IVF FAQs
Every doctors office is different and thus every IVF protocol is different. This is a general guideline of what to expect. Some clinics offer "needle free" cycles for the surrogate but this is far from the norm. Lupron is taken in the form of a shot though it is a very small needle, the type diabetics use. Estrogen and Progesterone are taken intramuscularly and those are the bigger needles that go into your hip/buttocks area. There is numbing cream available to make it as pain free as possible.
A mock cycle
Surrogates may have a mock cycle the month before your actual transfer to see how well you respond to the medication you are on.The doctor will even perform a mock transfer to see where in your uterus is the best place to transfer the embryos.
A FET( Frozen Embryo Transfer)
The protocol for a FET varies greatly again among clinics. Some doctors offer a "natural" cycle where little medication is involved but most require a medicated cycle, some fall in the middle.
Fresh cycle protocol for a surrogate
Once you are given the ok to start your cycle, you will be placed on birth control pills to sync your cycle to the intended mothers or egg donors .You are usually a week ahead of the woman providing the egg because after your lining is optimal, you can be kept in a holding pattern for up to two weeks waiting for their eggs to become ready. About two weeks after you started your birth control pills, you will start Lupron. Lupron is a subcutaneous (just under the skin) injection to shut down your bodies normal hormone production so the doctors can control your cycle and make sure everything is optimal for embryo implantation. Lupron is a daily injection that lasts about 4-6 weeks. While on Lupron, you will get your period, when that happens the doctor will add Estrogen to your protocol.It can be given in Pills, Patches or injections.You will stop taking your Lupron the day before the transfer but will continue on Estrogen. A few days before your transfer, Progesterone is added to the protocol, usually in the form of intramuscular shots. Estrogen is usually discontinued a few weeks into the pregnancy and progesterone somewhere between the 10th and 12th week of pregnancy.At that point, the placenta will take over and make all of the hormones the baby needs to thrive.
Protocol for the Intended mother or Egg donor for a fresh cycle
After taking Lupron to suppress the cycle, the IM or ED will start her period while on Lupron. On her cycle day 3,she will start her injectible medications to stimulate her ovaries to grow several eggs as opposed to one or two.This continues from 7 to 10 days depending on her hormone levels. Once the eggs are large enough(18-20 mm) She will take an injection of hCG (Human Chorionic Gonadtropin) which will release an LH surge that stimulates the eggs to mature. 36 hours after the hCG injection, the retrieval is done.
The Transfer
After the retrieval, the eggs are fertilized with the intended fathers or donor sperm and are allowed to incubate from 2-5 days. The reproductive endocrinologist will then transfer the embryos into the surrogates womb. This is will feel very similar to a pap smear and will last about 5 minutes. After the transfer, it is suggested that the surrogate have at least 24 hours of bed rest,some doctors even suggest up to 72. Some suggest none at all, follow what your doctors orders are. Stay positive! While there is no scientific proof that staying positive can improve your odds, their is no scientific proof that it does not. 10-14 days post transfer, you will go into the doctors office for a blood ( beta hCG) test that measures the amount of hCG you have in your blood.
