Cycle monitoring for timed intercourse (IC) is the process of monitoring either a natural cycle (no medications to stimulate the ovaries) or a cycle in which fertility medications are used to determine a patient’s most fertile days.
When to consider IC
You may wish to consider timed intercourse as a fertility solution, if ovulation does not occur normally or regularly, or if male factor infertility is not a consideration.
What are the steps involved?
The IC procedure includes many steps:
All patients will have baseline testing prior to starting a treatment to determine the best fertility care plan.
Cycle monitoring takes place during the first half of the menstrual cycle to follow the development of ovarian follicles. Each healthy follicle should contain an egg that will mature as the follicle grows, and eventually ovulate or release. We may monitor a unstimulated cycle (no medications to stimulate the ovaries) or a cycle in which follicle stimulating medications are used. Monitoring typically involves blood tests and internal (transvaginal) ultrasounds to track the development of a follicle (or follicles) and monitor for ovulation. Cycle monitoring typically involves 2 to 3 appointments over the course of approximately 2 weeks.
We monitor the patient for ovulation through blood tests and ultrasound and/or ovulation sticks. If you are close to ovulation or currently ovulating, the clinic will advise on the days intercourse is recommended.
There is a window in which fertilization occurs; the clinic will advise on the days intercourse is recommended. Do not use any gels, creams, lotions, lubricants or saliva during intercourse as it may negatively affect the sperm.
Approximately 2 weeks later, you will be asked to do a beta-hCG blood test to determine if you are pregnant. The nurse will make an appointment for an in-clinic test, or provide a requisition if you wish do the blood work at an outside lab.
What happens if the pregnancy test is positive?
If your pregnancy blood test is positive, you will be asked to repeat the test 2-3 days later to measure for appropriate rise of the pregnancy hormone. If the second pregnancy blood test has risen appropriately, you will be scheduled for an early obstetrical ultrasound around 7 weeks of pregnancy, then referred for obstetrical care.
What happens is the pregnancy test is negative?
If your pregnancy test is negative, you may be able to proceed into another cycle or it may be recommended that you follow up with your fertility care team to determine the best next steps in your fertility journey.
You physician may recommend fertility medications to increase the number of eggs which are produced during the menstrual cycle. Fertility medications may include pills and injection medications used to stimulate the ovaries. This should be before cycle monitoring.
Risks associated with IC
If you are taking fertility medications, there are some situations when a patient’s cycle may be cancelled. This could include when there are a high number of follicles developing, which can lead to an increased risk of multiple pregnancy, the patient’s doctor may advise on cancelling the cycle. If the patient’s cycle is cancelled, a review appointment will be booked with the patient’s doctor.
The goal of cycle monitoring for timed intercourse is to produce one healthy baby. A multiple pregnancy is not advised as it carries greater risk. The risks of a multiple pregnancy can range from 5% – 20% with fertility medications.
All pregnancies have a small risk for birth defects. The general risk for all pregnancies is approximately 3% to 5%. The risk of birth defects including cerebral palsy appear to be higher in those with infertility, even if they conceive without fertility treatment.
In some situations, your IUI cycle might need to be cancelled. If this happens, we will book an appointment with your primary doctor and a portion of your fees will be refunded depending on the treatments that have already occurred.