Posted on 09/27/2019 in Integrative Understanding of Infertility

Ovulation induction — what to expect?

Ovulation induction — what to expect?

Ovulation induction cycle’s background. 

Natural conception has always been a magical event. When two mind-blowing microchips (the oocyte and the spermatozoon) interacted with each other they synchronize their genetic content in one configuration to generate a new EMBRYO. But sometimes “capturing” this special “embryo generation” moment gets a bit difficult. Routinely, only one oocyte is released per cycle. In some cases, one oocyte is released every other cycle. Rarely, the oocyte release event doesn’t happen at all. And then there was a Real Pro... 

Take a closer look at ovulation induction cycle. The configuration is taken to an extreme. Six configurations with the other treatment protocols. Two “shapes” of preimplantation genetic screening for the embryos generated through IVF (PGS or PGD). Ideal synchronization with cryopreservation protocols. It will make you rethink about ovulation induction completely as it POWERFUL ENOUGH to be called Pro.

●Configurable with IUI

●Configurable with IVF

●Configurable with self–cycle gestational surrogacy

●Configurable with egg freezing (oocyte vitrification)

●Configurable with sperm freezing (sperm vitrification)

●Configurable with embryo freezing (embryo vitrification)

●●Self–cycle surrogacy involves own oocytes’ fertilization with a partner’s sperm and the embryo transfer into the Gestational Carrier’s uterus for further gestation.

Ovulation induction cycle explained in a mode “what to expect?” step–by–step.

Step 1 | Initial consultation with Fertility Expert: Discussions, discussions, discussions. 

Your initial consultation can be shaped as virtual (WhatsApp, Skype, online or email) getting–in–touch experience, as in-office experience or as landing somewhere with the status of International Patient experience. Whatever you choose is awesome. Any non–medicated timed intercourse, medicated timed intercourse, ovulation induction, IUI, IVF or other cycle’s “Roadmap” starts with initial consultation “milestone”.

Initial consolation shaped in “Discussion mode”.

Initial (pre-treatment cycle’s) consultation can take a form of “Discussion only” with your medical history review and treatment plan “generation” event. This initial consultation will be ideal for you if you feel yourself as a bundle of nerves or the bundle of taut nerves even when envisaging the consultation with fertility Pro in your mind.

What to expect from initial consultation shaped in “Discussion mode”?

● Medical history review

● Full “mode” of the medical consultation and treatment plan “generation event”

Initial consolation shaped in “Diagnostic mode”.

If you have a Pro nervous system, your initial consultation may involve medical history review, pelvic ultrasound scan of uterine and pelvic physiology and pathology, Antral Follicle Count (AFC), and treatment plan’s drafting. The pelvic ultrasound scan that will “validate” your uterine and pelvic physiology and “verify” your ovarian reserve. “Dual–mode” of initial consultation shapes your treatment option “at glance” as your fertility Pro has your screening results.

Moreover, the pelvic ultrasound scan is not only a valid diagnostic tool that “visualizes” the size and form of the uterus and ovaries, but also a “verification” tool that indicates the issues. It “verifies” the basic physiological function of the uterus and ovaries, and “identifies” the uterine malformation, the Fallopian tubes’ malformation, and abnormalities such as uterine fibroids, uterine polyps, and ovarian cysts.

In other words, a pelvic ultrasound scan is a tool that adds tons of capability to the Pro to “generate” the best flexible treatment protocol without complexity. The results of the ultrasound scan will be discussed along with all previous medical history. Plus, all-new plan for future diagnostic investigation will be turned from the envisaged–in–fertility–Pro–mind–mode to the noted–down–mode. The draft of the treatment protocol will be also created the same day.

What to expect from initial consultation shaped in “Diagnostic mode”?

● Medical history review

● Pelvic ultrasound scan of uterine and pelvic physiology and pathology

● Antral follicle count (AFC)

● Full “mode” of the medical consultation and treatment plan “generation event”

Initial consolation shaped in “Pro screening mode”.

If you are ready for the ultra-fast mode and want everything to start and end in “one time–frame” — the initial consultation literally “configured” with screening diagnostic testing is designed for you. “Pro screening mode” adds “tons” of capability without complexity plus saves your time as several screening tests are performed during the initial consultation, thus there is no need to come “on Monday after 02.00 pm”.

“Triple mode” of initial consultation that involves smart “configuration” of initial consultation, pelvic ultrasound scan of uterine and pelvic physiology and pathology, an antral follicle count (AFC) and Fallopian tube patency test (Hysterosalpingo Contrast Sonography, abbr. HyCoSy) makes your screening testing and medical evaluation completed for 80% just in one day. All in one. One for all. Your saved time “doubles down”.

It is designed for women who had a previous pelvic infection as pelvic infection could affect Fallopian tube function and patency. HyCoSy is also performed in women who wonder if their Fallopian tubes are patent. And it is always performed before ovarian stimulation cycle is started as in ovarian stimulation cycle embryo “generation” occurs naturally, through the timed intercourse. The other term of ovulation induction cycle is the medicated timed intercourse.

The Fallopian tubes are the natural cutting–edge super tool that transfers sperm, oocytes and generated embryos that drastically simplifies the process of fertilization (sperm cell’s penetration of the oocyte’s cytoplasm, the configuration of the dual genetic content in all-new, all–in–one) and early embryo development. It just got a whole lot harder to generate an ideal embryo if the Fallopian tubes’ function is affected or if the Fallopian tubes are with pathology.

Hysterosalpingo–Contrast Sonography (HyCoSy) involves “injection” of a specific dye that is passed through the Fallopian tube under the ultrasound guidance. Ultrasound guidance makes it possible for fertility Pro to see the passage of colored fluid blended with suspended air bubbles through the fallopian tubes. The other Fallopian tube is screened in the same way. HyCoSy visualizes tubal architecture and patency.

What to expect from initial consultation shaped in “Pro screening mode”?

● Medical history review

● Pelvic ultrasound scan of uterine and pelvic physiology and pathology

● Antral follicle count (AFC)

● Fallopian tube patency test (HyCoSy)

● Full “mode” of the medical consultation and treatment plan “generation event”

Initial consolation shaped in “All–In–One & One–For–All Diagnosing Screening for Couples”.

If you are both ready to start and complete initial diagnostic testing in “All–In–One & One–For–All Diagnosing Screening” mode — this transformative initial consultation that “answers” your basic fertility Questions are designed inclusively for you. It is a real unprecedented leap in your and your fiancé’s self–fertility imagination. This initial consultation is designed for couples who have never had fertility diagnostic screening and wonder about the treatment options they have.

“All–In–One & One–For–All Diagnosing Screening” initial consultation “configures” triple screening tests in a ONE-time frame. ●Semen Analysis, ●Pelvic ultrasound scan of uterine and pelvic physiology and pathology, ●Antral follicle count (AFC) are performed in one day. Semen analysis and the Pelvic ultrasound is performed before the initial consultation. This “shapes” your initial consultation into “already generated treatment plan discussion mode”.

The fertility Pro has already listed the treatment plans that will best work for you and is ready to discuss everything with you as he has your and your partner’s diagnostic screening results. This means that the consultation’s time frame will be spent in an open discussion mode of your actual situation generating a plan. Plus, the treatment plan’s first “release” will be done.

What to expect from initial consultation shaped in “All–In–One & One–For–All Diagnosing Screening for Couples”?

● Medical history review

● Semen Analysis

● Pelvic ultrasound scan of uterine and pelvic physiology and pathology

● Antral follicle count (AFC)

● Full “mode” of the medical consultation and treatment plan “generation event”

Step 2 | Preparation for ovulation induction cycle. Tests, tests, tests… The screening mode. 

If your initial consultation was shaped in “Discussion mode,” you should expect more investigations. Yup, this might make you feel a bit frustrated but most treatments only start after diagnostic testing. Your diagnostic screening will involve  four tests and extensive bloodwork:

●● Infectious Profile (STD Panel)

●● Pelvic ultrasound scan of uterine and pelvic physiology and pathology

●● Antral follicle count (AFC)

●● Fallopian tube patency test (HyCoSy)

Your partner will undergo only (1) diagnostic test that involves semen collection in a vial and transfer of the semen sample to the laboratory for further investigation. Plus, one more diagnostic test to exclude sexually transmitted diseases. And bloodwork, surely.

●● Semen Analysis

●● Infectious Profile (STD Panel):

If your initial consolation was shaped in “Diagnostic mode”, and your fertility Pro performed ●Pelvic ultrasound scan of uterine and pelvic physiology and pathology and ●Antral follicle count (AFC), you should expect one more fertility diagnostic test, one more diagnostic test to exclude sexually transmitted diseases, and bloodwork:

●● Fallopian tube patency test (HyCoSy)

●● Infectious Profile (STD Panel)

Your fiancé’s semen will be taken for an investigation to exclude the male factor infertility. And he will be screened for sexually transmitted diseases (one more screening test plus to his screening testing list):

●● Infectious Profile (STD Panel):

If your initial consolation was shaped in “All–In–One & One–For–All Diagnosing Screening for Couples”, you have already had ●Pelvic ultrasound scan of uterine and pelvic physiology and pathology and ●Antral follicle count (AFC), and your beloved has already had ●Semen Analysis, one test for you is still in a “waiting mode”, and one more test to exclude the STD:

●● Fallopian tube patency test (HyCoSy)

●● Infectious Profile (STD Panel)

And bloodwork, bloodwork, tons of bloodwork for you both.

Hysterosalpingo–Contrast Sonography (HyCoSy)

HyCoSy is done to exclude tubal factor infertility that not only interferes with conceiving capacity. Tubal factor infertility shapes the boundaries for everything, lowering drastically your chances to conceive naturally to the minimal mode. Comparing HyCoSy and HSG, HyCoSy is not associated with the risk of an iodine allergy. On the contrary, HSG involves the risk of iodine allergy for the patients undergoing it.

This diagnostic testing screens the Fallopian tubes for blockages, endometrial and myometrial contours (müllerian anomalies, myomas). It also screens the ovarian structure and “identifies” ovarian cysts. HyCoSy screening also is used for endometriosis diagnosis. Furthermore, this screening “tool” is an alternative to HSG (Hysterosalpingography) that is performed in the radiology department.

HyCoSy and HSG are both performed in a “fast time mode”, but the HyCoSy’s “configuration” has one “installed” “app” that redesigns it completely and makes it Pro. This breakthrough “app” is the ability to obviate ionizing radiation, especially in the case of suspected transient tubal spasm, that “extends” the screening time frame as it is necessary to await the resolution of the tubal spasm.

Blood tests required for women:

Complete hormonal profile on the 2nd or 3rd day of your period, early morning before eating:

● Complete Blood Count test

● Blood Chemistry

● Blood Type

● LH (Luteinizing hormone)

● FSH (Follicle-stimulating hormone)

● Estradiol (estrogen steroid hormone)

● AMH (Anti–Müllerian Hormone)

● TSH (thyroid stimulating hormone)

● Free T4 (Thyroxine)

● Prolactin

● Vitamin D Level

● Rubella blood test (Rubella is a contagious viral infection)

● Toxoplasma blood test

● HIV1

● HIV2

● Hepatitis B blood test

● Hepatitis C blood test

● Syphilis blood test

● Cystic Fibrosis Carrier Testing (the blood test)

Other tests required for women: 

●●Infectious Profile (STD Panel)

●●●If necessary: sonohysterography or Saline Induced Sonohysterogram (SIS) — a diagnostic test that involves an infusion of the special water into the uterus to shape the uterine walls and uterine cavity. This test shows uterine abnormalities such as scar tissue inside the uterus, polyps, or fibroids.

●●●●If necessary: Stress Test (EKG), a cardiological test that is done to answer the question is it possible for the patient to carry a fetus to term or nope.

●●●●●If necessary: Diabetes (Hemoglobin Glycosylated) test.

●●●●●●If necessary: Blood pressure monitoring is included in the diagnostic testing list.

Blood tests required for men:

● Complete Blood Count test

● Blood Chemistry

● Blood Type

● HIV1

● HIV2

● Hepatitis B blood test

● Hepatitis C blood test

● Syphilis blood test

Other tests required for men: 

●●Infectious Profile (STD Panel):

This stage is the hardest one as diagnostic testing may disrupt completely the hope of completing everything only with ovarian stimulation cycle. But it is vital to complete this stage as it is the best “DevOp” for your treatment “roadmap.”

Moving forward.

Step 3 | Controlled ovulation induction (ovarian stimulation) and its CONSTANT Monitoring. 

Pills, pelvic ultrasound, blood test; pills, pelvic ultrasound, blood test, timed intercourse; pills, pelvic ultrasound, blood test, and timed intercourse. This is the ovarian stimulation protocol “titled” basic. Number 1.

●●● oral pills for ovarian stimulation

Or INJECTIONS, injections, #mypoortummyzone, pelvic ultrasound, blood test, timed intercourse… Injections, again injections, #myTummyZoneHURTS as there are bruises after these injections, pelvic ultrasound, blood test, timed intercourse. This is the ovarian stimulation protocol tagged “injectable hormones for ovulation induction”. Number 2.

●●● injectable hormones for ovarian stimulation

Or HYBRID medicated controlled ovarian stimulation cycle. Oral medication is “blended” with a low [or moderate] dose of the injectable hormones. Pills, injections, pelvic ultrasound, blood test, timed intercourse; pills, injections, pelvic ultrasound, blood test, timed intercourse…

●●● oral pills for ovarian stimulation

●●● injectable hormones for ovarian stimulation

Step 4 | Scheduling sexual intercourse. 

Your fertility Pro is constantly monitoring your follicle growth and generating the timeframe in his virtual Calendar for your next intercourse. If you have a CREATIVE Fertility Pro with MBA (Master of Business Administration) Degree, GET Ready to any EVENT that his mind can GENERATE. Never mind if you will receive an urgent awakening call at 11.00 pm with instructions to start cuddling with your partner in your bed NOW. Just start it.

Routinely, timed intercourse is scheduled to the closest time frame of ovulation — 2 or 3 days before the ovulation. Snooze all the business for the later timeframe, like one week or next Friday. No answering for other calls except your Fertility Pro during these cuddling hours. Love at first, second, third, fourth, fifth, sixth, seventh, and eighth time is your only business for there 2 or 3 days. The other things will wait, be sure.

Step 5 | And then there was a Real Pro... Blood Pregnancy test. 

In 2 weeks after ovulation timeline, you’ll come to the clinic again to have your blood test done. Like any routine blood test. Unlike any routine blood test. As this blood test is powerful enough to be called Pro. The most accurate pregnancy authentication tool ever. Compared to the urine test, the blood pregnancy test has up to 99% of accuracy. Pregnancy–sensitive and easy to perform, it empowers the fertility Pros to detect clinical pregnancy without complexity. Just one blood sample — and you are done. The answer for your most anticipated question is “entrapped” into that Blood Test Tube with turquoise–color–coded top indicating your tube’s content. That Blood Collection Tube is silent now to answer your question but its secret will be decoded in the lab. The answer is coming soon... 

The blood pregnancy test is done to check your hCG (Human Chorionic Gonadotropin) hormone levels. hCG hormone is generated by the embryonic trophoblast tissue which nourishes the oocyte after it has been fertilized by a spermatozoon. This specific tissue will launch itself to the uterine wall and sooner will be a part of the placenta. hCG hormone is an accurate pregnancy indicator. If hCG levels are increased drastically, nope, nope just drastically but to Extreme Levels, the clinical pregnancy is achieved, Congrats!

Step 6 | Early pelvic ultrasound scan is the most accurate early pregnancy validation tool ever.

Anticipated moment of making the tiny heartbeat visual on the ultra–large ultrasound screen. The ultrasound scan captures more of what you have ever imagined. You need to see it to believe it. You need to hear it love it. If you can see that sparkling dot beating actively, you are officially pregnant. Love it from the first, second, third, fourth, fifth, six and seventh time as this moment makes all your memories about this day look better than ever.

The early pregnancy transvaginal ultrasound is a Pro system that captures and shoots the highest–quality photo and video content of what is going on inside. It is designed to show you what’s happening outside your glance — and lets your fertility Pro capture it for you. The frame of what is possible is widened to the way you have never thought about. Your first “meeting” with your tiny bundle takes the new virtual form. Your fertility Pro can edit this photo and video content with specific installed editing apps — zoom it, crop it, cut it, light it or shade it — and your memories about your pregnancy “roadmap” take the real form.

The early pregnancy transvaginal ultrasound is performed as early as week 3 by 5 weeks gestational age to detect the gestational sac. The diameter of the gestational sac is around 2 to 3 millimeters. Your fertility Pro detects it at glance. The gestational sac is shaped like a pearl–white rim around a clear center in your womb. Usually, the gestational sac becomes visible when your hCG hormone levels have reached 1500—2000. If your hCG levels are below 1500—2000, the gestational sac has the “night mode turned on” — it won’t be detected on the ultrasound.

The follow–up ultrasound that might be scheduled on 5.5 to 6 weeks gestational age should detect the “launching” of the yolk sac within the gestational sac. The yolk sac’s major function is a nourishment of the embryo. It can be seen by 5.5 to 6 weeks gestational age on a pelvic ultrasound.

The ultrasound that is performed on 6 to 8 weeks gestational age should capture the embryo heartbeat and its rate. And not only. They can measure your embryo from one end to the other. The ultra-wide mode and zooming add tons of capacity for your fertility Pro to visualize your embryo. Everything “goes” big on the ultrasound screen. Even hidden details.

No worries if the first ultrasound could not detect the gestational sac. Just reschedule your ultrasound in one week to check again. The most common reasons for no gestational sac detected by the early ultrasound are the following:

●It is too early for the gestational sac to be visible on ultrasound.

●The pregnancy is ectopic (the gestational sac is growing into the Fallopian tube, abdominal cavity, or cervix).

●The pregnancy resulted in a miscarriage.

Conclusive words about ovulation induction.

Editable. Configurable. Integrable. The protocols of ovulation induction (OI) are 

Ovulation induction is the fertility tool #1 among the young couples with ideal health but facing unexplained infertility. It configures the all-new perspective for these couples for conceiving naturally. All-New Designed Exclusively for You, ovulation induction is the most expected ever as its protocols are generated to “force” the oocyte to be released (if the oocyte is not released every cycle) or more oocytes to be released (if the oocyte is released every cycle). Ovulation induction redesigns the drastically lower chances of having the oocyte release (ovulation) to the highest ones.

Ovarian stimulation cycle pushes the boundaries of what your ovaries can do. The limited to only one natural oocyte’s release is pushed to the next level. Ovarian stimulation makes it possible to release two or more oocytes and even to conceive multiples (twins, triplets or even more)! Surely, if all these oocytes will be “captured” and penetrated by the sperm cells. Conceiving multiples is beyond your control. It just happens from time to time.

Close–up of two powerful microchips’ (an oocyte and spermatozoon) interaction has been always a Major Mystery. Blended in the Fallopian tube, sperm cells are trying to penetrate the oocyte’s envelope and fertilize it.

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