What recommendations about the treatment could be useful?

Treatment and Monitoring

Are there any side effects during stimulation for insemination or IVF?

Stimulation causes side effects due to the use of hormones. Some patients do not experience any discomfort and others suffer from symptoms such as a bloating, sensitive breasts, water retention, light headaches… If this occurs, inform the medical team and they will tell you what to do.

Can I do sports during the stimulation?

At the beginning of the stimulation you can continue doing sports with absolutely no problems.

After the first follicular control, we do not recommend that you continue to do intense physical activity as the ovaries are growing due to the stimulation and this increase in size can cause you discomfort. For this reason it is better to reduce or cease your activity in order to not experience discomfort or stronger pain. You will also feel better because the stimulation will tire you. We want you to be in the best possible state for your stimulation and stay in the clinic.

Does the treatment need to be taken at a specific time of day?

Depending on the treatment, we will tell you how to administer the medication and if there are preferred times of day for it to be taken.

For example, in the case of insemination or IVF, the doctor will give you a time period for certain medicines to be taken, according to your follicular development.

For the reception of fresh or cryopreserved oocytes, you can choose the timetable that best fits in with your lifestyle but you must keep to these times. For example, every 12 hours does not mean in the morning with breakfast and at night with dinner, but must be exactly 12 hours (e.g. 8:00 and 20:00). In the case of every 8 hours, this is not morning, midday and night, but 8:00, 16:00 and 00:00, for example.

It is important to stick to the times for taking the medicines because we need the body to have a constant and regular dose of hormones present. Respecting these times will also help you to avoid forgetting to take the medicine.

What is the difference between oestrogen patches and pills for the reception of the oocytes?

The patches have the same effect as the pills as they both contain the same dose of oestrogen.

Instead of taking the pills orally which may cause side effects for certain patients with gastric problems or other pathologies, the patches provide a slow release, transdermic diffusion of oestrogen which is a less aggressive treatment.

According to your age and medical history, your doctor will decide which type of treatment is more appropriate.

How should oestrogen patches be applied?

The patches can be applied to parts of the body where there is fat tissue: buttocks, outside of the thighs or arms, together or in different places. We recommend that you change the place each time to avoid irritation and saturation of the skin in the same place.
The patches should never be applied:

  • To the breasts,
  • To damp or oily skin due to the prior application of creams or oils,
  • To broken skin: wounds, moles,…
  • To an area subject to friction from clothes: waistband or bra straps,
  • In the same place as the previous patch: alternate 2 or 3 different places.

If the patch falls off, try to re-stick it in another zone or use a new patch which will be removed on the date set for the removal of the first patch in order to respect the planning. Wash your hands before using the patch.

Why is the dose of progesterone (vaginal eggs) higher than that recommended on the prospectus in the box?

Do not worry, it is quite normal to take a dose higher than that recommended by the manufacturer because this medicine is usually used in hormone substitution treatment for women in the menopause. In the field of assisted reproduction we use a higher dose because the requirements of a pregnancy are higher. Progesterone gives support at the beginning of a pregnancy.

The dose we prescribe is 200-800mg per day, depending on the protocol. If you lose a whole capsule, apply a new one. There are applicators available in the chemist’s to help you insert them. Remember to wash your hands before and after each application to avoid germs and possible vaginal infections.

What vitamins can I take?

For the woman, we recommend folic acid or vitamin B9. This helps to avoid the risk of neural tube defects, such as spina bifida in the foetus. The recommended dose is 0.4mg per day. In patients with diabetes, with a family background of spina bifida or any other specific deficiency or in some other specific cases, we recommend preparations with a dose of 5mg per day. This vitamin is water soluble and there is no risk of an overdose as it is eliminated in the urine.

For the man, there are also vitamin complexes available which improve the quality of the semen and which are based on L-carnitine, zinc, folic acid and vitamins C, B12, E. There are different types of vitamin complexes available such as Androferti, in Spain. There is no scientific evidence that these complexes increase the fertility of the man.

I am suffering from stress with the hormone treatment, what can I take?

We understand that the hormone treatment may upset you emotionally and cause a certain amount of stress while you are waiting to come to the clinic for your procedure to be carried out. We recommend you maintain a healthy lifestyle and take gentle exercise to channel your energy: yoga, walking, cycling, swimming… If you are very emotional, we advise you to consult your GP for him/her to prescribe you a non-aggressive natural treatment such as valerian or Bach flowers (active ingredient: populous tremula). There are many natural alternative treatments available that give good results. We should remind you that once the technique has been performed (transfer or insemination) not all plants and natural remedies are compatible with a pregnancy which means it is important to consult your doctor or chemist.

Is it necessary to have an endometrial ultrasound before my embryo transfer?

There is no need to have an endometrial ultrasound if your doctor has not recommended that you do so. Most women have a totally normal endometrial development even when they have had assisted reproduction treatment.

The doctor will only recommend it if there has been an insufficient endometrial response in previous treatments, after repeated uterine surgery, pelvic radiotherapy, or when there is a history of a thin endometrium.

Some patients, through their own choice, have an ultrasound for their own assurance. If you wish to do this, we recommend having it after 12 to 14 days of oestrogen treatment.

 

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