1. What is the basic control performed during menstruation?
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When the patient is menstruating, an ultrasound monitoring is performed to check whether the ovaries are at rest. With this ultrasound we check that there are no cysts or other structures in the ovaries that could prevent the beginning of the treatment.
In addition, it is usual to do a hormonal control (estradiol, LH and progesterone). If both controls are normal, it is possible to start with the treatment.
Sometimes, the results of the ultrasound or the hormonal analysis indicate a wait until the following month to start the treatment. In these cases, it is frequent to prescribe a contraceptive pill to keep the ovaries at rest.
2. Is it necessary to attend the clinic every day for the monitoring of an IVF cycle?
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No. In an IVF cycle, it is necessary to do a series of ultrasounds and hormonal controls, but not daily. The first control is usually done with the menstruation. Then, a control is done at the fifth day and, from there, the controls are performed on alternate days.
In any case, this basic scheme is tailored to the specific needs of each patient (thus, the controls may be more frequent or less in a particular case). It is also dependent on the protocol used for the stimulation of the ovary.
3. What is the monitoring that is done during the IVF cycle?
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In the controls of the cycle, a transvaginal ultrasound is always performed. With this ultrasound, the number of follicles in the ovaries is counted and the size of each follicle is determined. This information helps to adjust the dose of medication the patient must use.
According to the result of the ultrasound, it may also be necessary to do a blood test to measure one or two hormones: estradiol and LH. Estradiol allows us to assess the development of the follicles in the ovary and to estimate the risk of ovarian hyperstimulation.
LH allows us to detect some situations in which it may be necessary to add this hormone to the hormonal treatment.
4. How long does it take from the beginning of the stimulation to the egg retrieval?
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It depends on the type of treatment that is being performed and on every patient. In general, we can say that if a long cycle is done, the induction of the ovulation takes about 10-12 days. In contrast, in the short protocols with GRH analogs, the induction of the ovulation is usually a little shorter (9 to 10 days).
In summary, since the patient starts with the injections to grow the follicles in the ovaries (with Gonal, Puregon or Menopur) to the ovarian puncture to retrieve the eggs, it can take 8 to 12 days.
5. Is it necessary to rest in bed after the embryo transfer?
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Usually, after the embryo transfer, the woman is left to rest in bed (between 20 and 30 minutes). Although it is systematically done, no study has succeeded in demonstrating that resting after embryo transfer has a positive influence on the pregnancy rate.
What is certain is that these minutes of rest help the woman to be quiet and to relax, which can increase her sense of well-being.
Yes, if the exercise is smooth and it does not involve much effort. In contrast, in some cases, especially when the ovaries are too stimulated, it is advisable to rest, since with the sudden movements there is a risk of ovarian torsion.
It is appropriate to discuss with the physician who is monitoring the cycle whether it is advisable to exercise or not (it is not the same doing Yoga than playing paddle).
7. Should I change my diet during an IVF cycle?
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In general, the diet of any woman who intends to become pregnant must be healthful and balanced. It is important not to take alcohol and to reduce the consumption of coffee (no more than one a day). It is important to maintain an adequate hydration by drinking about 2 liters of liquid. It is necessary to avoid the excess of fats, but be careful not to fall on the opposite (the lack of fat may interfere with the absorption of some vitamins).
8. Should I take any kind of vitamins before starting the treatment?
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As a rule, any woman who is trying to become pregnant must take folic acid (400 mg daily in low-risk cases and 800 mg in high-risk cases). It has been shown that with this intake of folic acid, the number of children born with spine malformations are reduced (spina bifida, meningocele, etc.).
9. Should my partner have sexual abstinence before delivering the sperm sample?
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Yes. Either for artificial insemination or for IVF, it is advisable that the man has sexual abstinence for two or three days. In some particular cases, this period may be broader.
10. My partner has a frozen sperm sample. Is it necessary to provide a fresh sperm sample the day of the follicular puncture?
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No. Most of times a sperm sample is frozen before starting the IVF treatment to avoid the man to give the sample on that day. This is usually done with men on a tight schedule for whom it may be difficult to attend on the day of the follicular puncture to obtain the sperm sample. A sperm sample is also frozen if the man has any type of problem in obtaining it (impotency, etc.). When the couple lives outside Madrid, it is advisable to freeze the sperm sample before starting the treatment.
11. Mi partner has a vasectomy that was done many years ago. Can we have children with an IVF cycle?
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The first thing to do in these cases is a testicular biopsy to see whether there is still a normal production of spermatozoids. If the vasectomy was done less than 10 years ago, spermatozoids are found in the testicular biopsy on most occasions. If the spermatozoids are not found, then, the only option is to use donor sperm.
But, if sperms are found in the biopsy, then they can be used to fertilize the eggs with ICSI (intracitoplasmic sperm inyection).
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