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Clinical master

Treatment Plan
TREATMENT PLAN
TREATMENT PLAN TYPE
Management Review Committee
TREATMENT PLANNED
Diagnostic Cycle
Natural Cycle
Ovulation Induction
Gonadotropins
Letrozole
Metformin
Metformin plus
Natural Cycles
Gonadotropins COH
Letrozole
Metformin
Metformin plus
Donor Insemination
Natural Cycles
Gonadotropin COH
Letrozole
Metformin
Metformin plus
Conventional insemination
Testicular biopsy
Split ICSI/Conventional Insemination
Aneuploidy
Single Gene Defect
Translocation
Family Balancing
with PGD & MicroSort X for female
with PGD & MicroSort Y for male
with PGD only for female
with PGD only for male
Donor Egg
Family Balancing
MicroSort
X (desires female)
Clinical Master®
Treatment Plan
Y (desires male)
PGD and MicroSort
X (desires female)
Y (desires male)
X (desires female)
Y (desires male)
Testicular biopsy
Split ICSI/Conventional Insemination
Donor Sperm
Gestational Surrogacy
Egg donor
anonymous
designated (known)
Gestational surrogacy
Conventional insemination
Testicular biopsy
Split ICSI/Conventional Insemination
with Donor Egg
Conventional insemination
Testicular biopsy
Split ICSI/Conventional Insemination
True Surrogacy
Conventional insemination
Testicular biopsy
Split ICSI/Conventional Insemination
Expectant Management
CYCLE DAY 2-5 LABS
CCT (FSH, LH, E2, Baseline US)
Baseline Ultrasound (AFC & Ovarian Volume)
CYCLE DAY 7-12 LABS
CCT (d10 FSH)
Hx of PID or Hydrosalpinx
Recommend Doxycycline prophylaxis
Clinical Master®
Treatment Plan
beginning the day before HSG and for 5 days
day of procedure
Hx of PID or Hydrosalpinx
Recommend Doxycycline prophylaxis
beginning the day before SHG and for 5 days
day of procedure
CYCLE DAY 14-28
Trial Transfer
Cervical Cultures
Gonorrhea/Chlamydia
General Genital
LABS ANY DAY
HIV 1&2
for female
for both partners
for female
for both partners
for female
for both partners
for female
for both partners
Prolactin
BASELINE LABS ONLY ONCE
Rubella titer
Varicella titer
Blood type and Rh
MOCK CYCLE
for donor egg recipient
for gestational surrogate
LABS (MALE)
SA with strict morphology
24 hour motility test
Semen Cultures
Neisseria gonorrhea
Chlamydia
Aerobic bacteria
Hormone Profile
Testosterone
Clinical Master®
Treatment Plan
Prolactin
Karyotype
Y-micro deletion assay
LABS (REPRO ENDO)
Prolactin
TFT panel
Testosterone
ACTH Stim test
CAH Stim Test
LABS (AUTOIMMUNE)
Thyroid Antibodies
LABS (ID)
HIV 1&2
Both partners
Female partner
Male partner
Both partners
Female partner
Male partner
Hep C Antibody
Both partners
Female partner
Male partner
Both partners
Female partner
Male partner
Chlamydia IgG
Chlamydia IgM
Syphyllis (RPR)
Female partner
Male partner
Clinical Master®
Treatment Plan
LABS (METABOLIC)
Fasting Glucose and Insulin
AM Cortisol
Lipid Profile
ACTH Stim Test
CAH Stim Test
LABS (RPL)
MTHFR mutation
Protein S
Protein C
Factor V Leiden
Karotype Female
Karyotype Male
LABS (PG & PRENATAL)
Serial HCG levels (every 3 days)
Ectopic screen (serum HCG & pelvic US)
Type and Screen
Varicella
LABS (GENETIC)
Karyotype Female
Karyotype Male
Y-del Assay
Tay Sachs
Gauchers
Canavans
Hgb Electrophoresis
LABS (PRE-OP)
Blood Type & Screen
Clinical Master®
Treatment Plan
DIAGNOSTIC PROCEDURES (FEMALE)
Basic Ultrasound
Baseline (CD 2-4)
Antral Follicle Count
Diagnostic pelvic scan
Hx of PID or Hydrosalpinx
Recommend Doxycycline prophylaxis
beginning the day before SHG and for 5 days
day of procedure
Hx of PID or Hydrosalpinx
Recommend Doxycycline prophylaxis
beginning the day before SHG and for 5 days
day of procedure
Endometrial Biopsy
call and schedule 7-8 days after LH surge (OPK)
call and schedule on CD 21
with Integrin assay
DEXA scan
Mammogram
SEMEN CRYOPRESERVATION LABS
HIV 1&2
Semen Culture for GC & Chlamydia
EXPECTANT MANAGEMENT
Recommend expectant management for:
Patient requests expectant managment for:
PSYCHOLOGICAL EVAL & SERVICES
Schedule psychological evaluation
Obtain psych medical records
SUPPORT SERVICES
Refer for the Mind-Body Relaxation class
Informed of 10 week class
Separate fee charged by class instructor
Refer for Acupuncture services
ART CLASS & TRAINING
Schedule orientation class with nursing staff
Schedule injection training class with nursing staff
SMOKING CESSATION RECOMMENDED
Both partners
CONSULTS
Clinical Master®
Treatment Plan
Primary care
Routine gynecology for annual exam and/or pap smear
Andrology - Dr Opsahl
Andrology - Urologist
Andrology - Endocrinologist
Maternal Fetal Medicine consult for High-Risk pregnancy
Maternal Fetal Medicine consult for preconception counseling
Genetics counseling before PGD for genetic diseases
Gynecologic Oncology consult
indication:
Pelvic surgery consult
indication:
Other consult:
indication:
FOLLOW-UP APPOINTMENTS
Complete recommended tests then return to discuss
Fillin specific recommendations:
Next cycle
after andrology consultation
after surgery
to complete conversation (inadequate time to answer all questions)
after psychological counseling
Patient will return as needed
Financial Counseling
Medical Assistant/Nursing Consult
Clinical Master®
Treatment Plan
Clinical Master®
Treatment Plan
Clinical Master®
Treatment Plan
Clinical Master®
Treatment Plan
Clinical Master®
Treatment Plan
Clinical Master®
Treatment Plan
Clinical Master®
Treatment Plan
Clinical Master®

Source: http://www.eivf.net/Documents/New%20Documents/Web/ClickNBuilds/Treatment%20Plan.pdf

Microsoft word - 08dsp1738_information zum opferhilfegesetz_spanisch_korrigi.doc

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