month. For example, if you desire a May IVF treatment cycle, you should call your clinical team with your April period. IMPORTANT: Additionally, you should call our office on the first day of your period in your treatment cycle month. This is the all-important “Day 1” of your cycle.

Gonadotropins (Gonal-F, Follistim, Menopur) are the medications used in IVF that mimic your natural hormones that stimulate your ovaries to produce oocytes (eggs). You will be injecting a mix of gonadotropins over a 10 to 14-day period to stimulate the ovaries and develop the eggs to be used for IVF. During this time, we will monitor your progress via bloodwork and ultrasounds. You can expect to visit our office frequently during this time (approx 3-5 times) based on your response to medications. Each visit will last about 30 minutes.

Once the gonadotropin medications have stimulated your ovary to produce multiple eggs that are the right size, you’ll administer a single shot of hCG or human chorionic gonadotropin. hCG is similar to LH (luteinizing hormone) and works in a similar manner. This will “trigger” your ovaries to get ready for an egg retrieval at our office about 36-hours later. Your nurse will call you with instructions about when and how to administer this all-important trigger shot. The TIMING of this medication is extremely important as the egg retrieval is timed based on the time this injection is given. This medication allows maturation of the eggs.

Approximately 36-hours after the hCG injection, you’ll visit our office for an egg retrieval procedure. The procedure takes approximately 15-20 minutes. Upon arrival, expect to be at our office about 2–3 hours. Your eggs will be used in our on-site IVF lab. If you are creating embryos, they will be injected with sperm from your partner or donor sperm to spur fertilization. If you are freezing oocytes, they will be assessed for maturity and frozen accordingly.

Usually, we like to obtain a fresh sperm sample from the male partner on the same day as your egg retrieval. If we are utilizing frozen sperm, frozen samples stored previously will be thawed and prepared in sync with your retrieval procedure.

After Intra-Cytoplasmic Sperm Injection (ICSI), we will let you know how many eggs have been fertilized and developed into embryos the day after retrieval. Once embryos have reached the blastocyst stage of development (after 5-6 days) we will give you an update about how many embryos are available and either do a fresh transfer if planned or freeze the blastocysts with or without having done a biopsy for PGTfor a planned future frozen embryo transfer.

At STL Fertility, our primary transfer method for embryos is via frozen embryo transfer or FET. This is because data supports that FET’s offer higher implantation rates and better obstetrical outcomes through improved hormonal synchronization between embryo and uterus. Your FET will be scheduled based on when you get your period after your egg retrieval. If you are a patient who is a candidate for a “Fresh” Transfer, this will occur 3-6 days after your egg retrieval, and you will need to be on luteal phase support. These are progesterone injections after your egg retrieval to prep your uterus for a “fresh” embryo transfer.

About 10-14 days after embryo transfer (either fresh or frozen) you’ll visit our office for bloodwork measuring hCG levels to confirm pregnancy. Our office will usually have the results back by that afternoon. If pregnant, you can expect to remain on luteal phase progesterone support for another 6-8 weeks. Remember, pregnancy testing at home can be unreliable because the hCG injection can turn at home pregnancy tests positive. It is best to wait for blood levels of hCG to confirm pregnancy.