What is involved in treatment?
Treatment starts at the beginning of the woman’s menstrual cycle. Typically, you would commence drug treatment by one injection of Gonal-F on the second day of your period (day two of the cycle). Further injections are given on the fourth, sixth and eighth days of your cycle, and you need to attend the Centre on the ninth or tenth day of the cycle for an ultrasound scan. The scan is performed through the vagina with an empty bladder. It is not painful. Scanning via this route gives an excellent image of the ovary and it is possible to see the development of the follicles within the ovary. Follicles are the fluid-filled structures that contain the eggs. Although the eggs cannot be seen by ultrasound, the number of follicles corresponds to the number of eggs that are developing.Depending upon your ultrasound picture, further injections may be given on, or after, the tenth day of the cycle and the dose of drug may be increased or decreased. The aim of the stimulation is to achieve the development of two or three mature eggs to maximise your chances of pregnancy. Eggs are thought to be mature when they develop in follicles that are approximately 2cm in diameter. The number of follicles and the size of the follicles is therefore assessed at ultrasound. You may need two or more ultrasound scans in your treatment cycle to determine the optimum response.
When you have follicles of the appropriate number and size in your ovary, arrangements will be made for you to have a final injection (Ovitrelle). This causes the eggs to be ovulated approximately 24 to 40 hours later. The timing of your injection will be carefully determined to enable insemination to be performed around time of ovulation.
On the day of the insemination, the male partner would need to arrive at the laboratory 1½ hours before the planned time of insemination. He would need to produce a sperm sample there by masturbation. The sample will be prepared in the laboratory using specialised techniques to extract the healthiest, and most active, sperm. These sperm will be inseminated into your uterine cavity at the Centre. This is a straightforward procedure similar to having a cervical smear. The neck of the womb will be examined with the speculum and a very fine, flexible plastic tube passed through the neck of the womb into the cavity of the uterus. The sperm are injected through the plastic tube and will very rapidly reach the Fallopian tubes where it is hoped they will fertilise the egg(s).
After the treatment, you will be given some pessaries, or suppositories, to use to keep the lining of the womb receptive to any embryo(s) that may form. These pessaries are used for two weeks until a pregnancy test is performed. If you are pregnant, then the use of the pessaries may be continued for several more weeks.
