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.
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, as it will be updated with instructions for taking medication (if required) 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, 7 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 begin monitoring for your LH surge at home using an LH predictor kit starting on Day 10. These kits can be purchased at TRIO or your local pharmacy.
Once you detect your LH surge, please email your Primary Care Nurse and they will instruct you to take your Depot Lupron injection 1 week after your LH surge.
Approximately 2 weeks after your Depot Lupron injection, you will be advised to return to the clinic for your Assessment Day appointment.
6) Receiving Your Invoice
While you are taking your pre-treatment medication, you will receive your invoice (if applicable) from our scheduling coordinator.
This payment will be due in full on your Assessment Day.
7) Assessment Day
Your Assessment Day appointment includes bloodwork, 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 empty bladder transvaginal ultrasounds approximately 4–6 times until you are ready for trigger medication. After each visit, the nurses will review your ultrasound results and send any required medications to the pharmacy for pick-up.
Later that day, the doctors will review your results and provide instructions for the nurses to send to you through the iMineIVF APP, including medication dosing, follow-up appointments, and video links showing how to use the injections
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.
Please note that your sperm sample will need to be produced and/or thawed on the morning of your OPU.
13) Post-Egg Retrieval
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.
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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 |
| January 10 | Start LH Monitoring at Home |
| January 12 | LH Confirmed Report LH Surge to Primary Care Nurse |
| January 19 | Depot Lupron Injection |
| January 27 | Receive Assessment Day Details and Next Steps |
| January 28 | Receive Invoice |
| January 31 | Consent Forms Due |
| February 1 | Assessment Day Invoice Due Pick Up Stimulation Medication |
| February 2 | Start Stimulation Injections |
| February 6 | Return to Clinic |
| February 9 | Return to Clinic |
| February 11 | Return to Clinic |
| February 12 | Return to Clinic Trigger |
| February 13 | Return to Clinic |
| February 14 | Sperm Sample Produced and/or Thawed Egg Retrieval |
| February 15 | Call From Nurse Regarding Embryo Development |
| February 19 | 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 & Consent Forms From Day 1 Team |
| January 3 | Initial Appointment Pick Up Pretreatment Medication |
| January 10 | Start LH monitoring at home |
| January 12 | LH Confirmed Report LH Surge to Primary Care Nurse |
| January 19 | Depot Lupron Injection |
| January 27 | Receive Assessment Day Details and Next Steps |
| January 28 | Receive Invoice |
| January 31 | Consent Forms Due |
| February 1 | Assessment Day Invoice Due Pick Up Stimulation Medication |
| February 2 | Start Stimulation Injections |
| February 6 | Return to Clinic |
| February 9 | Return to Clinic |
| February 11 | Return to Clinic |
| February 12 | Return to Clinic Trigger |
| February 13 | Return to Clinic |
| February 14 | Sperm Sample Produced and/or Thawed Egg Retrieval |
| February 15 | Call From Nurse Regarding Embryo Development |
| February 19 | Fresh Embryo Transfer Remaining Embryo(s) Frozen & Stored |
| March 2 | Pregnancy Blood Test |