IVF monitoring visits at PFCLA

When starting the IVF cycle program, your doctor will ask you and your donor or surrogate, if applicable,  to participate in our IVF monitoring process to improve the chances of a successful pregnancy. Here's what to expect during the process.

Your initial visit

Before starting the monitoring process, you may need to take part in the initial tests below:

Baseline Estradiol (E2) blood tests

E2 is a form of estrogen made within the ovaries. Depending on various factors, you may be required to take an E2 test if you’re providing the egg for the IVF cycle. Your doctor may ask you to participate in this test between one to two days before starting the stimulation medications. 

Baseline ultrasounds

In some cases, your doctor may perform a baseline ultrasound. This examination assesses ovarian health, which allows for a follicle count, and can help your doctor determine whether  ovarian cysts are present. The presence of cysts may cause your doctor to halt the start of fertility injections. Your doctor may perform this exam one to two days before beginning injections.  

Note: In some cases, your doctor may order a baseline estradiol blood test instead. 

Testing requirements 

As of May 2005, the FDA requires all IVF cycles using an egg donor or surrogate to undergo certain infectious screening tests. Your physician will let you know exactly which tests are needed for your case. 

Learn more about IVF testing requirements ➜

Your first IVF monitoring visit 

In certain instances, after starting fertility drugs (such as gonal-f® and or menopur®), your doctor may ask you to come in for a monitoring visit. Here's what to expect during the appointment:

Vaginal ultrasound examination

During this examination, your doctor examines the ovaries via ultrasound and counts the number of follicles present. Follicles are fluid-filled sacs that contain and protect the egg. The follicle count helps determine how well you or your egg donor is responding to the fertility drugs, as each follicle contains an egg. 

Your doctor will also measure the follicles, which can show the maturity of the egg. As you or your egg donor continue to take the fertility drugs, these follicles will grow (about three mm in two days). Doctors tend to retrieve eggs when most follicles are between 18 and 20 mm in size, though this can vary. 

Your doctor may also look into the thickness and pattern of the uterine lining during this part of the visit. A poor lining can be an indicator that you may not be able to sustain a healthy pregnancy at this time. If that is the case, your doctor will discuss options with you.

Note: If you live far away, you can ask your doctor if it’s possible to have the vaginal ultrasound examination completed by a  local doctor. Please note that services not performed at PFCLA are not included in our financial packages. 

Additional Estradiol (E2) tests

Your doctor will sometimes perform E2 blood tests. When the follicles mature, the eggs secrete the E2 hormone. The more eggs or follicles present, the higher the estradiol level. Measuring E2 levels in the blood can act as an indicator as to how well the ovaries are responding to the drugs. 

Following the initial visit, your doctor will provide you with a new calendar and a specific set of instructions on how to proceed, such as:

• What medications to continue
• When to come back for another ultrasound if necessary

Note: Your doctor may ask you or your egg donor to come back for another appointment, two to four days after the initial visit. 

Follow-up visits

Your physician may ask you or your egg donor to come back for up to a couple visits before egg retrieval. Here's what to expect during those follow-ups: 

1. An ultrasound examination and possibly an E2 blood test to evaluate the growth of the follicles.
2. Further instructions on what to do daily with medications.

Follow up at a clinic local to you is possible if approved by your physician. Where possible, we try to reduce travel needs.