Outside monitoring has likely been mentioned only in passing up through now. What do outside monitoring appointments entail, and what can you expect with each of these visits?
In general, outside monitoring (and all monitoring, in general) encompasses the medical appointments scheduled to assess your response to cycle medication throughout the duration of the egg donation cycle. These appointments are scheduled early in the morning in order to provide same day results, and are completed at your treating physician’s office, or alternatively, at a cooperating physician’s office nearby your home (referred to as “outside” monitoring because tests are done outside your treating physician’s office).
At each outside monitoring visit, you will undergo a blood draw and transvaginal ultrasound. Your blood draw, performed by a phlebotomist, allows your treating physician to evaluate the quantitative levels of certain hormones in your body, specifically estradiol, progesterone, and luteinizing hormone. These hormone levels correspond to your response to cycle medication during ovarian stimulation.
The transvaginal ultrasound, performed by an ultrasonographer or physician, provides your treating physician the opportunity to visualize the egg-containing follicles within your ovaries, and further provides detailed information regarding the number and sizes of these developing follicles, which further corresponds to your response to medication.
Egg donors generally undergo a total of 4-8 appointments leading up to the egg retrieval procedure, with instructions for medication dosages following each visit, depending on how you are responding to medication. Once your follicles reach a certain size (generally, a few follicles on each ovary must reach a diameter of 18-20mm), you will be provided detailed instructions by your nursing team to take one final injection, called a trigger shot (this injection literally triggers the growing eggs to undergo final maturation via meiosis), and you’ll be provided specific details related to your egg retrieval day.