IVF is a method of assisted reproductive technology by combing female’s egg and the male’s sperm and fertilized outside the body. In
the process, one or more eggs are removed from the ovaries with a very thin needle aspirated through the vaginal wall under the ultrasound guidance. Every patient has their own
After reviewing the blood test results, Dr. Yelian will determine medications that will be used in your specific cycle.
Our center specializes in natural cycle IVF and minimal stimulation IVF. Our philosophy is to use less medication to produce the best quality embryo.
The medications may be used: Necon(OCP), Alesse(OCP), Estrace, Progesterone, Femara, Clomid, Tamoxifen, Gonal-F, Follistim, Menopur, Lupron, Ibuprofen, etc.
Starting Your Cycle
When all of the pre-cycle consultations and testings are completed, you are ready to start the IVF cycles. Please call LIC on the first full flow period day (referred to as cycle Day 1) to schedule a monitoring appointment. The phone number you need to call is '949-788-1133.
During Your Cycle
- Monitoring Follicular Development
During the natural cycle (NC) or minimal stimulation cycle (MS), the follicle(s) development is monitored through a combination of blood tests and ultrasounds. The blood tests include Estrodiol (E2), FSH, LH and progesterone (P4). It is important that the tests are done on a specific day, and the patients have to follow the treatment plan under the nurses’ instructions. FOR PATIENTS WHO MONITORED OUTSIDE OF OUR OFFICE, IT IS THE PATIENTS’ RESPONSIBILITIES TO BRING THE RESULTS INTO OUR OFFICE BEFORE 3 PM ON THE SAME DAY. Transvaginal ultrasound will be performed by a LIC ultrasound technician. Prior to the ultrasound exam, please empty your bladder. The SIS exam will be done by Dr. Yelian. It is typically performed from the patient’s menstrual cycle day 6 to 12.
According to the monitoring results, Dr. Yelian will be able to diagnose that if the eggs are enough matured or the eggs are ready to be retrieved. The patients will get Lupron injection which helps the egg to reach the final maturation process. The Lupron injection will be given in the late evening, and it’s approximately taking from 34 to 36 hours until the egg retrieval procedure. The nurses will instruct the patients about how to do the Lupron injections. A certain date and a certain time will be given by the nurses for Lupron injections, and the patients are responsible to carry out the process by themselves and give injections on time since it will affect the outcomes of egg retrieval. If the patients miss the injection time, please inject the Lupron as soon as you can, and call our office in the next morning to notify the nurses. We may be able to reschedule your egg retrieval day.
Please stop all oral medications (Clomid, Femara) or injections (Bravella, Follistim, Gonal-F, Menopur) on the day of the Lupron injection. The normal dose of Lupron injection is 0.15 ml or 0.2 ml; for some patients we may use HCG to instead, or use both HCG and Lupron as a double trigger. The HCG normal dose is usually 5000 IU or 10,000 IU.
On The Day of Egg Retrieval Day
DO NOT WEAR ANY PERFUME, LOTION OR DEODORANT ON THE DAY OF EGG RETRIEVAL PROCEDURE. Perfume, lotion and deodorant are toxic to the eggs. Please eat a light breakfast 2 hours before the procedure (This only applies for patients who are not using IV sedation.)
The Egg Retrieval procedure is performed transvaginally or transabdominally. The staffs who are attending the Egg Retrieval procedure will be: doctor(s), nurse(s), medical assistant(s), and embryologist(s). An ultrasound will be used to visualize the location of the follicles. A very thin medical needle will pass through the vaginal wall into the ovary. Most of the patients are not being sedated because the whole Egg Retrival procedure is very brief (only a few minutes). It is common to experience mild pain or menstrual–like cramping during the procedure. After the fluid is aspirated into the test tube, the Embryologists will take the aspirated fluid into the embryology lab to evaluate the viable eggs under a microscope.
If the patients are very sensitive to pain, the patients may request a local anesthesia or IV sedation.
FOR IV SEDATION PATIENTS, DO NOT EAT or DRINK AFTER MIDNIGHT OR AT LEASET EIGHT (8) HOURS PERIOR TO YOUR EGG RETRIEVAL PROCEDURE.
All patients should arrive to LIC 30 minutes earlier than the procedure time. The nurse will ask the patient to change into a procedure gown, and place covers on patient’s head and feet. Patients need to empty bladders before entering the procedure room.
The anesthesiologist will meet with you before the procedure. Please be aware there is an additional fee for the local anesthesia and IV sedation.
During the procedure, the partner will be required to wait in the waiting room. He will be placed into the semen collection room to do a fresh semen specimen collection if egg retrieval is successful.
Optionally male patients can collect semen sample at home, and then drop it off. It has to be on same day. For more information, please ask the receptionist about sperm collection instructions and specimen container prior to the ER appointment. The specimen has to be received within 1 hour after the time of production. DO NOT EXPOSE SPECIMEN TO EXTREME HOT OR COLD TEMPERTURE. Maintaining the specimen at body temperature, and there is no requirement for any sexual abstinence day(s) prior to semen collection. For patient’s safety, we require the male partner to sign consent if he is not be able to drop off the semen specimen; he must give the permission for his partner to drop off the specimen.
If the patient is planning to use frozen or donor sperm instead of a fresh specimen, please inform the nurses on the day of Lupron shots.
After Egg Retrieval
After 20 to 30 minutes rest, a nurse will check patient’s blood pressure; and have the patient to go to the restroom to remove gauzes. Please place the gauze on the stand inside of the restroom. As well, please inform the nurse immediately if there is any excessive bleeding after removing gauzes.
Patients may experience slight soreness in the next a few days. After the procedure, we recommend the patient to take Tylenol 500mg for 1 to 2 tablets every 4 hours to release pain. DO NOT EXCEED 8 TABLETS IN A 24 HOURS PERIOD.
Patients may experience a scant of spotting from the vagina, but patients should not experience any heavy bleeding. Please report it to the nurse if the bleeding is worse than spotting, or if patients have fever over than 100.4°F.
After the first few days of the procedure, please only take showers; avoid taking baths or hot tubs. We recommend patients to abstain from intercourse or use tampons for 5 to 7 days after the procedure.
For IV sedation patients, the sedative medications used during Egg Retrieval procedure will stay in the body system for up to 24 hours. Therefore, patients need a friend or a family member to drive; and a 24 hours recovery. Please ask the nurse a break letter for 24 hours.