It entails the patient to take oral contraceptive pills for a period of 21 days commencing from the 5th day of the period. On the 19th or 20th or 21st day a GnRh analogue injection (Zoladex) is administered subcutaneously from a prefilled syringe(fat layer of skin) below the umbilicus/navel either as a single dose of 3.6mg or at different sites like upper arm or thigh as a daily dosage (Inj. Gonapeptyl) using an insulin syringe.
Once the contraceptive pills are stopped, periods will start within two or three days and the patient reports for scan and blood tests on the 2nd or 3rd day of her periods. This is when we will start the ovarian hyperstimulation injections in order to procure more number of eggs for us to work on.
Now, the former regime can be followed by the patient in association with her own gynecologist in her home country and can report to us during her subsequent period for us to start the stimulation injections. We prefer to administer these shots because it gives us more consistency and is also easier to monitor patients for signs and symptoms of excessive stimulation, which is called ovarian hyperstimulation syndrome. So the trip can be planned in such a way that you still gain a month before you arrive here for the actual treatment by taking the pills and the shot and reporting here just for the Hormonal injections and further procedures.
Usually the injections are given for a duration of 12-15 days, starting from the 2nd/ 3rd / 4th of the periods, with a combination of recombinant or urinary or highly purified FSH with gonadotropins added as per protocol.
The growing ovarian follicles are monitored by regular ultrasounds performed on alternative. When they reach an optimum size, we will time for oocyte retrieval. The preparation process for the procedure will be explained in detail during consultation. The retrieval is done almost always under general anesthesia and in special cases with mild sedation. Hence we will do relevant investigations prior to this procedure.
Once retrieval, fertilization and transfers are done, we generally would like the patient to stay until blood tests for pregnancy and until the first trimester is complete; but if there is a need to fly back to home country we will assist you in that too. Post Embryo or Blastocyst transfers progesterone support is initiated until blood test. If positive for pregnancy these progesterones and other supportive medication are continued according to our instructions.