Leaders in Fertility Research and Care
Timothy N. Hickman, M.D. | Laurie J. McKenzie, M.D. | Katherine K. McKnight, M.D.
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Patient Frequently Asked Questions

(For the patients of Houston IVF)
These Questions and Answers are meant to be a guideline for our patients. They do not replace, nor should they be substituted for any instructions or advice provided by the physicians and/or nursing staff at Houston IVF.

Cycle Day One

1. I was told to call when I have “Day One.” But I am not sure if today is Day One.

It is Day One if;

  • It is before 5:00 p.m. and you are having full flow bleeding, which is heavier than spotting and more consistent with your heavier flow.
  • If you are experiencing full flow bleeding and it is after 5:00 pm, then the following day will be considered Day One.

2. It’s cycle Day One and I need to set up testing only.

If you only need testing and are not entering into an immediate treatment cycle then you can call on following business day. If that day is Monday you should expect to come into the office.

3. It’s cycle Day One and I am supposed to start injectable (FSH) insemination (IUI) cycle.

  • If your Day One is on a Friday or Saturday, call the office and tell the answering service that you need to speak with a nurse for scheduling.
  • If your Day One is on a Sunday, call the office on Monday for appointment.
  • If your Day One is on Monday through Friday (after 5:00) call the office the next day during normal office hours (7:30 am to 4:30 pm, Monday through Friday) and make an appointment.

4. It’s cycle Day One and you are starting a clomid cycle.

Call the office on the next business day.

5. It’s cycle Day One and you are going to start an IVF cycle.

  • If your Day One is on a Friday or Saturday, call the office and tell the answering service that you need to speak with a nurse for scheduling.
  • If your Day One is on a Sunday, call the office on Monday for appointment.
  • If your Day One is on Monday through Friday (after 5:00), call the office the next day during normal office hours (7:30 am to 4:30 pm, Monday through Friday)and make an appointment.

Ovulation Testing

1. Positive Luteinizing Hormone (LH) surge (ovulation).

LH testing should be done with first morning’s urine. Late day testing will result in the following day being counted as the actual positive testing.

  • If a positive LH test is on Saturday or Sunday, call the office and tell the answering service that you need to speak with a nurse for scheduling.
  • If positive LH testing is Monday through Friday call the office and speak to the Day One nurse.

Questions Related to Birth Control Pills

1. I am supposed to begin taking birth control pill.  What pill in the pack do I start with?
    When do I start them?

  • If you have been specifically instructed by your physician nurse on the starting day of your birth control pills, follow their instructions.
  • You will typically start birth control pills on either Day 2 or Day 3 after you have completed your Day 3 blood work.  If blood work has not been completed, you will need to schedule a lab appointment before starting the pills.
  • Patients will need to start with the first pill in their pack. All active pills contain the same dose of hormones.  The last row of pills in the pack are inactive and contain no hormones contained.

2. I am on birth control pill and am bleeding.

Some bleeding and spotting is normal while you are taking birth control pills.  If you are experiencing any discomfort associated with the bleeding, you can take Tylenol Extra Strength according to normal dosage instructions.

3. I have just stopped taking my birth control pills and am bleeding.

Bleeding is also normal after you stop your birth control pill.  It may even range in color, consistency and duration.

Common Medications Questions

1. I am currently in an IVF cycle, but forgot a dose of Medrol® and/or Doxycyline. Is this ok?

Yes, nothing will be compromised by missing a dose of these medications. Please continue doses as instructed and finish out your prescription.

2. I am in an IVF cycle and my partner is on Doxycycline. When does he stop this? What if he misses a dose?

  • The Doxycycline will be stopped on the same day you are instructed to do your trigger shot.
  • If a dose is missed, simply continue on the pills until trigger day. Nothing will be compromised in the cycle from missing a dose.

3. I am not sure how to take the injectable medication I was prescribed.

  • There are videos, in English and Spanish, on the Houston IVF.net web site that offers easy to understand instructions on the injectable medications.
  • Click on Patient Education, then Fertility Drugs. The side icon “Injection Training From Freedom Fertility Pharmacy”

Illness while in treatment

1. I am currently taking fertility medications, or about to start them but feel sick. What medication can I take?

  • If you have a fever, or just experiencing general malaise (vague bodily discomfort), Tylenol or Tylenol Extra Strength is the preferred drug of choice. You may take this according to dosage instructions. Please notify your nurse on the next business day.
  • If you have allergy symptoms, a saline based nasal spray, over the counter eye drops, and cough drops may be used. Please refrain from using Benadryl and other antihistamines if currently on infertility medications.
  • If your symptoms are not alleviated by the above medications, or you are experiencing more serious ailments, please follow up with your Family Care or Primary Cary Physician for further treatment. Notify your Houston IVF nurse of any treatment initiated.

2. I am experiencing burning and pain with urination.

  • Increase your consumption of fluids. If this occurs after your transfer, please notify the nurse and have your pharmacy contact information available so she may phone in a prescription for you, if warranted.
  • If you are not currently in a treatment cycle, you will need to follow up with PCP or Ob Gyn.

Post Procedure Complaints

1. I recently had my retrieval and now am experiencing cramping and bloating.

  • Cramping is normal after retrieval. Please take Tylenol according to dosage instructions for your discomfort. If your symptoms become worse or the cramping is accompanied by heavy bleeding, please seek care at your closest Emergency Room and notify the Houston IVF nurse.
  • Bloating is also normal after retrieval. The ovaries remain enlarged after retrieval and take some time to return to their normal size, which will relieve these symptoms. Increase your fluids, especially with high protein and high salt beverages (i.e. V8 vegetable juice, Gatorade).
  • If you are experiencing decreased urination, increased urine concentration, difficulty breathing and/or extreme discomfort please start monitoring your weight on a daily basis. Weigh yourself at the same time each day. If you notice a weight gain of 2 lbs or more in 24 hrs please notify your Houston IVF nurse.
  • If unrelieved discomfort, especially difficulty lying completely flat please notify the nurse. An appointment will be made for the following day for an ultrasound. You will need to fast 12 hours before your ultrasound. If excessive amounts of fluid are noted in the abdomen cavity a paracentesis (similar to the retrieval) will be need to alleviate these symptoms. This process is known as ovarian hyperstimulation (OHSS), which is more common in patients producing a high number of eggs and who have extremely high estrogen levels.

2. I recently had an insemination and now have bleeding and/or cramping?

  • Bleeding and cramping are both common immediately following insemination, sometimes until your pregnancy test. in other cases cramping and/or bloating could be present through the first trimester of pregnancy.
  • If bleeding becomes very heavy with pain please notify a Houston IVF nurse. Please note that in many cases after using fertility medications cycles may occur earlier or later than normal.

Problems During Pregnancy

1. I am pregnant and experiencing cramping and/or bleeding!

  • Cramping is normal in pregnancy. The lower abdominal muscles are changing and this is typically the reason for this symptom. You may take Tylenol according to dosage instructions for any discomfort.
  • Spotting is also normal in early pregnancy. Please monitor your bleeding and notify your nurse on the next business day. This may or may not be accompanied with cramping.
  • Heavy bleeding in pregnancy needs to be immediately evaluated. Contact the office if this occurs during normal office hours. After hours, you will need to go the Emergency Room. If you are on an aspirin regimen for heart, immediately cease taking the low dose aspirin and remain on bed rest until you have a professional evaluation.
  • If you have been released to your OBGyn, you should contact his or her office for instructions or go to the Emergency Room if you are unable to reach someone.

Sperm Collection Questions

1. How many days of abstinence are needed before semen collection?

2-5 days of abstinence is recommended prior to collection. Anywhere in this range is acceptable.

2. Can I do the sperm collection at home?

If you collecting at home, your sample will need to arrive at office within 1-1.5 hrs of collection. Also the sample will need to be collected in the sterile cup you were given by Houston IVF. The sample will need to be kept warm in route to the office. We recommend that you keep the sample container close to your body (in a pocket or between your) legs as this is the ideal temperature. Do not keep it on the floorboard or dashboard of the car.


Disclaimer:

The Questions and Answers are meant to be a guideline for our patients. They do not replace, nor should they circumvent any instructions or advice provided by the physicians and/or nursing staff at Houston IVF. Houston IVF offers and maintains this website to provide information of a general nature about our practice and conditions requiring the services of a reproductive endocrinologist and infertility specialist. The information is provided with the understanding that Houston IVF is not engaged in rendering surgical or medical advice via the web. Any information in the publications, messages, postings, or articles on this site are not considered a substitute for consultation with a reproductive endocrinologist or infertility specialist. To address individual medical needs, individual facts and circumstances will determine the treatment that is most appropriate.

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