The following explanations are important and will enable you to plan your schedule during treatment. Our aim is to help you gain an idea of how much time you will need to plan during your treatment month.
When all the medical preparations have been made, we will discuss the individual stages of treatment with you once again. Feel free to ask any questions that occur to you, however simple. Asking too many questions is always better than not enough; this will ensure that you are familiar with the procedures and enable everything to go smoothly.
Now we draw up the schedule for your treatment month together with you. We design a 'timetable' or 'stimulation plan' to reflect your personal situation, and prescribe the necessary medication.
To minimize the effort, and thus the stress, involved in the stimulation procedure, we are happy to show you or your husband or partner how to give the required injections (information brochure: "Instructions for performing injections" and a short film on using Menogon HP).
The trigger injection must be given 1.5 days before the puncture (generally between 9 pm and midnight) to enable the eggs to mature in time.
In rare cases, some stimulation procedures may result in spontaneous maturation of the egg. (To identify this or avoid missing premature ovulation, it may be necessary to collect urine samples at three-hourly intervals during the last phase before puncture, to detect any rise in the body's natural ovulation hormone (LH).) However, nowadays this situation can almost always be avoided by applying the 'long protocol' or by short-term use of an antagonist.
The time you will need in addition to the necessary injections can be summarized as follows:
First check-up: Either during the first days of menstruation (after downregulation using Decapeptyl or nasal spray) or before the start of stimulation, otherwise between the 9th and 13th day. Please plan to spend 1 – 1.5 hours in our Center, depending on the number of other appointments we have that day.
Second check-up: Again, please plan to spend 1 – 1.5 hours in our Center.
Further check-ups may be necessary (particularly in rare cases as described above where frequent urine samples are necessary). More check-ups may also be needed if your ovaries respond more slowly or more strongly than expected.
In particular, this may be the case in various forms of PCO syndrome. Additional examinations may be necessary to identify any increased risk of over-stimulation.
Ovarian stimulation injection (generally between 9 pm and midnight). This injection is given on our express instruction around 34 to 36 hours, or 1.5 days, before collection of the eggs (follicular puncture).
It is particularly necessary that you learn how to give yourself this injection. Otherwise you may have an unnecessarily long search for someone to give you the injection the injection at such a late time.
It is important that the correct trigger injection (Choragon/Ovitrelle) and only the trigger injection is given!!!
Absolute care must be taken to avoid any confusion between the injections. Any mix-up would mean that only immature eggs incapable of being fertilized or no eggs at all would be available on the day of puncture / egg collection. You may need to see your general physician or gynecologist the day after the trigger injection for a blood test. You must bring this blood sample (whole blood in a normal Monovette / vacutainer) on the day of the puncture; it can be kept in the refrigerator until needed.
The following diagram shows the progress of treatment. Please note that in individual cases the treatment sequence may differ significantly from the information in the diagram.
You can ask for a sick note (certificate of incapacity for work; in German Arbeitsunfähigkeitsbescheinigung, AU) for the days between the puncture (egg collection) and the transfer procedure (return of the fertilized eggs).
(= Day of the puncture procedure): Please come to the Kinderwunsch Centrum fasting on this day – in other words, please do not eat, drink or smoke after midnight of the night before. Patient registration takes place in the IVF 'Liegeraum' (reclining room), generally between 7.30 and 10.00 am, and around two hours before your operation is scheduled. This ensures that our anesthetists have plenty of time to discuss the procedure with you and that you can prepare for it.
Please do not make any other plans for this day; we will need to keep you under observation for at least two hours after the puncture procedure for medical and legal reasons.
Our comfortable reclining rooms are available for this purpose - as single or double rooms if required.
Collection of the eggs (= puncture) takes place transvaginally under ultrasound monitoring. A thin needle is used to penetrate the vaginal wall and the ovary generally located directly behind it, and the eggs in the follicle are extracted. Although this procedure is not very painful, we always recommend light anesthetic (intravenous painkillers and tranquilizers).
You may only leave the clinic when accompanied by your husband, partner or other companion.
To sum up, you must always arrive for a puncture procedure fasting, you must arrange to be collected from the clinic by a companion and you must not drive a car on that day.
In the early morning of the day of the puncture procedure, we also need a sample of sperm from your husband or partner, although it need not be at exactly the time of your puncture procedure.
The next day is your 'rest day', when you can recover from the (hopefully not excessive) stress of treatment. You can call our laboratory between midday and 2 pm to find out whether the eggs have been successfully fertilized and when the transfer will take place in the coming days. You will be specifically informed of any deviations (e.g. caused by Sundays, public holidays).
On the day of the transfer, the fertilized and divided eggs are returned (= transferred) to the uterus. This generally takes place two to three days after egg collection. Please do not make any other plans for this day if possible.
Registration again takes place in the morning in our IVF 'Liegeraum', but usually not before 10 am. After the embryo transfer you should plan to rest for around one hour before leaving.
You can go home at midday or in the early afternoon – this time without the need for a companion. However, your husband or partner is welcome to accompany you to the transfer and to be present during the procedure.
We will take all the time you need to answer your questions about what happens after the egg collection and transfer. We have summarized the main points in a separate brochure which will be given to you at the time.
dieser Text wiederholt weiter oben: The following diagram shows the progress of treatment. Please note that in individual cases the treatment sequence may differ significantly from the information in the diagram: