What Are Monitoring Appointments?

blood-draw

Part of the pre-transfer protocol includes scheduling and keeping appointments known as ‘monitoring’ appointments. These appointments, which are often completed at a reproductive health or IVF clinic in your hometown, allow your IVF doctor to monitor your body’s reaction to the pre-transfer hormone therapy.

Typically, these appointments consist of a quick blood draw and a transvaginal ultrasound. The blood draw monitors the presence of certain hormones in your blood, namely estrogen and progesterone. Your blood estrogen levels will play a direct role in the thickness of your uterine lining, while progesterone allows an embryo to remain lodged in your lining.

Typically you will also have a series of transvaginal ultrasounds as part of your monitoring appointments. The process, which may be new to you, includes placing a wand into your vagina to get an ultrasound image of your uterus and ovaries. The doctor will be monitoring your ovaries for potential cyst development and ovulation. He will also be watching your uterine lining very closely. Your lining should thicken during your medical cycle, with an optimum pattern ­being between 8-12mm in thickness. Ideally, the walls of your uterine will also touch in the middle, creating the image of a “stripe” on the ultrasound.

It is not abnormal for your lining to begin at a much lower thickness and to not display the stripe pattern immediately. In fact, it’s even normal. During your first monitoring appointment you are at a phase in your cycle where the lining is thin and a stripe pattern is not expected. As your month-long medication cycle progresses, your doctor will keep an eye on your hormone levels and adjust them as needed in order to create the ideal lining for transfer.

Most women will do anywhere from 3-5 monitoring appointments leading up to their transfer. You can typically expect these appointments to be quick and low pressure. Your nurse usually calls you with the results of your appointment as well as with any medication changes the same day as the appointment.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: An Essential Guide to Assisted Reproduction (Red Wheel Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.