Treatment Summary

I - CLOMID

Begin the Clomid tablets on CYCLE DAY 3. Take them for 5 days and make your first appointment to be seen on approximately day 10.

II - PERGONAL (OR ANY OTHER INJECTABLE DRUG) ALONE

1. As noted above, count the first day of the menstrual flow as "CYCLE DAY 1".A "day" is any time from midnight to midnight. If your period begins in the evening, count that as day 1.
2. Begin the Pergonal on DAY 3.
3. Make an appointment to be seen on approximately DAY 8.
4. You will be seen on the average of twice a week for blood and ultrasounds to monitor the response of your ovaries to the medication. This monitoring is essential if the Pergonal is to be given with the maximum degree of safety. The frequency of the visits may vary depending on how your ovary responds.
5. Maintain the Pergonal until ultrasounds and hormone levels indicate adequate stimulation. Once this has been achieved, I will tell you to take the 10,000 units of HCG.
6. Make an appointment to be seen in the office approximately 8-10 days after the initial (10,000 units) HCG shot.

III - COMBINED GnRH-PERGONAL THERAPY

1. The first day of your menstrual flow is " CYCLE DAY 1 ".Again, premenstrual spotting or staining does not count. A "day" is any time from midnight to midnight. If your period begins in the evening, count that as day 1.
2. Begin the GnRH ( Synarel or Lupron ) on DAY 1.
3. Begin Pergonal on DAY 5. Stay on the GnRH.
4. Make an appointment to be seen on approximately DAY 10.
5. Maintain the combined Pergonal - GnRH regimen until ultrasounds and hormone levels indicate adequate stimulation. Once this has been achieved, I will tell you to take the 10,000 units of HCG. At this time, you will then stop both the Pergonal and the GnRH.
6. Make an appointment to be seen in the office 8-10 days after the initial (10,000 units) HCG shot.

The initial 10,000 units shot of HCG triggers ovulation which will occur 30-36 hours after the shot is given.

To maximize the chances of a pregnancy, intercourse should take place the day of and the day after HCG if "IUI" is not being done.

If you are undergoing "IUI," please have intercourse the day of the 10,000 units HCG shot but then abstain the next day.

"IUI" will be carried out 36 hours after the HCG

IV - COMBINED CLOMIPHENE-PERGONAL REGIMEN

1. Again, count the 1st day of bleeding as "cycle day 1"
2. Begin the Clomiphene on cycle day 3. Take 1 tablet twice a day for 5 days.
3. Make an appointment to be seen in the office on cycle day 7.
4. If you cannot be seen on day 7, begin taking the Pergonal on day 7 at a dose of 150 units daily. Make an appointment to be seen as close to day 7 as possible.

Begin the Crinone 24-36 hours after ovulation has occurred, regardless of which treatment regimen was used. If you are uncertain as to when that should be, ask me.