IVF Estrace Priming FSH
+/-HMG Cetrotide/Ganirelix
Your treatment plan will be submitted to FCNE’s insurance team once all of the ordered testing has been resulted and valid consents are on file.
Please note that the insurance approval process can take up to 21 business days.
Once approved, you will be notified via the portal. The clinical team will then begin to work on the medication order within 72 hours. Please note that in most cases Prior Authorization is required (PA). The time from medication order to delivery to your home could take up to 10-14 days.
Please note that a cycle can’t be started until you have received all of the medications.
Instructions
1. Contact your Care Team on Cycle day 1 by calling 781-944-0052 OR send a message via the Patient Portal.
2. Abstain from unprotected intercourse from day one of your period until you have the pregnancy test at the end of your cycle.
3. Once your IVF cycle is approved and you have your IVF medications delivered, contact your Care Team by calling 781-944-0052 OR send a message via the Patient Portal. You will be instructed to come in for a progesterone and pregnancy blood test on cycle day 20.
4. You will receive portal instructions that afternoon to start taking estrace 2 mg tablets twice a day orally. You will be provided a date to return for monitoring. If you start your period before this date, you will contact your Care Team via the portal or call 781-944-0052 on the first day of full flow period by 3 PM. You will be instructed to STOP taking the estrace tablets and come in the next day for your baseline ultrasound and bloods before starting your injections. Every time that you come in for ultrasound and bloods you will receive portal instructions in the afternoon. These will include what medication(s) to take, how much, on what days and when to return for monitoring.
Please take morning injectable medications at a time that works with your morning schedule within a 2-hour time frame from day to day.
Please take evening injectable medications between 7 – 9 PM within a 2-hour time frame from day to day. If there is a day that you have plans to be out in the evening it is better to take the injection earlier before you go out.
The trigger injection (Human Chorionic Gonadatropin, Pregnyl, Lupron) will be injected at a time specified by FCNE and will be included in your instructions.
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5. You will be instructed to return for a blood test after 3 – 5 nights of injections.
We will send portal instructions that afternoon. You will come back for bloods and an ultrasound 2 – 3 days later.
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6. You will eventually add in daily injections of Cetrotide/Ganirelix . Please note that at this point in your IVF cycle, you may require daily monitoring until you are ready for an egg retrieval.
7. When you have enough follicles 17.5 mm or larger you will be instructed to discontinue your Gonal-F/Follistim (FSH), Menopur (HMG) and Cetrotide/Ganirelix and take a one time injection of HCG/Human Chorionic Gonadotropin/Novarel/Pregnyl/Lupron. This injection is taken at a VERY SPECIFIC TIME in the evening 36 hours before your egg retrieval.
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8. You will be instructed to have nothing to eat or drink starting @ 12 AM the day of your egg retrieval. You will arrive 30 – 60 minutes before your egg retrieval. You will be instructed not to wear make-up, jewelry or contact lenses. You will need a responsible ride home. If you are using a ride service such as Uber, LYFT or a taxicab you MUST be accompanied by someone to care for you.
9. If applicable, your male partner will produce a semen sample at home prior to traveling to the appointment. Collection kits are available at all our satellite offices and can be obtained in the office during morning monitoring. If you live more than 1.5 hours away and prefer to produce on site at FCNE please be sure to let us know.
If you are proceeding with an embryo transfer:
You will receive written instructions at your egg retrieval to begin Estrace/estradiol once a day beginning that evening. You will receive portal instructions the day after the egg retrieval with fertilization results, progesterone support instructions and embryo transfer instructions. Embryo transfer is scheduled for 5 days after the egg retrieval.
You will be instructed to arrive with a full bladder 15 minutes before your scheduled embryo transfer. You can eat and drink that morning unless otherwise instructed. Once the embryo transfer is complete, you will be discharged to your home with instructions to rest that day. Estrace and progesterone is continued as directed during this time.
You will come back for your pregnancy blood test 10 days after your embryo transfer. We will call you that afternoon with your results.
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If you are proceeding with an egg freeze or embryo freeze:
You will receive portal instructions the day after the egg retrieval with egg cryopreservation number or fertilization results.
An update for embryos will be provided via the portal one week later.
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If you are proceeding with an embryo biopsy for PGT:
You will receive portal instructions the day after the egg retrieval with the fertilization results.
An update for the embryo biopsy will be provided via the portal one week later. PGT-A results are typically available 14 days later. PGT-M can take up to 21-28 days.
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IVF- Estrace Priming FSH-HMG- Cetrotide/Ganirelix-updated 2-26-25