PATIENT INFORMATION GUIDE TO :
I.V.F (IN-VITRO FERTILIZATION) & I.C.S.I (INTRACYTOPLASMIC SPERM INJECTION)
FOLIC ACID You should take the recommended amount of folic acid daily before the scheduled treatment cycle. This is Department of Health advice for all women wishing to conceive and not just for assisted conception treatment. This vitamin has been shown to reduce the chance of spina bifida and is available from chemists. You should continue with it for as long as you are trying to conceive and for the first three months of pregnancy. Also, it is good advice to eat a balanced diet with plenty of vegetables and raw fruit.
SMOKING Smoking can be dangerous during pregnancy and can also decrease your chance of conceiving. Therefore, it is imperative that you do not smoke.
CONSENT Both partners prior to commencing treatment must sign a consent to treatment by insemination form.
NECESSARY TESTING A full set of Viral Screening for HIV, Hepatitis B (Surface and Core) and Hepatitis should be completed within 90 days of initial IUI procedure.This is as per EU Guidelines . A clear Rubella screen should be available for the female undergoing IUI procedure within 2 years of treatment. If is also recommended that all females attempting to achieve a pregnancy should have Cervical Smear tests carried out as per National Guidelines.
WHAT YOU NEED TO KNOW BEFORE TREATMENT BEGINS
Before commencing with the proposed treatment, please ensure you have been given the following information.
1 The limitation and possible outcomes of the proposed treatment
2 The possible side effects and risks of treatment
3 The technique involved
4 All alternative treatments
5 The costs involved and costs of alternative treatment
6 The availability of counselling facilities
7 The possible disruption to your normal life
STARTING TREATMENT
Day 1 of your menstrual cycle – please contact the clinic.
Should this fall at the weekend please commence your medication as prescribed and call the clinic on the next day it is open. The purpose of this phone call is to inform us that you are starting treatment and also to book your first monitoring Ultrasound Scan with us. This first scan will be booked between Day 6 and 9 depending on the length of your cycle.
Day 2. You should start your prescribed medications as follows; Menopur and Gonal F – please commence these medications at the prescribed dose EVENING/MORNING as advised by Doctor of Day 2.
Day 6 – 9. You will attend the clinic for your Ultrasound Scan. These scans are normally performed trans-vaginally and will require an empty bladder. Dr. Ayers or one of our Fertility nurses will perform your scan. These scans will need to be repeated every 2-3 days until the criteria for treatment has been met. An average cycle will require 1-3 scans.
A third medication, Orgalutran or Cetrotide, will be added once a follicle measuring greater than 13mm is seen on your Ultrasound Scan. When you are deemed to be ready for your Oocyte Retrieval you will be given further instruction regarding when to take your final medications and finally your trigger injection (Ovitrelle) to encourage ovulation.
You will also be contacted by your treatment co-ordinator in Clane and given a date and time to attend there for your procedure. You will also be given a specific time 36 hours prior to your Oocyte Retrieval to take your Ovitrelle.
Occasionally follicles do not develop in which case the treatment will need to be abandoned. This is a natural occurrence and usually the advice will be to proceed with treatment again on the following cycle.
In the event that you were to produce too many follicles you may also be cancelled so as to avoid the potential occurrence of Ovarian Hyperstimulation (OHSS).
OOCYTE RETRIEVAL
When the correct date has been determined you will be given an appointment time for your treatment. You will have been advised to fast from 12 midnight the night before your procedure.Your partner will be asked to attend the unit also to provide a semen sample. He should abstain from intercourse/ejaculation for 2 – 3 days beforehand.
If you are using Donor Sperm, this will be thawed for use on the day of Retrieval.
Oocyte Retrieval will occur in the Theatre Department of your selected Clinic. This Theatre operates with a ‘Clean Air’ environment. In order to maintain this, it is essential that you do not wear any make up, fake tan, perfume, body products etc. All jewellery must be removed. You will be given a special gown to wear and your hair and feet will also be covered.
The Doctor carrying our your procedure will position a cannula in your arm/hand. Through this will be given medications to provide a light sedation. This medication will make you sleepy and sometimes a little dizzy. This is nothing to worry about and you will be monitored very closely throughout the procedure.
This is usually a simple painless procedure lasting approximately 15-30 minutes. The procedure is performed on an outpatient basis. You will be monitored following the procedure and once you are feeling well enough you will be allowed home. Please ensure that you have someone to drive you home as you may still feel a little drowsy.
DISCHARGE
Following your discharge, please ensure that you commence the following as prescribed;
- Cyclogest Pessaries 400mg daily (until we advise you to stop)
- Flagyl 1g twice a day for 5 days
- Doxycycline 100mg twice a day for 5 days
You will subsequently be contacted by Medical Staff at your IVF Clinic regarding your follow up visit for Embryo Transfer.
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