IVF treatment – verywell.com

Posted: Published on August 9th, 2016

This post was added by Dr P. Richardson

The timing of the trigger shot is very important. Be sure to follow your doctor's instructions for this injection carefully.. Paper Boat Creative / Getty Images

The next step in your IVF treatment is triggering the oocytes to go through the last stage of maturation. The eggs must complete their growth and development before they can be retrieved.

This last growth is triggered with human chorionic gonadotropin (hCG). Brand names for this include Ovidrel, Novarel, and Pregnyl.

Timing this shot is vital.

If it's given too early, the eggs will not have matured enough. If given too late, the eggs may be too old and won't fertilize properly.

The daily ultrasounds at the end of the last step are meant to time this trigger shot just right.

Usually, the hCG injection is given when four or more follicles have grown to be 18 to 20 mm in size and your estradiol levels are greater than 2,000 pg/ML.

This shot is typically a one-time injection. (Yeah!) Your doctor will likely give you an exact hour to do this shot. Be sure to follow these instructions!

Above, I said that the eggs must complete their development and growth before being retrieved. That's only for IVF treatment.

IVM treatment is slightly different.

IVM stands for in vitro maturation. It's a relatively new technology that is similar to IVF but significantly differs at this point in the process.

During IVM, the eggs are retrieved before they go through all stages of maturity. You will not have a "trigger shot" during IVM.

The eggs retrieved will be matured in the lab environment.

Once the eggs are matured, the rest of the steps follow the IVF process.

We've assumed to this point that the ovarian stimulation drugs have worked properly. But that isn't always how it goes.

Sometimes the follicles don't grow. Your doctor may increase the medications, but if your ovaries still don't respond, the cycle will likely be canceled.

This doesn't mean another cycle won't work. You may just need different medications. However, if this occurs repeatedly, your doctor may suggest using an egg or embryo donor.

Another possible problem is your ovaries respond too well.

If your doctor thinks you're at risk of developing severe ovarian hyperstimulation syndrome (OHSS), your trigger shot will be canceled and the cycle will be stopped at this point.

Another possibility is your doctor will retrieve the eggs, fertilize them, but delay the embryo transfer. This is because pregnancy can worsen and extend recovery from OHSS.

During your next cycle, your doctor may suggest lower doses of medications, try different medications before your cycle starts, or even suggest IVM instead of IVF (explained above.)

While not common, a cycle may also be canceled if ovulation occurs before retrieval can take place.

Once the eggs ovulate on their own, they can't be retrieved.

Your doctor will likely tell you to refrain from sexual intercourse. It's important you follow these instructions!

It's possible you've ovulated up to a dozen eggs. Maybe even more. Imagine the disaster and danger of getting pregnant naturally with even half of those eggs.

Cancellation happens in 10 to 20 percent of IVF treatment cycles.

The chance of cancellation rises with age, with those older than age 35 more likely to experience treatment cancellation.

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IVF treatment - verywell.com

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