• 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

  •  

    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

  •  

    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

  •  

    IVF: Day 9

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

  •  

    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

  •  

    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

  •  

    IVF Cycle: Day 28

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

Collecting a Semen Sample

Collecting a Semen Sample

It’s okay to feel a bit uncomfortable about collecting a semen sample for sperm analysis. By and large, men describe the experience as awkward and embarrassing. The conditions can be less than ideal: you’re performing “on demand,” most likely in an anonymous, sterile environment, with the clinic staff “knowing” that you’re doing something that’s normally private, and you’re handing it over once you’re done.

But perhaps knowing what’s involved will reduce some of your reticence. Just keep in mind that it’s science. And it’s something that the nurses and staff at your clinic see every day, multiple times a day, 365 days a year.

How to Prepare

As part of the fertility workup, you’ll make an appointment to either produce your sample in office or drop it off at the clinic or lab after you produce a sample at home. With sperm, timing is of the essence and you don’t have much “wiggle room” for time delays. Make sure you are on the same page with your clinic about the time of your appointment.

You’ll need to refrain from any sexual activity for at least two days, but not more than 10 days before you collect your sample. This means no sex or no ejaculation of any kind, including masturbation.

Longer or shorter periods of abstinence may result in a lower sperm count or decreased sperm motility. Samples produced after two days of abstinence will usually have the highest numbers of motile sperm with the greatest forward velocity, when compared to samples produced after shorter or longer abstinence.

Some men think saving up all their sperm for the day of their test is what’s preferable, but waiting too long between ejaculates is a big mistake: Older sperm begin to die if ejaculations are infrequent and the percentage of live sperm decreases with increasing abstinence. That’s right, a long period of sexual inactivity can result in less active sperm.

And you’ll want to clean up your act. No smoking, drinking or drugs during the 10 days preceding you sperm collection (of course, you may want to consider these lifestyle changes even further in advance). Specific things that could affect the quality of your sperm sample include:

  • Medicines, such as cimetidine (Tagamet), male and female hormones (testosterone, estrogen), sulfasalazine, nitrofurantoin, and some chemotherapy medicines.
  • Caffeine, alcohol, cocaine, marijuana, and tobacco.
  • Herbal medicines, such as St. John's wort and high doses of echinacea.

Collecting the Sample

Masturbation is, most likely, the way you’ll collect your semen specimen. If you have severe male infertility, resulting in few or no sperm in the ejaculate, you may require a surgical procedure such as microsurgical epididymal sperm aspiration (MESA) or testicular sperm aspiration (TESA). Most doctors recommend you ejaculate directly into a provided sample cup and not use a condom. If you must use a condom, your lab will provide a special semen collection condom.

There are a few rules. First, take a shower and start out clean. Then, right before you get down to business, double check to make sure your hands and penis are clean. Wash them with soap and then rinse them with a lot of water.

You need to be a purist. You shouldn’t use any lubricant, including saliva. And, as mentioned, don’t collect your specimen in a condom (the spermicidal agents will alter the results of the analysis).

You will need to ejaculate directly into a sterile container provided by your clinic or lab. Avoid touching the inside of the cup and try to get the first part of your ejaculation as it is thought to be the most sperm-rich. If any semen spills, do not attempt to transfer it to your cup. Sorry, start again.

As soon as you’ve collected your sample, put the lid on your container. Make sure your name and the time and date of your sample is clearly printed on the cup.

Transporting Your Semen

If you collected your sample in a place other than your clinic, you need to get it to the laboratory within one hour after ejaculation because sperm do not have a long life outside of the body and at different temperatures. Delays in delivering semen and exposure to various temperatures will results in lower overall motile sperm count and poor semen cryopreservation.

Your semen sample shouldn’t be exposed to any extreme temperatures and, in fact, should be kept as close to body temperature as possible. The sperm motility value will be inaccurately low if the semen sample gets cold and or if it gets too hot.

Keep your specimen container upright in a plastic bag, with the lid securely tightened. The specimen should not be placed in your partner’s purse, or in your pocket or briefcase. Keep it as close to your body as possible, perhaps by tucking it under your clothing on the way to the clinic.

B.Y.O.P.

Most likely you will be in a room at your clinic provided for sample collection. Here’s a head’s up: Most of these rooms (sometimes, it’s the clinic bathroom) are pretty, well . . . uninspiring. Just know this in advance. And you may want to bring your own porn or Victoria’s Secret catalog. By many accounts, the selection is often outdated.

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