Introduction

1. Introduction QUICK START: Controlled Ovarian Hyperstimulation Cycle

2. Prior to beginning your cycle, you must have: • Completed your checklist • Signed all consents • Obtained all of your medication for your cycle • Checked with your financial coordinator that you are financially cleared for your cycle. You will not be allowed to start any medication if you are not financially cleared.

3. Ovulation • Women with regular menstrual cycles are normally ovulate just one egg a month. • The menstrual cycle is regulated by the pituitary gland. This gland sends two signals to the ovary called Follicle Stimulating Hormone or FSH and Luteinizing Hormone or LH. These two hormones encourage egg development and trigger ovulation. Introduction

4. Ovulation Ovulation

5. FSH (Gonadotropin) FSH Injectable FSH stimulates the ovulation of more than one egg

6. Injection Training • Take the time to watch RMA’s injection training videos • Hormonal injections are administered for 5 to 12 days in order to grow the ovarian follicles and allow the eggs to mature • Expect to administer approximately 1-2 injections daily • *Ask your nurse what injections your physician will be prescribing. Click here to view our Injectable Medication Training Videos

7. Monitoring follicle Ultrasounds Blood Work IUI 5-12 days Monitoring 1-2 Days 1-2 Days 1-2 Days 3-4 Days Intercourse TRIGGER DAY 3

8. IUI Intrauterine Insemination Intrauterine insemination, or IUI is a procedure that places washed sperm directly into a woman’s uterus around the time of ovulation. This may improve a woman’s chance of getting pregnant because more sperm will make their way closer to the egg.

9. Side Effects from Injectable FSH • Cramping, mood swings, headaches • Multiple pregnancy • Ovarian Twisting (torsion) • Ovarian Hyperstimulation Syndrome (OHSS) Side Effects

10. Questions