1. It is essential that close monitoring with ultrasound and blood tests (estrogen and progesterone) be done to reduce the chances of adverse consequences and to increase the chances of success.
2. Please call the office when your period starts (day 1 of your cycle). If your period starts after 9:00 pm, day 1 is the next day. Medicines are usually started on day 3 of the cycle. A baseline ultrasound and blood-work are required before starting the medicine. You should call to arrange testing as soon as your period starts. If your period starts on a weekend, please leave a message at 973-971-4600. We can start the medicine between days 3-5 of the cycle; your doctor will determine the start after review of the baseline studies.
3. The tests that will be done initially and at most visits will be an ultrasound and two blood tests: estrogen and progesterone. The ultrasound determines how many follicles are developing and how mature they are, based on their size. The estrogen level is a reflection of the follicle's activity. The progesterone level also reflects follicular activity and is a tip-off of ovulation starting to occur spontaneously
4. After the baseline tests, you will take the medicine 3-5 days, then return for an ultrasound and blood tests. Lab results are reported late in the afternoon after the physicians have reviewed them. You will be called at your home number by a nurse or physician and informed of (a) adjustments in medicine dosage, or (b) when to return for repeat testing. Most cycles will have 3-6 rounds of tests. Thus, you should expect to be seen every 1-3 days until the follicles are mature.
5. If you have not been called with your results and plans by 7:30 pm, please call our emergency number at (973) 971-4600. Our answering service will contact a nurse or a physician for you.
6. Once we have reached our goals for follicle development and the estrogen is in a safe level hCG will be give to induce the final maturation of the egg and ovulation. Do not take the hCG until you are told to. hCG is given because spontaneous ovulation will occur in only a small number of women treated with these medicines.
7. We generally do two inseminations (IUI's) because we feel that it increases the chances of conception. The inseminations will be about 12 and 36 h after the hCG injection. If inseminations are not used, timing of intercourse will be discussed with you
8. About 5 days after the hCG, a progesterone level will be drawn to confirm that ovulation did occur.
9. The earliest a pregnancy test may be done is 16 days after the hCG was given. Please call if you get your period sooner.
