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pregnancy test comes at about one month."},"fly_home_after_days":{"min":1,"max":3,"unit":"days","qualifier":"Flying is usually fine 1-3 days after embryo transfer, once pain settles and no OHSS signs appear."},"follow_up_visits":[{"purpose":"assessment","requirement":"routine","after":{"min":2,"max":14,"unit":"days","qualifier":"Stimulation monitoring with ultrasound and blood tests, several visits, counted from start of stimulation"}},{"purpose":"result_review","requirement":"routine","after":{"min":24,"max":35,"unit":"days","qualifier":"Pregnancy blood test about 9-14 days after embryo transfer, counted from start of stimulation"}},{"purpose":"assessment","requirement":"conditional","after":{"min":35,"max":55,"unit":"days","qualifier":"Early pregnancy ultrasound if test is positive, counted from start of stimulation"}}],"indications":["Tubal factor infertility","Male factor infertility (often with ICSI)","Unexplained infertility after failed less invasive treatments","Endometriosis-related infertility","Diminished ovarian reserve or age-related infertility","Ovulatory disorders not responding to ovulation induction","Preimplantation genetic testing for inherited conditions","Fertility preservation (egg/embryo freezing)","Absent or unsuitable uterus requiring gestational carrier","Recurrent pregnancy loss with a suspected genetic cause"],"main_risks":["Ovarian hyperstimulation syndrome","Multiple pregnancy (higher with more than one embryo transferred)","Bleeding or infection after egg retrieval","Injury to adjacent pelvic organs (rare)","Anesthesia/sedation-related risks","Ectopic pregnancy","Miscarriage","Emotional and physical stress from hormonal medication","Cycle cancellation due to poor response or no fertilization/viable embryos","Congenital anomalies/preterm birth and low birth weight in IVF pregnancies"],"pain":"Injections cause mild discomfort and bloating during stimulation; egg retrieval is done under sedation, followed by mild to moderate cramping for a day or two; embryo transfer is usually nearly painless.","preparation":["Fertility assessment of both partners (ovarian reserve, semen, uterus)","Infectious disease screening and blood tests as required","Consultation on stimulation protocol and embryos to transfer","Training on self-injection of prescribed hormonal medication","Fasting before egg retrieval as instructed by the clinic","Lifestyle optimization (no smoking, limit alcohol, healthy weight)","Arrange transport home after sedation","Medication review by fertility team; changes only by prescriber","Starting folic acid or prenatal vitamins as advised","Counseling and consent, including embryo storage and genetic testing"],"recovery_timeline":[{"phase":"Ovarian stimulation (about 8-14 days)","description":"Daily hormone injections with periodic ultrasound and blood monitoring; bloating and mild discomfort possible.","restrictions":["Avoid strenuous exercise as ovaries enlarge"]},{"phase":"Egg retrieval day and next 1-2 days","description":"Transvaginal ultrasound-guided retrieval under sedation (about 15-30 minutes); rest, cramping and light spotting.","restrictions":["No driving on the day of sedation","Avoid heavy lifting and strenuous exercise"]},{"phase":"Embryo transfer (typically day 3-5 after retrieval for fresh transfer)","description":"Brief catheter transfer without anesthesia; normal daily activity can resume.","restrictions":["Avoid strenuous exercise per clinic advice"]},{"phase":"Luteal phase and pregnancy test (about 9-14 days after transfer)","description":"Progesterone support is usual; blood test confirms pregnancy.","restrictions":["Avoid intense exertion and intercourse if clinic advises"]}],"rehabilitation_days":{"min":1,"max":3,"unit":"days","qualifier":"Return to ordinary activity after egg retrieval; embryo transfer needs essentially none."},"result_longevity":"A live birth is permanent, but IVF does not restore natural fertility; another child usually needs a new cycle or frozen embryo transfer. Frozen embryos can be stored for years.","revision_rate_pct":null,"scars":"There are no visible scars, because egg retrieval is done by a transvaginal needle puncture under ultrasound guidance and no skin incision is made.","sessions_or_stages":{"sessions":{"min":2,"max":2,"unit":"visits","qualifier":"Procedural visits in one fresh cycle: retrieval and transfer; monitoring visits not counted. Frozen transfer or repeat cycles add more."},"stages":[{"code":"ovarian_stimulation","label":"Ovarian stimulation with hormone injections (at-home medication with monitoring)","after":{"min":0,"max":0,"unit":"days","qualifier":"Start of cycle"}},{"code":"egg_retrieval","label":"Transvaginal egg retrieval, fertilization and embryo culture","after":{"min":9,"max":16,"unit":"days","qualifier":"From start of stimulation"}},{"code":"embryo_transfer","label":"Fresh embryo transfer","after":{"min":12,"max":21,"unit":"days","qualifier":"From start of stimulation; typically 3-5 days after retrieval"}}],"qualifier":"One standard fresh IVF cycle (with or without ICSI); embryos may instead be frozen and transferred in a later cycle."},"success":null,"techniques":[{"name":"Conventional IVF insemination","suits_whom":"Couples with adequate sperm parameters, e.g., tubal factor infertility","recovery":"Same as standard cycle; brief recovery after retrieval."},{"name":"IVF with ICSI (intracytoplasmic sperm injection)","suits_whom":"Male factor infertility, previous fertilization failure, or frozen/surgically retrieved sperm","recovery":"Same as standard cycle."},{"name":"Freeze-all with frozen embryo transfer","suits_whom":"Patients at risk of OHSS, undergoing genetic testing, or needing endometrial optimization","recovery":"Transfer occurs in a later cycle; no additional sedation usually needed."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":0.25,"max":0.5,"unit":"hours","qualifier":"Egg retrieval procedure itself (about 15-30 minutes), excluding stimulation period, lab work, embryo transfer and recovery time in clinic."},"initial_assessment_documents":["Recent AMH and FSH blood results","Pelvic ultrasound with antral follicle count","Semen analysis report","Previous IVF or fertility treatment reports","Hysterosalpingography or hysteroscopy report (if available)","Infectious disease screening results (if available)"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Fresh cycle fits one 2-3 week stay with monitoring abroad; freeze-all or frozen transfer needs a second short trip."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how much experience the clinic has with these procedures","scope":"procedure","source":{"url":"https://cybercemetery.unt.edu/oilspill/20120926161258mp_/http://www.cdc.gov/art/SelectingARTProvider.htm","host":"cybercemetery.unt.edu","quote":"How much experience do you have with these procedures?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Check whether specialists in reproductive endocrinology are involved in the care","scope":"procedure","source":{"url":"https://cybercemetery.unt.edu/oilspill/20120926161258mp_/http://www.cdc.gov/art/SelectingARTProvider.htm","host":"cybercemetery.unt.edu","quote":"Are any specialists in reproductive endocrinology?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Check how the clinic's counselling service works","scope":"procedure","source":{"url":"https://hfea.gov.uk/choose-a-clinic/finding-the-best-fertility-clinic-for-you/","host":"hfea.gov.uk","quote":"Talk to your clinic to find out how their counselling service works.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Check that the doctor explains each IVF step before any treatment starts","scope":"procedure","source":{"url":"https://www.nhs.uk/conditions/ivf/risks/","host":"nhs.uk","quote":"Your doctor should discuss the options with you and explain each of these steps before any treatment starts.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask whether a national regulator oversees the clinic and what laws it must follow","scope":"treatment_abroad","source":{"url":"https://hfea.gov.uk/treatments/explore-all-treatments/fertility-treatment-abroad/","host":"hfea.gov.uk","quote":"Ask your clinic if there’s a national regulator or what laws they are required to follow.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C6","text":"Check that the facility is internationally accredited","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"ACS recommends that medical tourists use internationally accredited facilities","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":403}},{"id":"C7","text":"Check whether follow-up care is at the same facility as the procedure","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":403}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Difficulty breathing","urgency":"emergency","general":false,"source":{"url":"https://www.nhs.uk/conditions/ivf/risks/","host":"nhs.uk","quote":"you have difficulty breathing","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"W2","text":"Tummy pain low down on one side","urgency":"emergency","general":false,"source":{"url":"https://www.nhs.uk/conditions/ivf/risks/","host":"nhs.uk","quote":"you have tummy pain, low down on one side","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"W3","text":"Vaginal bleeding or brown watery discharge","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/conditions/ivf/risks/","host":"nhs.uk","quote":"you have vaginal bleeding or a brown watery discharge","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You want a less invasive and less expensive option first","name":"Intrauterine insemination (IUI)","source":{"url":"https://my.clevelandclinic.org/health/treatments/22457-ivf","host":"my.clevelandclinic.org","quote":"IUI is less expensive and less invasive than IVF.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"technique_details":{"status":"ok","items":[{"id":"conventional-ivf","name":"Conventional IVF insemination","how_it_works":{"text":"Eggs are fertilized with sperm in a laboratory","source":{"url":"https://www.nhs.uk/conditions/ivf/","host":"nhs.uk","quote":"The eggs are fertilised with the sperm in a laboratory.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":0,"max":0,"unit":"days","label":"Same day","source":{"url":"https://my.clevelandclinic.org/health/treatments/22457-ivf","host":"my.clevelandclinic.org","quote":"Many people will return to normal activities right after their egg retrieval procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"ivf","name":"IVF with ICSI (intracytoplasmic sperm injection)","how_it_works":{"text":"Sperm is injected directly into the egg","source":{"url":"https://www.hfea.gov.uk/treatments/explore-all-treatments/intracytoplasmic-sperm-injection-icsi/","host":"hfea.gov.uk","quote":"It involves the sperm being injected directly into the egg.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":0,"max":0,"unit":"days","label":"Same day","source":{"url":"https://www.uhcw.nhs.uk/ivf/treatments/ivf/","host":"uhcw.nhs.uk","quote":"After the procedure, women are encouraged to carry on with their normal routine ( with some exceptions) as there is no evidence to suggest that bed rest has a positive effect.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}},{"id":"freeze-all","name":"Freeze-all with frozen embryo transfer","how_it_works":{"text":"All embryos are frozen, with none transferred in the fresh cycle","source":{"url":"https://www.hfea.gov.uk/treatments/treatment-add-ons/elective-freeze-all-cycles/","host":"hfea.gov.uk","quote":"creating embryos using IVF or ICSI and then choosing to freeze them all so no embryos are transferred in the 'fresh' cycle","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":0,"max":0,"unit":"days","label":"Same day","source":{"url":"https://www.uhcw.nhs.uk/ivf/treatments/ivf/","host":"uhcw.nhs.uk","quote":"After the procedure, women are encouraged to carry on with their normal routine ( with some exceptions) as there is no evidence to suggest that bed rest has a positive 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