1. Medications for Ovarian Stimulation will be prescribed to stimulate the ovaries to produce several eggs in order to increase the chances of pregnancy. There are two protocols namely Long Protocol and Antagonist Protocol available under the IVF treatment at Wings and you will be advised by our doctor as appropriate.

– Under Long Protocol, Injections will be started on the 21st day of the previous menstrual cycle. A sonography and blood test is conducted before the actual stimulation is started. You will be asked to come to the Wings center on the second or third day of your next menstrual cycle to start the actual ovarian stimulation.
– Under Antagonist protocol, fewer injections and the injections for ovarian stimulation are started from the second day of the menstrual cycle.
– In both protocols, injections are to be taken at approximately the same time every day. Though, the injections can be taken at your Home in order to minimize the disruption in your medication, it is advisable to come to the hospital for your injections. Our medical staff will provide instructions on how to administer the injections. It is common to experience some discomfort and mild side effects, while taking these medications.

2. The next step is the Ultrasound examination. A vaginal ultrasound examination is conducted five days after the administration of medications to measure the response of your ovaries with regard to the number and size of the follicles. If the response is poor and only one or two eggs are expected, or when the chances of pregnancy are low, we might suggest cancelling the IVF cycle.

3. Further, HCG injection is given to trigger the final maturing of the eggs when they are ready for collection. Egg collection is planned approximately 36 hours after the HCG injection. The embryologist will inform you when your husband/partner is required to give his semen sample.

4. The next step is Ovum pickup (Egg Collection) where the procedure of removing the eggs from the ovaries is carried out with the help of transvaginal sonography under general anesthesia. The procedure takes about 15 –30 minutes and on an average 8 – 10 eggs are collected from each ovary. You will be able to go Home, three hours after the procedure is completed. It is common to have some vaginal bleeding after this procedure, but that settles down in a day or two. Discomfort as a result of the swelling of the ovaries is common.

5. After Ovum is picked, fresh semen sample should be collected on the day of the ovum pick-up (egg collection). However, if a fresh sample cannot be produced on the same day, a previously frozen sample can also be used.

– The semen sample is best produced by masturbation – Lubricants should NOT be used as they can affect fertilization – It is sometimes difficult for some men to produce a semen sample on request. In this case, you may collect the sample at Home/elsewhere and bring it to Wings Clinic within an hour of collection. – Unless advised otherwise, abstinence is recommended prior to two days before the egg collection. However, an abstinence of more than four or five days will reduce sperm quality.

6. After ovum is picked up and semen is collected, the eggs will be fertilized in the lab either by standard IVF or by ICSI. On the next day, the embryologist will examine the eggs for fertilization.

7. Now the egg is fertilized and Embryo is formed. Embryo transfer is performed two or three days after egg collection. The embryo is transferred through the cervix into the uterus via a thin, soft plastic tube guided by sonography. You will be asked to take some injections and/or tablets after the embryo transfer to support the luteal phase. It takes only a few minutes and causes no discomfort.

8. You can resume all normal activity including sexual intercourse, after the procedure. However, heavy work such as lifting weights or climbing stairs is not advised.

9. Embryo freezing can also be done if there are more than three well-developed embryos, it is possible to freeze them for a later transfer, if necessary. This procedure will be discussed with you before the embryo transfer. Separate consent forms must be signed for embryo freezing.

10. A Pregnancy test is conducted approximately two weeks after the embryo transfer where you will undergo a test for beta-HCG to check if gestation has been achieved. If the test is positive, a vaginal ultrasound scan will be performed to confirm this and view the gestational sac. If the beta-HCG test is negative, further treatment will depend on whether you have frozen embryos or not.