There are a lot of steps to clear prior to an egg retrieval, so it makes sense that you are staring the process now, a few cycles beforehand. At this point, they will want to test your baseline numbers when you get your period (FSH, AMH, estrogen, progesterone) to see off the bat what the issue could be. High FSH and low AMH would indicate diminished ovarian reserve, which is most likely not the case if you’re under 35. AMH indicates egg reserve and FSH indicates how hard your body has to work to produce and ovulate an egg.
In the meantime before your cycle, you’ll have to also do a blood work up to ensure you are clear of STDs, immunity up to date etc. your clinic will also talk to you about genetic testing if you have not done this. You will make a treatment plan with your doctor/nurses (fresh transfer, frozen transfer, PGT testing, etc.) and they will tell you which medications you’ll need. You will have to check your IVF benefits with your insurance and work out prior authorizations with them- for both the medication and IVF treatments. You’ll want to order your medication before starting to have them ready. There will be legal paperwork about the embryos- storage, what happens to embryos in the event of one spouses death or a divorce, etc.
When you’re ready to start the retrieval process, your clinic will either put you on birth control for a few weeks prior or will go based off of your natural cycle. When you get your period you go in for monitoring on day 2, and typically begin stims medications that evening or next day. In a typical antoganisr cycle, This will usually include follistim and menopur in the beginning to promote egg production. After a few days they will add ganorelix to prevent premature ovulation, and eventually, after about 8-10 days, you will add a leupron/hcg trigger to trigger ovulation exactly 36 hours before your egg retrieval. Expect frequent monitoring in the mornings- blood work and ultrasound- to monitor follicle development.
Post retrieval you will be told how many eggs were harvested. Next day you’ll find out how many fertilized, and five days later, how many made it to blastocyst embryos for transfer. At this point you will either have a fresh transfer, or they will freeze them for a frozen transfer if you are doing PGT genetic testing or if you’re at risk for OHSS. My frozen transfer was exactly 4 weeks after my retrieval, and was much less intensive in terms of medication and monitoring.
Good luck to you!