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Before You Start Monitoring During an IVF Cycle


Updated August 25, 2009

Before you start monitoring during an IVF cycle, there are several important things that you should know. As if the nightly (and sometimes one in the morning as well!) injections weren't bad enough, your fertility specialist is probably requesting that you come into the office everyday for a blood test and ultrasound. Here is everything you need to know about what they are looking for, and why it's necessary.

How Often Will I Have to Be Monitored During an IVF Cycle?

Of course, this is up to your physician. Typically, patients are required to be in for testing every morning, though it may be less frequent in the beginning of the cycle. If you have any concerns about the frequency of monitoring during IVF, please speak with your doctor before you start.

What Kind of Testing Is Necessary?

You will probably have your blood drawn and a transvaginal ultrasound performed.

Why Is Monitoring During an IVF Cycle so Important?

Your doctor will need to follow your response to the medications that you are taking very closely. Your medication dosages may change on a daily basis, as the doctor is fine tuning your response based on the results. Without such frequent monitoring, there is a greater chance that you could become sick or have a poor response.

What Happens If I Don't Go?

Before skipping an appointment, you must speak with your doctor or nurse. There are usually points in the cycle where monitoring is 100% necessary. In fact, I've even seen women have their cycles canceled because of frequent absences.

What Do The Ultrasound Appointments Mean?

Over the course of your cycle, follicles on your ovaries will begin to grow and develop. The sonographer will be visualizing your ovaries and measuring the diameters of each follicle. The endometrial lining will also be measured. Each physician will have their own standards, but growth of the follicle by about 2mm each day is common.

What Blood Tests Are Drawn?

Again, each clinic will have their own policies, but generally speaking, the doctor usually wants to look at your estrogen, progesterone and LH (leutenizing hormone) levels. Sometimes they may draw blood for other purposes. Please check with your nurse or doctor for more information.

What Should the Estrogen Level Be?

There are a number of factors which can affect your estrogen level, depending on your age and the medications you are on to name a few. While each doctor will follow your estrogen level according to their own policies, they are looking to see that the level is rising appropriately. Usually they want to see the level double every two days. If your estrogen level drops significantly during your cycle, this may indicate a need to cancel the cycle and start over. If you have an estrogen drop during your cycle, please do not hesitate to speak with your doctor about your concerns.

Progesterone and LH

Rising levels of progesterone and LH can indicate that you may be breaking through your suppressive medication and that your body may be getting ready to ovulate. Your doctor will want to monitor your levels to make sure that there are no early signs of ovulation. If those levels do begin to creep up, he can follow them very closely and make the appropriate medication adjustments. An ovulatory progesterone (usually above 3, but depends on the way the lab runs the bloodwork) while cycling may also indicate the need for cancellation. Again, please speak with your doctor about any concerns.
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