• Timeline
  •  

    Menstrual Cycle: Introduction

    The average length of the menstrual cycle is 28 days. More

    menstrual
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    Menstrual Cycle: Days 1-5

    Day 1 of menstruation is the first day of your cycle. More

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    Menstrual Cycle: Days 1-13

    Days 1-13 of your menstrual cycle are the "follicular phase" More

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    Menstrual Cycle: Days 10-18

    Days 10-18 of your menstrual cycle are considered the "ovulatory phase". More

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    Menstrual Cycle: Days 15-28

    Days 15-28 of your menstrual cycle are considered the "luteal phase". More

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    IUI: Introduction

    With intrauterine insemination (IUI), a doctor uses a soft catheter to place sperm directly into the uterus. More

    iui
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    IUI: Day 1

    Fertility drug injections begin at the start of the your menstrual cycle. More

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    IUI: Day 2

    Follicles begin to respond to the fertility drugs and grow. More

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    IUI: Day 3

    Daily fertility drug injections cause your follicles to continue to grow. More

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    IUI: Day 4

    Your follicles continue to grow. More

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    IUI: Day 5

    As the follicles respond to the fertility drugs, your doctor will monitor your progress with vaginal ultrasound. More

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    IUI: Day 6

    Your body is producing more estrogen and your uterine lining begins to thicken. More

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    IUI: Day 7

    Fertility drug injections continued and you are monitored for ovulation. More

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    IUI: Day 8

    Daily fertility drug injections continue and follicles continue to grow. More

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    IUI: Day 9

    Your follicles are still developing and you continue fertility drug injections. More

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    IUI: Day 10

    You discontinue using injectable fertility drugs. More

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    IUI: Day 11

    The hCG trigger shot is injected to help follicles mature and release the eggs. More

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    IUI: Day 12

    Your follicles and eggs are almost mature. More

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    IUI: Day 13

    Ovulation occurs. More

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    IUI: Day 14

    Sperm is washed and you are inseminated when you are ovulating. More

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    IUI: Day 15

    The embryo, now in the fallopian tube, will continue to divide. More

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    IUI: Day 16

    The embryo continues to grow. More

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    IUI: Day 17

    The embryo travels from the fallopian tube to the uterus. More

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    IUI: Day 18

    Hormone levels continue to increase. More

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    IUI: Day 19

    The uterine lining is now 8-12 mm thick. More

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    IUI: Day 20

    Your embryo is working to ultimately attach to the lining of your uterus. More

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    IUI: Day 21

    Your embryo will attach to your uterine lining. More

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    IUI: Day 22

    The embryo is starting to implant. More

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    IUI: Day 23

    The embryo continues to implant. More

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    IUI: Day 25

    Your body begins to produce hCG and progesterone production continues. More

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    IUI: Day 26

    The embryo continues to grow, and progesterone support continues. More

  •  

    IUI: Day 27

    The embryo continues to grow. More

  •  

    IUI: Day 28

    A blood pregnancy test will determine if you are pregnant. More

  •  

    IVF: Introduction

    More

    ivf
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    IVF: Day 1

    On Day 1 of your IVF cycle, you'll begin fertility drug injections. More

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    IVF: Day 2

    On Day 2 of your IVF cycle, you'll continue fertility drug injections. More

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    IVF: Day 3

    Your follicles continue to grow as they respond to the fertility drug injections. More

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    IVF: Day 4

    Your follicles continue to grow as you continue daily fertility drug injections. More

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    IVF: Day 5

    As you continue to use fertility drugs you will be monitored by your fertility doctor. More

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    IVF: Day 6

    The lining of your uterus is beginning to thicken as you continue fertility drug injections. More

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    IVF: Day 7

    Daily fertility drug injections continue, and your fertility doctor may start monitoring hormone levels. More

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    IVF: Day 8

    You'll continue fertility drug injections and follicles will continue to grow. More

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    IVF: Day 9

    You'll continue fertility drug injections and follicles will continue to grow. More

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    IVF: Day 10

    You'll stop using fertility drugs at this point in your IVF cycle. More

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    IVF: Day 11

    Once your body has responded to the fertility drugs, you'll receive an hCG injection (trigger shot) and egg retrieval will be scheduled. More

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    IVF: Day 12

    Your eggs are almost mature, and are ready for egg retrieval. More

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    IVF: Day 13

    At this stage of the IVF cycle, your eggs are retrieved and fertilized. More

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    IVF: Day 14

    Your eggs are fertilizing in the lab. More

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    IVF: Day 15

    Embryos will continue to develop, and if PGD has been scheduled the procedure will take place. More

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    IVF: Day 16

    Usually on Day 16 of your IVF cycle your embryo transfer will take place. More

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    IVF: Day 17

    The embryo is in your uterus, and cells continue to divide and increase. More

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    IVF: Day 18

    The embryo continues to grow and hormone levels increase. More

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    IVF: Day 19

    The lining of your uterus is now 8-12 mm thick. More

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    IVF: Day 20

    Your embryo is working to attach to the lining of your uterus. More

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    IVF: Day 21

    The embryo attaches to the uterine lining. More

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    IVF: Day 22

    The embryo begins to implant in the uterine lining. More

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    IVF: Day 23

    The embryo continues implanting in the uterine lining. More

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    IVF: Day 24

    More

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    IVF: Day 25

    Your embryo continues to grow and progesterone continues to be produced. More

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    IVF: Day 26

    Your implanted embryo continues to grow. More

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    IVF: Day 27

    The implanted embryo continues cell division. More

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    IVF Cycle: Day 28

    It's time to take a blood pregnancy test. More

Give Us the Bad News Nicely, Please

Give Us the Bad News Nicely, Please

Unlike the mostly happy baby updates coming out of ob-gyn offices, the news from reproductive endocrinology offices is usually a little tougher to deliver and to receive.

Since most fertility procedures are out-of-pocket expenses, we are within our rights to expect to be cared for by a kindly team with an outstanding bedside manner. Fortunately for me, my RE and his team were all-stars at delivering information and care (whether in person or by phone), answering my questions thoroughly and clearly. My doctor was genuine in his desire to achieve success and seemed, almost, to take any setbacks personally. I sometimes felt like I was letting him down when my beta tests came back negative! That's why when I hear about less-than-compassionate encounters with those providing fertility services I'm more than shocked, I'm outraged.

This past week, a woman I know got a double whammy. Her last, best hope at getting pregnant was not only denied, it was stomped on by both the physician and his staff. Her doctor not only rebuffed her treatment request, he behaved toward her as if she were a statistical data point, not a live woman sitting in his office. She describes the encounter as though it's happening to someone else - clearly trying to make sense of it all:

"Dr. Fearless doesn't even meet your eyes after the initial handshake. You hand him your file, and briefly (and confidently) explain your hope to freeze some eggs, and why, and about the last chemical pregnancy and the current anovulatory cycle, and knowing what your odds are, but wanting to give it a whirl anyway. As you speak, he flips through your file, occasionally typing notes into his computer. Finally he says, ‘I see you were pregnant once, a long time ago.' You start to explain about the subsequent chemical pregnancies and the clotting disorder which is now under control, but he interjects that only pregnancies confirmed by ultrasound 'really count.'"

From there, this shaken woman submits to a test against her better judgment and expects to hear from the doctor's office in a day or so. She heads out hoping that she'll hear she can proceed with freezing her eggs.

". . . the sidewalks are filled with children in colorful puffy jackets calling out to parents pushing well-wrapped babies in strollers. You are stunned, but calm, as you make your way back to the parking garage where you’ve left your car. When you are almost there, you turn your phone back on to call the friend you'd tentatively planned to meet for coffee in order to cancel, and there is a message. From the RE's office.

You lean against the railing in front of a brownstone, amid the cheerful family bustle, and listen, heart frozen, to the following affectless voicemail message: ‘According to your blood work and ultrasound, Dr. Fearless, unfortunately, believes that there will be no real chance for you . . . he believes that there will be no such luck with you getting pregnant with your own eggs and your next choice will likely be a donor...' The message-leaver gives you the contact information for the donor coordinator who can explain the process, then, for good measure, she repeats, with more confidence this time, the ‘no chance of getting pregnant with your own eggs, so donor will be your next step' part and signs off."

Seriously!!? How can anyone in their right mind think that this kind of information can or should be left in a voicemail? These are not procedures anyone undertakes lightly. The implications are enormous.

I'm only glad my friend was strong enough to call back the next day and voice her displeasure. The unknown is whether that particular office will continue to engage in this poor practice.

Here's my fear: That in their quest to get to the next success story there are some RE offices that lose their humanity in the process. I shudder to think how often this kind of emotional abuse happens to other couples.

I might just have to send a belated thank you card to my old RE team. They more than earned it.

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