How is my assisted conception cycle monitored?
It is important in fertility treatment cycles to monitor the response of your ovary to stimulation with the medication we ask you to inject yourself with; we use both ultrasound scans and blood tests to do this.
The aim of monitoring is to ensure that you have an optimal response to the medication and that the timing of the procedure to retrieve the eggs from your ovary is performed at the best time. We also monitor your response to ensure that you are not over responding to the medication (producing too many follicles/eggs) and that the lining of your womb is likely to be receptive to embryos replaced.
Does more frequent monitoring improve my treatment outcome?
As clinicians we like to have as much information as possible and traditionally scans were usually done in the middle of your injections (usually day 5-6) of your injections so that we could increase or decrease your medication to optimise the response.
Recent studies however have shown that changing the dose of medication (particularly increasing the dose) in the middle of your cycle does not significantly alter the amount of eggs retrieved nor change the outcome of treatment. For this reason we are not advising routine scanning in the middle of the stimulation cycle and instead concentrating on getting the right dose of medication from the start.
For some patients however we do advise a scan in the middle of stimulation, particularly in patients who are at risk of overstimulation and who start on low doses of medication, you will be advised if you would benefit from an additional scan.
I had a scan in the middle of my last treatment, should I not have one now?
As previously stated there is no evidence from large studies that changing the dose of medication will alter your response in the middle of your treatment, indeed the best information as to how you are likely to respond comes from analysing your previous stimulation cycle and that will allow us to optimise stimulation for you.
When do I need to be monitored?
You will need a scan before you start treatment to ensure that there are no issues with your ovaries or womb, we may if you have had treatment to your cervix previously also take the opportunity at this time to perform a trial of embryo transfer with or without an endometrial scratch (if you have not had a previous transfer or scratch). Following this you will usually be booked for a final scan to ensure the follicles have reached the right stage of maturity as close to the planned day of egg collection (usually on the planned day of the trigger injection which is taken 36 hours prior to egg collection).
What if I can’t attend on the last day of treatment?
The further we perform your final monitoring (scan and blood test) from your trigger injection the less accurate we can be with regard to optimising the timing of your egg collection and also it will reduce our ability to identify patients who will benefit from electively freezing their embryos to improve pregnancy rates.
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