You would like to get pregnant. I need your help as well. Please do not plan many activities from a week before the stimulation until a week after embryo transfer. You can get your car for maintenance or get hair cut done later !!! Especially if you are coming to see me for the secondary fertility. Please have a babysitter coverage and try not to make your schedule full.
Suppression, Stimulation, and Trigger Stage
Once your stimulation starts, keep me in the loop during the stimulation cycle (avg: 11 days): the day of trigger shot, egg retrieval, and embryo transfer day because you need to come to see me more often during the time. Here’s the time line. After you get the suppression check, you are very likely to start the stimulation drug (gonal-f, menopur, follistim, braville or any of these drugs combined). You are required to get ultrasound and blood work done on day 4/5 and day 7/8 to check your E2 level, the size & numbers of follicle growth and the thickness of endometrial lining. You are very likely go to get screened these test 2-3 days in the row on the day 9-10-11. If your follicles are growing evenly (means not one is dominating) and your E2 level is in the range, it is very likely you will get triggered on the day 11 (as early as day 8 and as late as day 17).
I prefer to see my patients twice during the period but all depend on their status of progress and one treatment around the trigger. After you get triggered, you are going to get egg retrieval 36 hours later. Take a nice rest on the day of egg retrieval with plenty electrolyte (coconuts water is the better source than sugary sports drinks on the market) and protein of your choice when you come back from the procedure. I would like to see you the day or night before embryo transfer and after the embryo transfer.
After that, I will see you twice for implantation stage – the possible early implantation stage (example: frozen transfer – embryo is “expanded grade AA” or “already hatching”)- very likely I need to see you in this stage twice. And one more time on the later implantation stage – day 9-10-11 counting from as the day 1 is the day after egg retrieval. Frozen transfer day is already day 5 implantation day. Nobody can predict when your embryo will be implanted so that I will treat you at the early implantation time and later implantation time to cover the whole implantation period. After that, we concentrate on only positive thinking and pray for the best result.
You do not want to think about the negative result, however, more than a dozen patients each year, become pregnant by coming for acupuncture when their period starts (day 3/4) after failed IUI/IVF. After one to two cycles after failed IUI/IVF, your body still contains stimulation medications so that your chance is higher than normal if we can nail the right ovulation time. I believe “less stressed out” uterus accept conception with “left over stimulation” to trigger the strong ovulation and keep progesterone level on the luteal phase high and long! I can NOT stress enough the fact that do not waste your following cycles after failed IUI/IVF.
I will try fit you in to my clinic schedule as much as possible. Please use email or text as the main communication methods.
Implantation will not occur as soon as you have done IVF. Please take a look at this chart.
Once you find out you are pregnant after done the series of IUI/IVF, you are already 4weeks pregnant. Congratulations !You are asked to come to get blood test two more times at your fertility clinic to confirm your hcg level will double. In the week 7-8, you are asked to come to your fertility clinic for the ultrasound to see your pregnancy status to find out singleton or multiple pregnancy. This is the very first time to hear your baby’s heart beat. The normal fetal heartbeat at 6 weeks is about 90 to 110 beats, and 120-180 per minutes at 8 weeks.
I suggest (never force you to come) my patients to come to see me at least up to 13th week. During the 11th week of pregnancy, your baby is about the size of a thumb but clearly see the head, torso, arms and legs. If you have twins or triplets, that is another story. For twins and triplets, I would like to monitor you closely until 23 weeks. I have met patients who lost twins and triplets and not able to conceive ever since. It might be coincidence but all of them lost their babies during the 21st -23rd week pregnancy. I monitor very closely with my patients around the time and let my patients go after that.
You will be able to find out the sex of your baby the 16th week. In the week 11-13 (the last day for this test is 13th week and 6 days pregnant) is also the time you will see your gynecologist for early risk assessment test ( Nuchal Translucency Screening Test)to assess your baby’s risk of having down syndrome and some other chromosomal abnormalities as well as major congenital heart problems. Here’s differences between screening test and diagnostic test (CVS and amniocentesis) It will help you decide whether you need CVS (choronic villus sampling) or amniocentesis. Here’s what American Pregnancy Association says about the prenatal testing. You are more than welcome to come to see me on the weekly basis but I usually let my patient go and suggest them to come back to see me around 30th week in order to have the easier labor. Weekly acupuncture treatment will help you tremendously. When it comes to the 30th week, your stomach will be pretty big but get much bigger for next 10 weeks which will leads you to have restlessness sleep, sacrum (low back) pain, headache, carpo tunnel, hyper tension etc… I am able to help you turn the baby’s position (breeched baby) around 35-6th week. It all depends on how big the baby is and I need the permission from your doctor. If the baby is still small, the chances are your baby will turn again ! I am able to induce your labor as well. My happiest time is the baby announcement arrives on my iPhone!!!
Tests, Protocols and Medications
- Anti-Mullerian Hormone (AMH) – ovarian reserve
- Antral Follicle Counts– egg supply and predicting response to ovarian stimulation drugs
- Beta 2 Gylcoprotein – elevated levels(blood test)
- Cervical Stenosis – Cone Biopsy – LEEP (Loop Electrosurgical Excision Procedure)
- Comparative Genomic Hybridization (CGH)
- Comprehensive Chromosome Screening (CCS)
- Elevated level of NK cells and infertility
- Estrogen Priming Protocol
- Follicle Stimulating Hormone (FSH) ovarian reserve (Day 3)
- HCG level / LH surge numbers both singleton and twins
- Hydrosalpinx – Fallopian Tube problem
- Karyotyping – advanced genetic testing
- KCT – Lupus Anti-coanticoagulant Antibodies
- Preimplantation Genetic Diagnosis (PGD) – Embryo Morphology, Chromosome Abnormalities