Consistently above the national birth rate average in all measured categories*

IVF Treatment Protocol

If, after testing and consultation with Dr. Simckes, in vitro fertilization (IVF) is chosen as your next step, you will meet with your Care Liaison to help best coordinate the process between your schedule and the Fertility Partnership’s protocols. You will be assigned a “target date” for when we anticipate retrieval of your eggs for fertilization. Almost all patients will be ready for retrieval within 2-3 days before or after the target date.

At the Fertility Partnership, we have chosen to “batch” or group our patients as we have concluded that this will allow us to provide the best service to our patients.

You will be placed on a birth control pill when you start a menstrual cycle and will remain on the pill until we instruct you to stop. Some medications will be initiated while still on the pill.

Day One of the cycle is the first day of spotting or bleeding that occurs after stopping the pill.

Day 3: We typically begin the fertility/stimulation medications.

Day 5 or 6: The first ultrasound is performed to monitor your progress. Changes may be made in your stimulation protocol. Patients usually are seen every other day for ultrasound monitoring, and when eggs are ready to be harvested from your ovaries, a “triggering” medication is given by injection. The timing of this injection is crucial for proper scheduling of the retrieval procedure.

Egg retrieval: Eggs are retrieved from the female, and the male provides a semen sample. The eggs are left in the incubator for 4 to 6 hours after retrieval to complete the final stage of maturation. Normally 65 to 80 percent of the eggs will be mature and ready to be inseminated.

Post-Retrieval Day 1: Fertilization is assessed 14 to 20 hours after insemination.

  • Visualization of two pronuclei confirms normal fertilization of the egg. One pronuclei is derived from the egg, and the other one from the sperm.
  • Our lab staff or your Care Liaison will call you by 5 p.m. to notify you about your fertilization results.

Post-Retrieval Day 2: Embryos will begin to divide; however, the embryologist will not remove your embryos from the incubator on Day 2. This is a “day of rest” for the embryos.

  • If you are doing a Day 3 transfer the office will call to schedule the transfer time and give necessary instructions for the transfer.

Post-Retrieval Day 3: The embryologist will evaluate all embryos and group them based on quality. The embryos should be six to eight cells, and they are graded on a scale of “1 to 5” with “1” being the highest grade.

  • If you are doing a Day 3 transfer, the embryologist will select the best one to three embryos for transfer, and place any remaining embryos of decent quality into extended culture for possible freezing on day 5 or 6.
  • If you are doing a Day 5 transfer the lab will call before 5 p.m. to provide an update on the status of the embryos. Additionally, you will be notified by the office of the embryo transfer date, time and any necessary instructions.

Post-Retrieval Day 4: Embryos will not be removed from the incubator, as this also is a “day of rest” for the embryos.

Post-Retrieval Day 5: The team will re-grade the embryos, select the best one or two embryos for transfer, and place any remaining embryos of good quality either into cryo-storage or extended culture for possible freezing the following day.

Post-Retrieval Day 6: Those embryos that stay in culture until this day will be assessed for potential cryopreservation. The embryologist will call you regarding the final disposition of all embryos.

Checking for pregnancy usually occurs as a blood test on day 14 post-transfer. You be instructed to repeat the test 48 hours later if the initial test is positive.

If you are pregnant, you will have a follow up ultrasound approximately three weeks post-transfer and will have repeat ultrasounds until a fetal heart tone can be demonstrated. At about six weeks post-transfer (eight weeks gestation), the Fertility Partnership will transfer you back to your OB/GYN for ongoing care.

If you are not pregnant, a follow-up visit with Dr. Simckes will be scheduled to personally review the cycle with you and plan next steps.