Saturday, November 05, 2022

What you should know while you are undergoing IVF treatment ?

 The good news about IVF is that, because it's been around for so many years, treatment protocols have become very standardized. which means most IVF clinics will know exactly what to do for the patients who come to them, which is great because patients are no longer being used to skinny pigs Not that they were ever used to skinny pigs, but there was a lot of uncertainty involved, a lot of which has now disappeared. So we know pretty much how to treat any patient who comes to us. 

Having said this, there is a certain degree of trial and error involved in every IVF cycle because, even though we use a standardized treatment protocol, not every patient is standardized, and every patient is going to respond differently to any protocol we use. Now we will categorize patients, for example, based on their age or based on their AMH levels or their antral follicle counts, or what we think will reserve isn't even based on their response to previous IVF cycles.

 But having said all this, no matter how many tweaks you make or how many well-informed decisions you make, the proof of the pudding is in the eating, and it's only by actually doing the IVF cycle that you will learn what went well and equally what didn't go well. Conceptually, I tell patients to think of IVF as a series of hurdles; you need to cross all the hurdles to reach the finish line; you need to grow the follicles; we need to get the eggs out, we need to check the eggs are mature; the embryologist needs to fertilize the eggs; we need to make good quality blastocysts, and they need to implant. Some things are in the doctor's hands, some things are in the patient's hands, and of course, a lot of it is in nature's hands, and we really can't control the implantation process.

This is why we do a certain amount of tweaking, and this is why monitoring during an IVF cycle is so important. Is the patient responding the way we expect it to respond, or is there something that is going on that is not what we'd expected? We can cause correct based on these studies or levels based on follicular scans based on what we think the ovarian responses are, and this is valuable information, and that's why we tell patients, it's so important that you know in advance what your IVF doctor is going to do for you. This is why we have standard treatment templates and standard treatment protocols. So ask your doctor what the protocol is for the treatment.

They should give it to you in advance, even before starting the cycle, so that there are no unexpected surprises; you know exactly what's going to happen; you're in control of your life and if things are going the way you expected that's great. Equally, this will tell you if things aren't going the way we expected, we need to make some changes, so you can have an intelligent discussion with your doctor and ask them what changes they're going to make and why, and sometimes we can make these changes during the IVF cycle itself. So for example, when we start the superovulation, it usually takes about five days of gonal F or HMG injections or FSH.

 We can check ovarian response by doing an ultrasound scan and checking the E2 level, and if it's not okay, that's a moment of truth during that IVF cycle. We can sometimes bump up the doors or sometimes we need to make certain changes in the protocol, like adding different drugs, and if we can't make those changes in that IVF cycle, we're sometimes forced to cancel the cycle. But that's still valuable information because we can use this information to improve the treatment protocol for the next IVF cycle, and that's why you, as a patient, need to be well informed as to what the treatment plan is going to be. You need to know what's going to happen next and what the expected response is. If things aren't going according to plan, your doctor should be able to explain to you what he's going to do, and armed with this information, your anxiety and stress levels will be much less because you are in control of what's happening.

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