In each protocol ultrasound is done and estrogen blood level is checked on the second or third day of menstrual bleeding. After receiving the results dose of medicine is determined for each particular case. While stimulating treatment is going on, patient will be invited for planned check-ups to do vaginal ultrasonography in order to check the number and size of developing follicles. Sometimes depending on the ovaries condition additional investigation of estrogen level in blood might be necessary.
The aim of the treatment is to obtain maximum number of follicles with diameter of 16-20 mm. Basing on the results of intermediate estrogen test applied dose of medicine may be changed. It's necessary to reach estrogen level of 200 pg/ml in follicles which are bigger than 14 mm.
After obtaining necessary results 5.000-10.000 units of Human Chorionic Gonadotropin injection are made to ensure maturation. Average duration of treatment in our clinic varies between 10.4 + 1.7 days. When 32-36 hours passed after final injection eggs can be retrieved.
Another important factor which is investigated while doing ultrasound is structure and thickness of the inner layer of uterus called endometrium. It's crucial for pregnancy whether endometrium structure is favorable. If it is 6 mm or thinner on the day of HCG injection, chances for pregnancy become lower. According to our practice pregnancy rate in such situations is 11,8%. If endometrium thickness is more than 14 mm it also has negative effect. Even if pregnancy happened, possibility of miscarriage will be high.
