IVF- Microflare FSH +/-HMG

Your treatment plan will be submitted to FCNE’s insurance team once all of the ordered testing is 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. Your provider may elect to use a short course if birth control pill prior to beginning the cycle. The Care Team will provide these instructions when you report cycle day one of your period.

2. Once your IVF cycle is approved and you have your IVF medications
delivered contact your Care Team by calling781-944-0052 OR send a
message via the Patient Portal. IF, you are taking birth control pills, we will give you a stop date for the pill and a date for your baseline ultrasound and bloods. We expect you to get a period after stopping the birth control pill. You do not need to let us know when you get it. If you are not on the birth control pill, you will be instructed to return the following morning for blood work and vaginal ultrasound.

3. Abstain from unprotected intercourse from day one of your period until
you have the pregnancy test at the end of your cycle.

4. 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) will be injected at a time
specified by FCNE and will be included in your instructions.

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 or 3 days later.

6. When you have enough follicles 17.5 mm or larger you will be instructed to
discontinue your Microdose Leuprolide Acetate, Gonal-F/Follistim (FSH) and
Menopur (HMG) and take a one time injection of HCG/Human Chorionic
Gonadotropin/Novarel/Pregnyl. This injection is taken at a VERY SPECIFIC
TIME in the evening 36 hours before your egg retrieval.

7. 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 taxi cab you MUST be accompanied by
someone to care for you. If applicable, your husband or male partner will
need to produce a semen sample when the two of you arrive the day of the
egg retrieval if you are not using donor sperm or frozen sperm.

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.

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.

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.