Questions During Treatment (FAQ)

You will be asked to provide a mobile number and email address for us to be able to contact you for results. On the day we ask you to have a blood test and/or ultrasound, your results will be reviewed by Dr Clark, and we will contact you later in the day with your results and further instructions. 

If you have a blood test after 9am at a site other than Fertility First, it is high likely that your results will not be available until the next day. The nurses will only contact you when your results have received and reviewed by Dr Clark.

Please do NOT add any extra tests to any blood forms that we have given/emailed to you. If tests are added that were not requested by Dr Clark you could incur a large out of pocket fee.

The correct storage and administration of your drugs is a very important part of your cycle which you control. Please take time to check all your instructions during clinic hours and ring us if you are not clear what to do. Please follow the information and instructions we have given you. Any variation from these instructions can lead to a reduction in your chances of getting pregnant, and in some cases, can result in the whole cycle needing to be cancelled.

Forgetting to take the drugs necessary for a successful treatment is one of the most common problems encountered in treatment cycles. It can be very easy to forget when life is busy and you’re feeling anxious about getting things right.

We strongly advise putting some form of alarm or reminder in place if you are concerned you might forget, particularly for the Synarel, Lucrin and Pregnyl/Ovidrel trigger injections.

Synarel is only used by women doing an IVF or ICSI treatment cycle. The impact of forgetting to take Synarel as directed depends on how long ago the last dose of Synarel was taken and how long you have been taking it for. The longer you have been taking Synarel, the less likely a missed dose will affect your treatment. Synarel needs to be taken 12 hours apart. Any longer can lessen its effect. Upon realising that you have forgotten a dose, take the dose immediately, and then continue taking it night and morning when you normally would, even if the next dose is only a few hours away.

Please inform Fertility First staff on the next working weekday. Ringing us over the weekend or at night cannot change the effect of what has already happened. However, you might need to take the Synarel for a longer time before starting your stimulating (FSH) injections.

We strongly advise putting some form of alarm or reminder in place if you are concerned you might forget, particularly for the Synarel, Lucrin and Pregnyl/Ovidrel trigger injections.

Decapeptyl is only used for women doing an IVF or ICSI treatment cycle. The impact of forgetting to take Decapeptyl as directed, depends on how long ago the last dose of Decapeptyl was taken and how long you have been taking it for. The longer you have been taking Decapeptyl, the less likely a missed dose will affect your treatment. Decapeptyl needs to be given once a day, at the same time each evening. Any longer can lessen its effect.

If you forget a dose, when you realise, take a dose immediately, then continue taking it at night when you normally would, even if the next dose is only a few hours away.

Please inform Fertility First staff on the next working weekday. Ringing us over the weekend or at night cannot change the effect of what has already happened. However, you might need to take Decapeptyl for a longer time before starting your stimulating (FSH) injections.

The impact of either Gonal F or Puregon depends on how long ago the last dose was taken and which treatment you are doing.  Women doing IVF or ICSI will be more affected than women who are doing an intrauterine insemination, ovulation induction or frozen embryo cycle. The longer the gap between injections, the more likely a missed dose will affect your treatment. Less than a day is not usually a problem. If you forget a dose, when you realise, take a dose immediately, then continue taking it daily as you normally would. If the next dose is in only a few hours’ time, try and take it a little later in the day.

Please inform Fertility First staff on the next working weekday. Ringing us over the weekend or at night cannot change the effect of what has already happened. However, we might need to see you earlier than your next planned appointment.

An Ovidrel and Pregnyl injection ensures that the egg completes its final maturation and is the most important injection not to forget, particularly for IVF and ICSI patients.

If you forget your trigger injection, which is timed at 37 hours before your egg collection, by more than 3 hours – do not take it. Instead, ring us in the morning so we can re-schedule your theatre day. If you have taken the injection within 3 hours of the original time, ring us the next morning so we can rearrange the timing of your egg collection for the day of surgery.

If you are doing an intrauterine insemination, ovulation induction or frozen embryo cycle, provided you take your trigger injection the same day, your treatment will not be affected. If you don’t remember until the next day, please ring Fertility First before you take it as we will probably have to re-schedule your planned treatment day.

 If missed by one day, take it now.

Take the forgotten Crinone dose as soon as you realise it has been missed, then take it again when you normally would. If in doubt, please contact the nurses.

This website provides instructions for MOST of the drugs used during treatment cycles. Please be aware that videos on YouTube or other platforms may NOT be correct for the treatment you have been prescribed. They may contain different dosages & preparation instructions.

• Trigger: ASAP, or 37 hours before – depending on treatment
• Follow up injections: may be taken at any time of day as long as it is the same time each day – only injection critical is trigger for IVF±ICSI egg collection
• Low dose aspirin and/or Clexane injections: if instructed by Dr Clark following positive pregnancy test
• Folate supplementation: always
• Crinone gel: depends on your treatment regime. Refer to instructions from nurses

• Synarel/Decapeptyl: once trigger has been taken (you will be given specific instructions once you reach this stage)
• Gonal F or Puregon (FSH): once trigger has been taken (you will be given specific instructions once you reach this stage)
• Trigger injection: only done once at time instructed unless a blood test indicates that your body needs more.
• Follow up hCG: On dates given. If unwell when taking, please call Fertility First.
• Luveris/Pergoveris: day before trigger (you will be given specific instructions once you reach this stage).
• Saizen (Growth Hormone): may be day after trigger depending on how much you have left (you will be given specific instructions once you reach this stage).
• Crinone gel: continue until pregnancy test. Stop if not pregnant. You may need to continue Crinone once pregnant depending on your hormone levels, as advised by nurses.
• Folate supplementation: Always continue.

In life, menstrual cycles vary in length because different women’s eggs take different times to grow to maturity. Therefore, the first half of the menstrual cycle varies from 7 to 21 days on average, giving a 21 (7+14 days) to 35 days (21+14 days) between one period and the next. This does not mean that the eggs are of different quality, only that they are individual in the time it takes them to grow to maturity.

However, when you have a treatment cycle you will usually have a follicle-stimulating hormone (FSH) injection (brand names Gonal-F or Puregon) in the first half of the cycle, this assists egg/s to grow by encouraging new blood vessel formation to the follicle (sac the egg grows in). We know that eggs with the best blood flow are more likely to result in a pregnancy. Sometimes the improved blood flow also means that your eggs might mature a bit earlier than usual, so the time to treatment may be less than you expected. The second half of the cycle is still fixed however.

• When should I do the test? – 2nd urine of day (try to hold urine in bladder for 3hrs after first urine of the day)
• When is a test positive? – When two lines are the same after the instructed time limit.
• What should I do if a test is positive? – Call mobile between 9am & 12 noon on weekends and public holidays, 6pm to 9pm weekdays or at the Clinic after 10am weekdays,
• What should I do if a test is negative on weekends or public holidays? – Attend scan as planned. You do not need to call with a negative result unless the nurses advise you to do so.

• Rest: If you wish, but this is not required
• Exercise: As usual but be careful – do not overheat the body and do not lift heavy weights.
• Intercourse: As usual. The embryo cannot fall out so continue your life as normal.
• No hot baths or spas

• After IUI or embryo transfer procedure: Spotting is normal, but if you have any bleeding or pain, call Fertility First.
• After egg collection (OPU): Spotting is normal, but if you have any bleeding or pain, call Fertility First.

• After IVF: if you are experiencing excess bloating after egg collection please call the nurses and limit your fluid intake to 1.5L per day. You will receive detailed instructions regarding egg collection procedure & post-operative care at the time we are booking you in for your egg collection.
• After luteal phase injections: If you are nauseous, vomiting or suffering from constipation, contact the Clinic or after hours’ phone and we can discuss lowering the dose of Pregnyl to help you feel a little more comfortable.

If you are not pregnant, your period will come 13 to 15 days after:

• The day of treatment for IUI and IUDI (intrauterine inseminations)
• The day of ovulation for ovulation induction cycles
• The day of ovulation for FET (frozen embryo cycles) or fresh embryo transfer (in a Central IVF donor oocyte cycle) – not the day of transfer, or
• The day of egg collection for IVF and ICSI cycles.

The time from ovulation to the period is always a fixed period of 13 to 14 days. The reason for the apparently different timings above is that in situations where embryos are returned, they are transferred 2 to 5 days after ovulation, so the time to the next expected period will be less than a natural cycle.

When you have a treatment cycle, you will usually have had three (3) to four (4) supporting injections of either Ovidrel pen (6 clicks per dose) or Pregnyl injections (1500 per dose) for the second half of the cycle. These ensure that all the messages required to support the lining of the uterus until an embryo can implant, are maximised.

Sometimes these injections can mean your period is delayed by a day or so, so for that reason we do not do a pregnancy test until 16 days after the day of ovulation or egg collection. Any pregnancy test done prior to this time is likely to give a false positive reading, i.e. suggest you are pregnant when you are not. Do not do urine pregnancy tests at home prior to this time as you may receive a false positive reading.

If your pregnancy test falls on a Saturday, we will do it on the previous Friday. If a low reading is received an additional test may be required on the Monday.

As you have usually had some stimulation to the ovaries, they are likely to have produced more of the hormone oestrogen, which encourages the lining of the uterus (endometrium) to plump up in readiness for an embryo to implant. Therefore, if a pregnancy does not happen, you might get a heavier period than normal, particularly if you have had a fresh IVF or ICSI cycle.

It is safe to take medication such as Naprosyn or Naprogesic to reduce the bleeding and any pain. It will be most effective if you take it as soon as you start bleeding.

Sometimes some women get a much lighter period than they expect or normally get. It is very important, in this case, that we check your blood for pregnancy hormone. You might have had an early pregnancy that did not continue.

In some cases, this pregnancy might have occurred in the fallopian tubes (ectopic). It is very important that we get this information, so we can individualise your current and future treatment appropriately. Please call and book a blood test with Fertility First if spotting occurs on the due menses date. 

We will give you the date to do a pregnancy test, which is usually 16 days after the date of ovulation or egg collection, for the reasons stated previously in the section ‘what to expect if a period comes’.

You can do a urinary pregnancy test at home, but we really like to do a blood test as well, as this is much more accurate. Women who are pregnant can have negative urine tests, as they are designed to be less sensitive, reducing the risk of false positives, i.e. telling women they are pregnant when they are not.

It is also important that we do the blood test on day 16, as above, because this also gives us the opportunity to tell you the chance of the pregnancy being ongoing. Unfortunately, the studies this calculation is based on, only allows for the estimate to be made using a blood level taken 16 days after ovulation. This test will also help us to decide if there is anything else we have to do to maximise the chance of an ongoing pregnancy.

If the pregnancy does not go on, any information about an early pregnancy can be important for the future as there might be other things we can do next time to maximise an ongoing pregnancy.

Information about whether a pregnancy started or not, also helps you to decide whether you wish to do another form of treatment.

• Bleeding: depends on the colour and the amount. If the blood is bright red or heavy contact your obstetrician or plan a repeat scan at Fertility First
• Pain: Contact Hospital Emergency if severe
• Book pregnancy scan: nurses will advise date of this scan
• Continue with Cartia and Clexane (if prescribed) until obstetrician says otherwise.