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 10-12 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.
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 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 (Downtown, Thornhill, North York)
- 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:
- Appointment Details for Initial Tests on Day 2-5 of your cycle
- App Instructions
- 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 proceed.
3) Attending Your Initial Appointment
When you arrive at TRIO for your scheduled appointment time, you will sign in for your tests and speak with your nurse.
After your appointment, please visit the pharmacy to pick up your medication.
Please check your iMineIVF APP after 3:30 pm on the day of your appointment for updated instructions regarding your medications and when to return to the clinic for further monitoring. If you do not receive an update by 4:00 pm, please contact the after-hours nurse at 416-948-4761 and leave a message. A nurse is available by phone from 4:00 pm to 8:00 pm, seven days a week.
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 instructed to take your Depot Lupron injection.
Depending on your protocol, you may also be instructed to start taking Estrace and/or Micronor for approximately 4 weeks.
Then you will take a second Depot Lupron injection.
Approximately 2-4 weeks after your second injection, you will be instructed to return to the clinic for your Assessment Day.
6) Receiving Your Personalized Treatment Calendar
Approximately 2-4 weeks after your second Depot Lupron injection, 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)
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.
Please note that your invoice (if applicable) will be due in full on your Assessment Day in order to proceed with your treatment cycle.
After your appointment, please visit the pharmacy to pick up your stimulation medication.
If your Assessment Day test results are within the normal range, you will receive an update on your app after 3:30 pm 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. The nurses will provide 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 from the pharmacy. 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
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.
13) Post-Egg Retrieval
After your egg retrieval, the OR nurses will assist you to the Recovery Room. Before you leave, the nurse will review your detailed discharge instructions with you, including how to take your post-egg retrieval medications. Your instructions will also be available in the iMineIVF APP. Any required prescriptions will be sent to the pharmacy for pickup before you leave the clinic.
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, any viable embryos will be frozen between days 5–7 of development. You will receive your final embryo update on day 7.
- 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 Counseling Completed Engaged MD Videos Watched |
| January 2 | Receive Appointment Details & Consent Forms From Day 1 Team |
| January 3 | Initial Appointment Pick Up Pretreatment Medication Depot Lupron Injection Start Estrace and/or Micronor (if applicable) |
| January 31 | Second Depot Lupron Injection |
| February 23 | Receive Treatment Calendar, Invoice & Next Steps |
| February 27 | Consent Forms Due |
| February 28 | Assessment Day Invoice Due Pick Up Stimulation Medication |
| March 1 | Start Stimulation Injections |
| March 5 | Return to Clinic |
| March 8 | Return to Clinic |
| March 11 | Return to Clinic Trigger |
| March 12 | Return to Clinic |
| March 13 | Sperm Sample Produced and/or Thawed Egg Retrieval |
| March 14 | Call From Nurse Regarding Embryo Development |
| March 18 | 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 Counseling Completed Engaged MD Videos Watched |
| January 2 | Receive Appointment Details from Day 1 Team |
| January 3 | Initial Appointment Pick Up Pretreatment Medication Depot Lupron Injection Start Estrace and/or Micronor (if applicable) |
| January 31 | Second Depot Lupron Injection |
| February 23 | Receive Treatment Calendar, Invoice & Next Steps |
| February 27 | Consent Forms Due |
| February 28 | Assessment Day Invoice Due Pick Up Stimulation Medication |
| March 1 | Start Stimulation Injections |
| March 5 | Return to Clinic |
| March 8 | Return to Clinic |
| March 11 | Return to Clinic Trigger |
| March 12 | Return to Clinic |
| March 13 | Sperm Sample Produced and/or Thawed Egg Retrieval |
| March 14 | Call From Nurse Regarding Embryo Development |
| March 18 | Fresh Embryo Transfer Remaining Embryo(s) Frozen & Stored |
| March 29 | Pregnancy Blood Test |
