This is a general guide that will take you through what to expect during your upcoming treatment cycle. Please note that your personalized treatment cycle and timeline will depend on how your body responds throughout your cycle. According to your protocol, your treatment cycle will take approximately 6-8 weeks. Please note that monitoring appointments will be scheduled between 7:00 a.m. and 9:00 a.m. during your treatment cycle. This ensures that there is enough time to process your tests within our lab so that your doctor can review your test results and provide you with same-day instructions.
Arranging Treatment at a Satellite Clinic
If you are not already a patient at the Satellite Clinic you wish to monitor at, please contact the Satellite Clinic as soon as possible.
You must be seen by the physician at the Satellite Clinic prior to reporting your Day 1 to begin treatment. The Satellite Clinic will discuss the process and applicable fees with you. Once arrangements have been made with the Satellite Clinic, you will be ready to report your Day 1 to start treatment.
1) Reporting Your Day 1
Your Day 1 is considered the first day of full flow (not spotting) of your period. When you are ready to report your Day 1, please email your Satellite Clinic in addition to the Day 1 Team at day1@triofertility.com with the following information:
- Your Full Name (as it appears on your Health Card)
- Your Date of Birth
- The Date of Your Day 1
- Your TRIO Physician
- Treatment Type (IVF)
- Your Monitoring Location (name of Satellite Clinic)
- Any days you will be unavailable to come to the clinic
Please note: TRIO requires all patients and applicable partners to have up-to-date infectious diseases bloodwork on file in order to proceed with treatment. Up-to-date means within one year, except for patients using a donor or gestational carrier. For these patients, please confirm with the Third Party Coordinator.
2) Receiving Your Initial Appointment Details
Within 48 hours of reporting your Day 1, you will receive an email from the Day 1 Team which will include your Electronic Consent Form instructions.
Please Note: Consent forms must be completed and returned to TRIO prior to your Assessment Day in order for your cycle to start.
You will also receive your appointment details for Day 2-5 testing from your Satellite Clinic. If applicable, they will also provide you with your invoice for your treatment cycle.
3) Attending Your Initial Appointment
When you arrive at your Satellite Clinic for your scheduled appointment time, you will sign in for your tests and speak with your nurse.
After your appointment, please pick up your medication.
Later that day, your Satellite Clinic nurse will contact you with instructions for taking medication (if required) and when to return to the clinic for further monitoring.
4) Recording BMI & BP Measurements
Please be advised that due to The College of Physicians & Surgeons of Ontario Out of Hospital safety policies, TRIO cannot perform egg or sperm retrievals with conscious sedation on any person with a Body Mass Index (BMI) greater than 40.
At your Initial Appointment, you will meet with your nurse to record the following measurements:
- Weight
- Height
- Blood Pressure
If your BMI is greater than 40, please discuss this with your physician prior to starting treatment.
5) Starting Pre-Treatment Medication
If the results of your Day 2-5 tests are within the normal range, your IVF counselling has been completed, and your Engaged MD videos have been watched, then you will be starting birth control pills for approximately 1-3 weeks.
You may experience some bleeding while on the birth control pill. Please note that this is normal, and you do not need to report this bleed.
Just before you have finished taking the birth control pill, you will be instructed to start GnRH Agonist injections (such as Suprefact or Decapeptyl) for approximately 2 weeks before returning to the clinic for your Assessment Day. The birth control pill will continue for approximately 5 days after injections begin.
6) Receiving Your Personalized Treatment Calendar
While you are taking pre-treatment medication, you will receive the following from our scheduling coordinator:
- Your Personalized Treatment Calendar with specific details about your cycle
- Invoice (if applicable)
- Next Steps (including your Assessment Day details)
Your invoice (if applicable) will be due in full prior to your egg retrieval.
Please note that it may take up to 11 days to receive this information via email.
7) Assessment Day
Your Assessment Day appointment includes both a full bladder abdominal ultrasound and a transvaginal ultrasound. You will also sign up to see your nurse to review your ultrasound results and see how your cycle is progressing.
After your appointment, please pick up your stimulation medication.
If your Assessment Day test results are within the normal range, your Satellite Clinic nurse will contact you with instructions for starting your stimulation medication.
8) Starting Stimulation Medication
You will be taking the stimulation injections for approximately 8-13 days depending on how your body responds to the medications.
9) Monitoring Appointments
While taking stimulation injections, you will return to the clinic for bloodwork and transvaginal ultrasounds between 4-6 times until you are ready for trigger medication. Your Satellite Clinic nurse will be providing you with instructions regarding your specific dosing and follow up monitoring appointments.
10) Taking Your Trigger Medication
When you are ready for your egg retrieval, your nurse will advise you to pick up your trigger medication. You will take this medication at a specific time, which will be 35-36 hours prior to your egg retrieval. At this time, you will also receive detailed instructions about this procedure.
11) Returning for Bloodwork
The day after you are triggered, you will return to the clinic for one final bloodwork appointment and speak with your nurse. If your results are within the expected range, your egg retrieval procedure will take place the following day. An egg retrieval is also known as an Ovum Pick-up or OPU.
12) Egg Retrieval Day
The egg retrieval will take place at TRIO’s downtown clinic (655 Bay St., Toronto). For more information about this location, parking, and accommodations, please email your Patient Care Coordinator to request a copy of TRIO’s Downtown PDF guide.
During the egg retrieval you will be given medications that can cause drowsiness and it would not be safe for you to drive. Please ensure you have someone to take you home after the procedure and to stay with you for the rest of the day.
Please note that your sperm sample will need to be produced and/or thawed on the morning of your OPU.
13) Post-Egg Retrieval
After your egg retrieval, the OR nurses will assist you to the Recovery Room.
Before you leave, the nurse will provide you with detailed discharge instructions, including the administration of post-egg retrieval medication.
14) Receiving Lab Updates
The day after your OPU, you will receive a call from TRIO to tell you the number of eggs that were mature and how many of those eggs fertilized.
- If you are proceeding with a freeze-all cycle, your viable embryos will be frozen on Day 5 or 6 of development.
- If you are proceeding with a fresh transfer, you will have your transfer on Day 5 of development and freeze all remaining embryos. In this case, you will be scheduled for a pregnancy test approximately two weeks after your embryo transfer.
15) Next Steps
Once your cycle is complete, you will need to arrange a follow-up appointment with your TRIO physician to discuss your results and next steps.
Example Treatment Cycle IVF with Freeze All
Please note that these calendars are intended for example purposes only. Your personalized treatment cycle and timeline will depend on how your body responds throughout your cycle.
| Day | What to Expect |
|---|---|
| January 1 | Report Day 1 to Day 1 Team & Satellite Clinic Counselling Completed Engaged MD Videos Watched |
| January 2 | Receive Appointment Details from Satellite Clinic Receive Consent Forms from Day 1 Team |
| January 3 | Initial Appointment Pick Up Pretreatment Medication Start Birth Control Pill |
| January 12 | Receive Treatment Calendar, Invoice & Next Steps Start GnRH Agonist Injections |
| January 16 | Last Birth Control Pill |
| January 25 | Consent Forms Due |
| January 26 | Assessment Day Pick Up Stimulation Medication |
| January 27 | Start Stimulation Injections |
| January 31 | Return to Clinic |
| February 3 | Return to Clinic |
| February 5 | Return to Clinic |
| February 6 | Return to Clinic Trigger |
| February 7 | Return to Clinic |
| February 8 | Invoice Due Sperm Sample Produced and/or Thawed Egg Retrieval |
| February 9 | Call From Nurse Regarding Embryo Development |
| February 12 | Remaining Embryo(s) Frozen & Stored |
Example Treatment Cycle IVF with Fresh Transfer
Please note that these calendars are intended for example purposes only. Your personalized treatment cycle and timeline will depend on how your body responds throughout your cycle.
| Day | What to Expect |
|---|---|
| January 1 | Report Day 1 to Day 1 Team & Satellite Clinic Counselling Completed Engaged MD Videos Watched |
| January 2 | Receive Appointment Details from Satellite Clinic Receive Consent Forms from Day 1 Team |
| January 3 | Initial Appointment Pick Up Pretreatment Medication Start Birth Control Pill |
| January 12 | Receive Treatment Calendar, Invoice & Next Steps Start GnRH Agonist Injections |
| January 16 | Last Birth Control Pill |
| January 25 | Consent Forms Due |
| January 26 | Assessment Day Pick Up Stimulation Medication |
| January 27 | Start Stimulation Injections |
| January 31 | Return to Clinic |
| February 3 | Return to Clinic |
| February 5 | Return to Clinic |
| February 6 | Return to Clinic Trigger |
| February 7 | Return to Clinic |
| February 8 | Invoice Due Sperm Sample Produced and/or Thawed Egg Retrieval |
| February 9 | Call From Nurse Regarding Embryo Development |
| February 12 | Fresh Embryo Transfer Remaining Embryo(s) Frozen & Stored |
| February 24 | Pregnancy Blood Test |