Often when someone begins to research and explore their upcoming IVF journey, it can sometimes be confusing in regard to what a potential timeline may look like. This article will act as a general guideline for what to expect through an IVF journey with us at Pacific Fertility Center Los Angeles – PFCLA.
Consultation with our Physician
The first step is to have a consultation scheduled with our IVF specialists to discuss the IVF process and treatment plan for an individual case. This would be when more specific questions about your unique experience would be raised. For example, you might want to ask the physician about why screening tests are needed and what they look for. Another question may be is there an illness in your family history that is or could be of concern? The more communicative you are with your physician will help determine what is needed for your journey to be as successful as possible.
Financial Consultation
Your financial coordinator will guide you through the different pricing package options around the time of your initial consultation with our physician. You can connect with your financial coordinator before speaking with a doctor, or you may first want the doctor’s advice on which IVF package is the best fit for you. We have a variety of options for individuals to choose from, so you can decide if you want to focus on reducing your cost or paying a little extra for more peace of mind.
Pre-Cycle Testing: 1 Week
Pre-cycle labs:
It is important to know what types of tests your physician requires and what types of medications will be ordered for you during the process. At PFCLA, our physicians typically order blood tests to check female patients’ ovarian reserve and look for any abnormalities. Male patients will also go through blood tests, and a semen evaluation is usually required prior to starting the IVF treatment. These pre-cycle tests can be done at our clinic or at your local facility to reduce your travel if you do not live in the Los Angeles area.
The examples of tests needed for female patients are below:
- AMH (Anti-Mullerian Hormone)
- AFC Ultrasound (Antral Follicles count)
- PAP smear
- CBC (complete blood count)
- TSH (Thyroid-stimulating hormone) and Free T4
- Prolactin
- Varicella IgG Antibodies
- Measles IgG Antibodies
- Rubella IgG Antibodies
- Hepatitis B Core antibody
- Hepatitis B Surface antigen
- Hepatitis C antibody
- Antibody Screen
- Syphilis
- Cytomegalovirus (CMV) IgG/IgM
- AboRh Blood Type
- HIV 1/2
- Chlamydia
- Gonorrhea
The examples of tests needed for male patients are below:
- Semen evaluation
- Hepatitis B Core antibody
- Hepatitis B Surface antigen
- Hepatitis C antibody
- Syphilis
- Cytomegalovirus (CMV) IgG/IgM
- AboRh Blood Type
- HIV ½
- HTLV-I/II Antibodies
- Chlamydia
- Gonorrhea
The results for the above lab tests usually take a week to finalize.
Genetic Carrier Screening: 2-3 Weeks
When you are preparing to become pregnant, you want everything to go right. While most babies are born healthy, with every pregnancy there is a small chance of having a baby with a genetic disorder. With genetic carrier screening, you can learn your risk for passing an inherited genetic disorder to your child and may be able to reduce it.
Genetic carrier screening is a type of genetic test that analyzes your DNA to provide specific information about your child’s risk for certain genetic disorders. The results can allow you to make more informed reproductive choices.
This test is usually ordered during the beginning of your IVF journey. You will have this test done as part of the pre-cycle lab work before creating the embryos. This test could be blood drawn or a home saliva test. The results usually take around two to three weeks to finalize.
Medications
During IVF cycles, fertility doctors prescribe various fertility medications to their female patients as part of the treatment process. These fertility drugs trigger the release of various hormones that stimulate egg production and maturation while also regulating ovulation.
By taking these medications, women are essentially made more fertile during the possible egg retrieval and embryo transfer procedure, which improves the chances of a successful pregnancy.
There are different kinds of fertility drugs, as well as different dosages that may be prescribed for IVF. Your IVF physician will decide the medication protocol based on your unique case.
Below are the examples of medications that may be used for your IVF cycle:
- Follicle-Stimulating Hormone (FSH): Follistim or Gonal F
- Human Menopausal Gonadotropin (hMG): Menopur
- Human Chorionic Gonadotropin (hCG): Lupron or Novarel
Medications typically used for a Frozen Embryo Transfer cycle are the below:
- Progesterone
- Estradiol
Egg Retrieval Stimulation Cycle Timeline
After your IVF physician reviews all your pre-cycle lab results and orders your medications, you are now ready to start the egg retrieval stimulation cycle. Injections usually start from day 2 or day 3 of your menstrual cycle.
The average time for the egg retrieval stimulation cycle ranges from 10-14 days, but each case can vary depending on how the patient’s body reacts to the medications. This timeframe starts when the patient begins medication used for ovarian stimulation for the egg retrieval procedure.
Fertilization and PGT-A Testing
The day after the eggs have been fertilized, we will provide a fertilization report. The fertilized embryos will be cultured for 5-7 days, and then be biopsied and sent for PGT-A (preimplantation genetic testing). Once the embryos have been fertilized and biopsied, it takes around two weeks to receive the genetic testing results. After we know the embryo’s results, you will then be ready to prepare for an embryo transfer cycle.
- What is PGT-A Testing
The PGT-A tests all 23 pairs of chromosomes for structural/numerical abnormalities.
Preparing FET (Frozen Embryo Transfer) Cycle
After embryos are created, you will be ready to prepare a Frozen embryo transfer cycle.
When it comes to a FET (Frozen embryo transfer) cycle, each case can vary due to several factors. In a typical scenario, the embryo transfer procedure usually occurs between days 19 and 21 of the patient’s menstrual cycle. This is followed by a pregnancy blood test approximately 10 days post-implantation. We will continue to follow up with the pregnancy until the 10 weeks OB ultrasound. Typically, after 10 week’s OB ultrasound, you will then be discharged to her OB’s care.
When to Try Again if an Egg Retrieval Cycle Fails?
Not all the cycles are successful for the first attempt. Lots of patients achieve success within a few attempts. If your first cycle outcome is not ideal, you can try again after speaking to the IVF physician.
You will expect a period to start 1-2 weeks after the egg retrieval procedure, your ovaries will need to rest for that period. The soonest time to try again will be starting with the next following period.
When to Try Again if a Frozen Embryo Cycle Fails?
Successful embryo transfer outcome depends on many factors such as endometrium lining thickness and embryo grading. If the first attempt fails, don’t be discouraged as you can try again. You will expect a period to start about a week after a negative HCG test. After you speak to your IVF physician, the soonest you can try again will be within that period; no additional wait is required. Of course, if you feel like you need more time before trying again, you can always discuss with your IVF physician to figure out the best timeline for your specific case.