Those of us working in IVF clinics sometimes take for granted our day to day processes and forget that our patients are not aware of what we do behind the scenes. An example of this is the constant communications that are taking place between your nurse, scientist and specialist.
To give you an idea on what is happening behind the scenes, I will walk you through a typical treatment cycle and what communications are taking place during the treatment.
Typical Treatment Cycle
1. Cycle Planning
As you all know your specialist in consultation with you and your partner, will devise a treatment plan specifically tailored for you. Your specialist makes this decision based on a number of factors. These factors include but are not limited to:
- Age of the female partner undergoing treatment
- Baseline blood test results such as AMH and FSH
- Baseline pelvic ultrasound scan results (recent within 12 months)
- Cause of infertility (if known)
- Semen Analysis results (recent within 12 months)
- Body Mass Index
- Information from previous treatment cycles, if applicable
- The type of treatment that you wish to have
When you and your partner have this initial consultation with your specialist, they will be reviewing the results of a recent semen analysis and using this, as well as information gained from the list above, they will generate a cycle plan specifically taking into consideration you and your partners situation and needs. This cycle plan is then forwarded to your nurse, at whichever clinic you are attending – Fertility Solutions Sunshine Coast or Fertility Solutions Bundaberg.
When your nurse receives the cycle plan, she then goes about ordering and preparing all the medications and relevant paperwork for this cycle. She also collects all your screening tests results to ensure that nothing has been missed. Your nurse will also be ensuring that the relevant consent forms have been completed.
Before you start a treatment cycle, your case will be discussed at our weekly nurses and scientists meeting. At this meeting, patient notes are reviewed along with recent test results and the cycle plan provided by your specialist. Sometimes, after this meeting, a recommendation will be made to your specialist to ‘tweak’ the treatment plan, based on any recent findings or results since you last saw your specialist.
2. Treatment Commences
When your cycle is about to commence, you will most likely have been asked to have a blood test when your period arrives. Your nurse will be reviewing these results and discussing these with your specialist before you begin any medications. At this point, your specialist will be giving you the green light to commence treatment – or they may need to change the devised approach based on these results. After this review, your nurse will then discuss the results with you and let you know the next step.
Once your treatment has commenced, you will be following the information your nurse has provided you regarding starting medications and when to have blood tests and scans. Each time you communicate with your nurse – either face to face, over the phone or via email – she is constantly reviewing your treatment plan in accordance with cycle and test result findings. In the background, she is communicating these findings to your specialist, so that he/she is also up to date with your treatments, even if you don’t see your specialist (as in IUI cycles). If there is anything out of the norm, your nurse will be contacting your specialist for a review, requesting their input.
Each week at the nurses and scientists meeting, not only are the patients who are about to start treatment discussed, but also those who are already in treatment. At this point, the team collectively are looking at how you are responding to treatment and if anything needs to change. This meeting is also where a decision is likely to be made as to the optimal time for your egg collection, insemination or embryo transfer. Again, if there are any concerns from a scientific or nursing perspective about you or your treatment, these concerns are promptly reported to your specialist, so that changes can be made, if necessary.
If you are having an IVF cycle, the scientists are constantly communicating with you, your nurse, and your specialist about the number of eggs collected at your procedure, the number of eggs that fertilised normally and how the embryos progress. Each time you speak with a scientist, you can be assured that your nurse and specialist have also received a follow up report about this communication. The scientist will also contact your specialist or nurse for discussions if things are not going to plan and perhaps the embryo transfer needs to be brought forward.
3. Interesting Cases
Every month, the nurses, scientists, and specialists come together for a clinical meeting. At this meeting your nurse, scientist or specialist can table a specific case for discussion. This is particularly important, as it enables everyone to have input into any changes that could be considered for your cycle. The old saying, of course, is “several heads are better than one” and that is absolutely true with case discussions. The aim of these discussions is that you receive cycle planning that is based on best practice, evidenced base medicine, and recent research.
I hope that you can see that there are many discussions that go on behind the scenes between your nurse, specialist, and scientist, with the ultimate aim being to maximise the chance of a successful cycle for you. Individuals and how they respond from one month or cycle to the next can be vastly different, even if the exact same treatment plan that resulted in a previously good outcome is used again.
It is because we are working with individuals that we need to constantly be reviewing results and making changes as required. What works today may not work tomorrow, but you can rest assured that our focus is to achieve a maximum result for you and your partner.
If you have any questions relating to your specific situation please feel free to contact your fertility nurse or specialist to arrange for a follow up.