Things to Know Before You Start Monitoring During an IVF Cycle

Before you start monitoring your progress with an in vitro fertilization (IVF) specialist during your IVF cycle, there are several important things that you should know. As if the nightly (and sometimes another one in the morning) injections weren't bad enough, your fertility specialist is probably requesting that you come into the office every day for a blood test and ultrasound.

In vitro fertilization
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The Importance of Monitoring During an IVF Cycle

Your healthcare provider will need to closely follow your response to the medications that you are taking, which may include medications taken prior to IVF along with medications taken for IVF. Your medication dosages may change on a daily basis, as the healthcare provider is fine-tuning your response based on the results. Without such frequent monitoring, there is a greater chance that you could become sick or have a poor response.

What You Need to Know Before You Start Monitoring

Now you know that monitoring is important, but what is it going to mean for you exactly? The following seven tips will help you understand what to expect once monitoring starts:

1. You may have some very early mornings for a while. Of course, this is up to your healthcare provider. Typically, patients are required to be in for testing every morning, though it may be less frequent at the beginning of the cycle. If you have any concerns about the frequency of monitoring during IVF, please speak with your healthcare provider before you start.

2. Daily blood tests and ultrasounds will be normal. You will probably have your blood drawn and a transvaginal ultrasound performed every time you go in. This also depends on your healthcare provider and condition, but be prepared for daily tests.

3. Skipping appointments is a big no-no. Before skipping an appointment, you must speak with your healthcare provider or nurse. There are usually points in the cycle where monitoring is 100% necessary. In fact, some women may have their IVF cycle canceled by their healthcare provider because of frequent absences.

4. Growing your follicles will be a priority. Over the course of your cycle, follicles on your ovaries will begin to grow and develop. The sonographer will be visualizing your ovaries and measuring the diameters of each follicle. The endometrial lining will also be measured. Each healthcare provider will have their own standards, but the growth of the follicle by about 2mm each day is common.

5. Your hormones will be watched like a hawk. Again, each clinic will have their own policies, but generally speaking, the healthcare provider usually wants to look at your estrogen, progesterone, and LH (luteinizing hormone) levels. Sometimes they may draw blood for other purposes. You should feel comfortable asking your medical team what the blood test results mean and what ranges your hormones should be at.

6. Estrogen will become your best friend. There are a number of factors which can affect your estrogen level, depending on your age and the medications you are on to name a few. While each healthcare provider will follow your estrogen level according to their own policies, they are looking to see that the level is rising appropriately. Usually, they want to see the level double every two days. If your estrogen level drops significantly during your cycle, this may indicate a need to cancel the cycle and start over. If you have an estrogen drop during your cycle, please do not hesitate to speak with your healthcare provider about your concerns.

7. You will be throwing words and acronyms around (e.g., progesterone and LH) like a pro. Rising levels of progesterone and LH can indicate that you may be breaking through your suppressive medication and that your body may be getting ready to ovulate. Your healthcare provider will want to monitor your levels to make sure that there are no early signs of ovulation. If those levels do begin to creep up, he or she can follow them very closely and make the appropriate medication adjustments. An ovulatory progesterone (usually above 3, but depends on the way the lab runs the blood work) while cycling may also indicate the need for cancellation. Again, please speak with your healthcare provider about any concerns.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Society for Reproductive Medicine. Assisted reproductive technology: a guide for patients.

  2. Radiopaedia. Follicular monitoring.

  3. American Association for Clinical Chemistry. Fertility testing.

  4. Society for Assisted Reproductive Technology. Cycle cancellation.

  5. Al-Azemi M, Kyrou D, Kolibianakis EM, et al. Elevated progesterone during ovarian stimulation for IVF. Reprod Biomed Online. 2012;24(4):381-388. doi:10.1016/j.rbmo.2012.01.010

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."