How to start my first step?

Normally, IVF procedures take about three weeks from “ovulation induction” to “embryo transfer”. Common treatment plans nowadays have become very diverse. In addition to the traditional long protocol and short protocol, GnRH antagonist protocol is also available at present. Therefore, patients have more friendly approaches, more flexible treatment courses, and more accurate drug dose to reduce patient burden and achieve a steady successful rate.

For patients from abroad, GnRH antagonist protocol is preferred to meet the schedule of flight arrival in Taiwan. Please refer to the following procedures and figure for the treatment of GnRH antagonist protol：

1. It is suggested to arrive in Taiwan a few days earlier than the initiation of menstrual cycle, and then go to the reproductive center between the 1st and the 3rd day of menstrual cycle. Once the patient has decided to participate in IVF treatment, she can pick up prescriptions. There will be consulting nurses to instruct on the procedures of menotropins self-injection and related notes during the program.
2. The patient will start to self-inject menotropins from the 2nd or 3rd day of the menstrual cycle. The use of menotropins injections should be in accordance with the prescription dose for approximately 10-12 days. The patient should self-inject menotropins at a fixed schedule on daily basis during this period. Currently menotropins injections have been designed as pens, which are rather easy to use by the patient herself.
3. The patient is required to come back for ultrasound follow-ups, which is usually the 5th day after the initiation of menotropins. The objectives of follow-up visit are mainly for follicle monitoring using ultrasound and for deciding whether the dose of menotropins requires further modification. In addition to aforementioned procedures, the patient is like regular tourists and is allowed moving freely. Hence, a tour in Taiwan can also be considered during the stay.
4. Once the follicles are mature (usually on the 10th-12th day after ovulation induction, but it may vary depending on individual conditions), patient will receive HCG injection for oocyte final maturation, and ovum pick up operation will be arranged. The ovum pick up operation takes about 1 hour, and the patient will regain her activities after a few hours of rest after the procedure.
5. The time for ovum pick up is also the time for sperm collection. If the couple failed to return to the center at the same time, the husband is allowed to visit the center at any time prior to oocytes collection. The sperm can be frozen in advance and thawed for fertilization.
6. The embryologist will then perform in vitro fertilization and embryo culture after ovum pick up operation. After approximately 3-5 days, embryo transfer, which takes about 1 hour, will be arranged. After proper rest, the patient can regain her regular activities very soon instead of being bed-ridden for all day. Normally it is the time to schedule return flight.
7. A pregnancy test at local gynecology & obstetrics clinic 10-14 days after embryo implantation is recommended. The patient may need to give some blood samples for hCG measurement in order to obtain more accurate results. If the results came back positive, the gynecologist will confirm the location of implantation using transvaginal ultrasonography.

It takes total of 3 weeks to complete the above procedures. If the patient is able to stay in Taiwan for such a long time, she can pick up the menotropins injections after the 1st clinical visit, perform self-injections at her hotel and return to the center until the day of HCG administration, ovum pick up operation, as well as embryo transfer.

As to the husband, we suggest the couple to visit the center together at the 1st clinical visit. Not only can we evaluate both parties for infertility at the same time; the couple can jointly understand the entire course and care and be supportive for each other. In addition, due to the maturation of sperm cryopreservation technique, we can perform sperm collection and cryopreservation for the husband at the 1st clinical visit, and then thaw the sperm for fertilization after ovum pick up afterward.

2-1The patient is welcome to provide her medical records and related laboratory reports derived from her own country to the reproductive center in Taiwan. After discussion with physicians in Taiwan, the patient need to acquire a certification for diagnosis in advance and then start to apply for medical visa.

• Documents prepared by the patient：General information, patient application form, related medical records or laboratory reports for reference, and official marriage certificate.
• Documents prepared by the Reproductive Center：The application form provided by the hospital and the treatment plan provided by the physician. (The length of stay depends on the approved treatment plan, no longer than 3 months. Multiple entries are available)

2-2Procedures for visa application of patients from China: In addition to the “Exit & Entry Permit (Republic of China)”, the patient is also required to apply for “Taiwan Travel Permits for the Mainland Residents” in China.

• Documents prepared by the patient：General information, patient application form, related medical records or laboratory reports for reference, and official marriage certificate.
• Documents prepared by the Reproductive Center：The application form provided by the hospital and the treatment plan provided by the physician. After receiving the hard copy of “Exit & Entry Permit (Republic of China)”, the hospital will return the document to the patient.
• The procedures for applying for “Taiwan Travel Permits for the Mainland Residents”：After receiving the hard copy of “Exit & Entry Permit (Republic of China)”, the patient can bring the permit to “Taiwan Affairs Office” in individual province in China to apply for “Taiwan Travel Permits for the Mainland Residents”. The managing officer will specify the reasons for visiting Taiwan on the “Taiwan Travel Permits for the Mainland Residents”, and issue a medical visa (type: Q) for the patient. This is a visa for a direct flight to Taiwan, which can be granted in 2-3 weeks at regular “Taiwan Affairs Office” in China.
  If the patient selects a one-stop flight th-0rough the 3rd place instead of a direct flight, an “Exit-Entry Permit for Travelling to and from Hong Kong and Macau” is required rather than “Taiwan Travel Permits for the Mainland Residents”.