When you are trying to conceive with the help of a fertility specialist, your doctor needs to closely track your body's response to any medications. Regular check-ins, often referred to as "morning monitoring" appointments, help track your progress.
In this article:
Morning monitoring refers to appointments performed at a fertility clinic (usually in the early morning) around every other day during a fertility treatment cycle. The term may also be used to refer to monitoring a fertility patient undergoes during the diagnostic process to help your doctor assess your "baseline" fertility prior to developing a treatment plan.
During a fertility treatment cycle, keeping a close watch on your hormone levels, follicle count, uterine lining, and other factors greatly increases your chances of success.
Test results from these regular appointments provide your doctor and Care Team with critical information they use to help fine-tune your medication protocol. Without such frequent monitoring, there is a greater chance that you could have an adverse reaction to the medications or have a poor response, leading to the cancellation of a treatment cycle.
Whether you are trying to conceive with the help of timed intercourse, ovulation induction, intrauterine insemination (IUI), or in vitro fertilization (IVF) treatment, morning monitoring is an essential part of the process.
Here's a deeper dive on what we're monitoring and why:
For those undergoing IUI treatment, it's important to achieve a low number of follicles, as a higher number of follicles greatly increases your chances of multiple pregnancy (i.e. twins, triplets, or higher order multiples).
Every body responds to medications in different ways, which is why regular appointments are so critical during fertility treatment.
For example, monitoring might reveal that your uterine lining is too thin - this is sometimes related to medication. Clomid may be helping you ovulate, but also thinning out your uterine lining too much, necessitating a medication adjustment by your doctor.
Here's everything you need to know before your first morning monitoring appointment at Illume Fertility (if you are a patient at another fertility clinic, please refer to their policies).
Note: If there has been a change to your insurance plan or current address, please inform a Front Desk Ambassador and they will be happy to update your file with the new information.
No special clothing is required, however, we do suggest wearing a loose-fitting top with sleeves you can easily roll up (if long-sleeved) as you will be getting your blood drawn.
Morning monitoring is by appointment only, no walk-ins will be accepted. You may select the location closest to you for convenience, simply let your Patient Navigator know which office you prefer so the team knows to expect you.
Appointments are scheduled Monday through Friday each week:
Note: If you require weekend monitoring, this appointment will be scheduled at our Norwalk, CT office.
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Morning monitoring typically includes a blood draw and a transvaginal ultrasound (to visualize your ovaries and perform a follicle count).
Before performing any blood work, we will ask questions such as, "How do you do with blood work?" "Do you get nauseous or faint?" If the answer is yes, don't worry! We are always happy to lay you down in an exam room for your blood work to help you be more comfortable.
Let's walk through a full morning monitoring appointment together so you feel confident and prepared before your first visit. Here's what will happen when you arrive at our office:
Note: Vaginal ultrasounds are completely painless for most patients, with few patients experiencing only a slight sensation of pressure or very mild discomfort.
After your ultrasound is complete, the provider will advise on specific next steps, for example, "You will remain on the same dose of medication and return to the office in two days!"
If there are any changes to your medication protocol or treatment plan, a nurse will always call later in the afternoon to explain further once blood work results are reviewed.
You are welcome to ask any questions you may have regarding today's monitoring appointment. If you have additional questions, or want to speak with your primary doctor to discuss anything else, please reach out to your nurse or patient navigator!
Since you may not always be seeing your primary doctor (who knows you best), morning monitoring is not the time to have a longer consult. However, if you have questions or concerns after your morning monitoring appointment, please reach out to your Care Team so they can ensure you receive adequate time with your primary doctor to talk through them.
We know it can be frustrating to not have more time with a provider when your head is swirling with questions. Please keep in mind that our goal is always to be able to see each patient on time and give them our full attention.
At the end of your morning monitoring appointment, the team will always advise you on whether or not to expect a follow-up call. Know that you will always receive a call if there is any change to your treatment plan.
At Illume Fertility, you can expect to receive a phone call about any blood work results from your nurse before the end of the day (typically, prior to 4PM). We know it can be nerve-wracking waiting to hear this news, especially when you are anxious about pregnancy test results or hormone levels.
Rest assured: Your Care Team is working diligently to communicate the day's results to each patient as efficiently as possible, and you have not been forgotten.
If your provider reviews your results and sees that you’re not responding well to a medication, they will call you as soon as possible to let you know and discuss next steps.
If you do not receive a call, don't panic! Here's what it means:
Here are some other frequent questions and concerns we receive about morning monitoring:
If you live far away from your fertility clinic or have other extenuating circumstances, you may request to have outside monitoring appointments performed at a different lab. Please inform your Care Team (nurse, patient navigator, and doctor) so that they may email you a requisition form to give to the outside lab.
Keep in mind, outside monitoring may delay test results in some cases, and special coordination between your fertility clinic's team and the external lab is critical to maintain continuity of care.
It is normal for follicle counts to vary a little bit from scan to scan. However, even if the follicle count you receive from one provider differs slightly from another, these numbers should still be close to each other.
Rest assured that each provider, whether they are a physician assistant, reproductive endocrinologist, or nurse practitioner, have been extensively trained in ultrasound monitoring and will provide the most accurate assessment possible.
At Illume Fertility, our physician team rotates through all five locations, so it is unlikely that you will see your primary doctor at each morning monitoring appointment.
However, all nine doctors (as well as our advanced practice providers) work collaboratively as partners, and always keep each other informed with regular discussions of patient protocols.
One of the benefits of having multiple providers involved in each patient's care? More expert eyes on your case! Whether you see your primary doctor or another Illume provider during morning monitoring, you can be confident that they all work as a team.
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Yes! Monitoring appointments may fall during your menses - particularly during the diagnostic stage. If you arrive wearing a tampon or menstrual cup, you can simply remove it prior to your vaginal ultrasound and replace it as soon as you're done (usually less than 5 minutes).
Note: Each exam room and bathroom will always be stocked with pads and tampons.
Whether you only require minimal morning monitoring, or end up becoming best friends with the team at your office after countless visits, know that every person you encounter is cheering you on and wants to see you succeed.
No matter what it takes, we will be by your side until you achieve your goals!