IVF Module

To access the IVF module select the IVF tab in a patient's Clinical window.

The IVF tab displays the IVF treatment cycles, embryo thawing, semen analysis, semen prep and semen freeze information.

The Open Partner button allows you to open the clinical record of the partner that has been linked to this patient. If a name appears next to this button but you are unable to select this button, it means that a partner has been entered in the Partner's Name field of the patient's Demographic window. Once you link a partner using the Select Partner button you will be able to use the Open Partner button.

The Select Partner button allows you to search your data base and select this patient's partner so that they can be linked. The partner must be a patient in your data base in order to use this function.

The Deselect Partner button allows you to unlink the currently linked partner.

The IVF treatment cycle section will display a summary of the information contained in the records. 

Below is a summary of the information displayed in the table:

No: The treatment cycle number.

Date: The date of the last menstrual period (LMP).

Type: The type of IVF treatment cycle (i.e. embryo transfer, freeze, thaw).

Foll: The number of follicles that were produced.

Eggs: The number of oocytes collected.

Fert: The number of eggs that were fertilised.

Trans: The number of transferred fertilized embryos.

Frozen: The number of fertilized embryos that were frozen.

BHCG: The date when a test was done to see if the treatment resulted in a pregnancy.

Result: Indicates if the BHCG result showed a positive or negative pregnancy result.

FH: Is the number of foetal heartbeats identified in an ultrasound.

Result: Indicates if a pregnancy is viable or not viable.

Comp: Indicates that the treatment cycle is complete.

NPSU: Indicates whether the cycle has been marked as reportable or not reportable to the National Perinatal Statistics Unit (NPSU).

A treatment cycle can be added to the clinical record by clicking on the Add Record  icon to the right of IVF Treatment Cycles.

At the top of the Modify Treatment Cycles window it will display the name and DOB of the Patient and their Partner. The patient details are populated from their demographic field. If the partner's details are entered in the Secondary tab of the patient's demographic record or by using the Select Partner button in the IVF tab, then this information will be populated automatically. Alternatively it can be entered manually into these fields.

The Cycle No field represents the cycle number that the patient is undertaking in this treatment cycle. For example, if this is their first cycle, you would type '1'.

The Site field is where you would enter the number given to your practice by the National Perinatal Statistics Unit (NPSU) to identify your practice.

The LMP field contains the patient's last menstrual cycle. This can be added by clicking on the Calendar  icon and selecting a date.

The Cycle Type field indicates the type of cycle for this record. By default the list contains: AI (Artificial Insemination), DI (Donor Insemination), ICSI (Intracytoplasmic Sperm Injection), IVF (In-vitro Fertilization) and THAW (a cycle which thaws previously frozen embryos). You can add additional types by selecting Add Item in the Cycle Type drop-down menu, typing the name of the cycle and clicking OK.

The ET x field is the number of embryo's transferred. This can be selected from the drop-down list which contains ET x1, ET x 2 and ET x 3.

The Cycle ID is the unique ID number for this treatment cycle.

At the bottom of the Modify Treatment Cycles window are navigation buttons that allow you to move between different cycle records for this patient. 

Go to First Record button

Go to Next Record button

Go to Previous Record button

Go to Last Record button

The Delete button will delete the entire cycle treatment record.

The Print button will print the information displayed in the Cycle Details, OPU Details, Laboratory, Embryo Tracking and Pregnancy tabs.

The Admin tab is used to record administrative information regarding the cycle.

The Counselling checkbox is a way to indicate if the patient has undergone counselling, which may be mandatory for some treatments. Ticking the checkbox will automatically enter today's date in the date field. This can be manually changed by typing into the field.

The Consent checkbox is a way to indicate that the patient has signed their consent form. As with the Counselling checkbox, ticking the checkbox will automatically enter today's date in the Date field, but can be manually if required.

Blood test information can be entered and displayed in the Blood Tests section.

Note: This area is not used to order results but only to display a summary of the pathology results which are relevant to the treatment cycle.

Individual blood tests can be added by clicking the Add Record  icon. This will bring up the Add Blood Test window:

Click on the Test drop-down menu and select the test to add from the list. You can add tests to this list by selecting Add Item..., typing the name of the test and clicking OK. You can indicate if this test was for the Patient, Partner or if it returned an Abnormal result. Click OK to save to the patient record.

To add a set of blood tests, click the Select a set drop-down menu and select the desired test. These sets are populated from that sets that are created in the Pathology Request window.

You can also select if the test was for the Patient, Partner, or if the result was Abnormal from the Blood Test section. Any results that are abnormal will appear in red text.

To delete a blood test result, click in the Date column of the result you want to delete and click the Delete icon. 

You can also record the cause of infertility (i.e. Tubal, Endometriosis, Male Factor, Other, Idopathic) and other information such as height, weight, number of live births, pregnancies over 20 weeks, pregnancies under 20 weeks, and how many Medicare 13200 items have been charged.

The Cycle Details tab is used to record the medication used to stimulate and control the patient's menstrual cycle.

The Downregulation and Timing drop-down boxes allow you to select which drugs will be used for these cycles. New drugs can be added to this list by selecting Add Item from the drop-down menu, typing the name of the drug and clicking OK. The From and To dates to the right of these drop-down menus allow you to record the date range which these drugs are to be given.

The Follicles field shows how many follicles have been observed during the cycle. This number can be typed or it will be automatically updated with the numbers from the Follicles field of the latest ultrasound result.

The Batch No. field is the batch of the drug used for the cycle.

The Normal Cycle Length field allows you to enter the normal menstrual cycle length of the patient.

The Was injectable FSH stimulation given? checkbox allows you to record if FSH was given to the patient in this cycle.

The Start Date field allows you to enter the date that the cycle was started on by typing or selecting the Calendar  icon. On selecting a date a request window will appear for you to enter the number to days of this treatment cycle. Once you click OK, the number of days that you selected will now appear in the table. You can add or remove days from this cycle by clicking the Add Day or Delete Day buttons respectively.

The table has space for your to specify up to eight drugs that the patient may take over the course of their cycle. To assign a drug in one of these columns, click the drop-down  icon above the drug you wish to specify and select the required drug and subsequent dose.

To add a drug to this list, click the drop-down arrow icon and select New. In the window that appears, type the name of the drug in the Drug field. To add different doses for this one drug, click the Add Dose button and type the dosage you require. To remove a dosage, select it from the Dose list and click Delete Dose. Once you are happy with the information entered, click Save. Repeat this process until you have all the relevant drugs that you require.

If you would like to edit one of the drugs in your list or their dosages, click the drop-down menu icon and select Edit. 

Once you have selected the relevant drugs for this cycle you can assign them to a particular day by clicking in the field to the right of the date in the table. When you do this a window will appear asking you to enter the batch number for this drug. Enter the batch number and then click OK.

The dosage for this drug will now appear in the table. If you want to remove this dosage from the table, double-click on the dose, click the Clear button and then click OK. Repeat this process with any other drugs that you require. Below is an example of what your table may look like:

The P4 column allows you to enter the progesterone results for the patient by clicking in the field for the relevant day, typing the result in the window that appears and clicking OK.

The LH columns allows you to enter the lutenising hormone results for the patient in the same way as the progesterone results.

The USS column allows you to enter information from ultrasounds that are performed during the cycle. The first time that you click in this field, today's date will appear in orange text. If you click the same field again you will be presented with the Ultrasound Record window.

The numbers that you enter into the Right Ovary Follicles and Left Ovary Follicles field will be automatically calculated and entered into the Total Number of Follicles field. Enter the relevant information and click Save.

If you want to print or remove this record from the cycle, double click on the relevant USS record and click either Print or Delete.

If the treatment was cancelled at anytime during this process, you can enter the date into the Cancelled Date field.

The OPU (Ovum pick up) tab is used to record details of the eggs to be used for the treatment cycle.

If the eggs are to be collected from the patient, these details can be entered on the left-hand side of the window.

The OPU Number field is the number of eggs that was retrieved from the procedure.

The OPU Date/Time field is the date and time that the eggs were collected. You can click on the Calendar  icon to select the date, or manually type this information into the fields.

The Clinician field is the name of the person who performed the OPU. If it was a Genie user, their name can be select by clicking the drop-down arrow  next to the Clinician field. Otherwise the name can be manually typed into this field.

The Endom Cavity field allows you to record the measurement of the endometrial cavity in centimeters.

The Cx Length field allows you to record length of the cervix in centimeters.

The Catheter Setting field allows you to enter the relevant setting use in the procedure in centimeters.

Any notes about the procedure or plans can be entered in the Comments and Future Plans fields respectively.

If the patient is to receive eggs from a donor, this can be specified on the right-hand side of the window. If you store donor information in your Genie database, click the Oocyte Donor button, search for the donor in your database, select them and click Select. Their name will not appear in this window, only their Patient ID number. If the donor egg is sourced privately, you can record the specific code for this donor in the Private Donor Code field.

The Laboratory Tab is used to record details of procedures performed in the laboratory involving the preparation of the samples from the female and male, and the insemination of the egg.

This window is divided into four sections: OPU, Insemination, Andrology and Hyaluronidase.

The OPU section is used to record information about the oocytes that were obtained from the OPU procedure (see OPU Details). 

The Insemination section is used to record information about the number of oocytes collected at different maturity and the number used in the insemination process.

The Andrology section is used to create and link records relating to the semen used for this treatment. You can add a new record by clicking the Add Semen Prep button. If you have previously added a semen prep record, you can link it to this treatment cycle by clicking the Link Semen Prep button, highlighting the correct record and clicking Select.

Once a semen prep record has been added and linked to this treatment cycle, you can review the record by clicking the Open Semen Prep button. 

The Hyaluronidase section is used to record if the enzyme hyalyronidase was used to prepare the gametes.

The drop-down menu arrow  icons to the right of some fields allows you to select an option to populate the field rather than type it. If the drop-down menus have the option to Add to Menu, you can customise what appears in this menu by selecting Add to Menu, typing what you would like to appear in this list and clicking OK.

The Scientist field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences. Once selected you will be required to enter the password of the user you are choosing in order to link them to this record.

The Embryo Tracking tab is used to record the condition and fate of the oocytes for this treatment cycle.

The No. of Oocytes field indicates how many eggs will be used for this treatment. When you enter a number into this field and press the Tab key on your keyboard, the table will be populated with the number of rows relevant to the number that was entered.

The No. Fertilised field allows you to record how many of the oocytes were fertilised. 

To add information about one of the oocytes, double-click on one of the red numbers and the following window will appear:

In this window you can select which Treatment this oocyte will be used for (IVF, ICSI, GIFT, DSP), if patients under went Preimplantation Genetic Diagnosis (PGD) or Assisted Hatching and the grading scores of the oocyte over a six day period. The Fate drop-down menu allows you to specify if the oocyte is to be transferred (ET), frozen (FRZ) or discarded (OUT). If you select FRZ you will be able to enter information into the Straw No and Pre-Freeze Score fields. 

You can use the navigation buttons at the bottom of the windows to move to the next oocyte record and add the relevant information.

 Go to First Record button.

 Go to Next Record button.

 Go to Previous Record button.

 Go to Last Record button.

Once you have entered the information as required, click OK and the information you have entered will be populated into the table in the Embryo Tracking tab.

Based on what is entered into this table the Transferred, Frozen and Discarded fields at the bottom of the window will automatically display how many oocytes relate to each section.

Transferred

 Next to the Transferred field you have fields to enter the Date and Time that the transfer took place, the Type of transfer and whether the oocyte was at Cleaved or Blastocyst stage of development. You can added items relevant to you into the Type, Catheter and Syringe drop-down menus by selecting the Add Item option, typing the new item and clicking OK. There are also fields that allow you to record how many attempts were made to transfer the embryo, the volume that was injected, if there were any difficulties and who was the Clinician and Scientist that performed the transfer.

When selecting a user from the Scientist field, you will be required to enter the password of the user you are choosing in order to link them to this record. The Scientist field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences.

Frozen

If the fate of the oocytes is to be frozen (FRZ), you can add freeze details by clicking the Add Freeze button. Frozen embryos can only be added if the Cycle Type at the top of the Modify Treatment Cycle window is set to AI, DI, ICSI or IVF.

The Name, Aetiology, Male DOB, Cycle Stim, OPU Date and Insem. Date fields are automatically generated from previously populated fields within the Admin, Cycle Details, OPU Details and Laboratory tabs.

The Print button will allow you to print the details entered into this record, the Delete button will delete this freeze record from the patient's clinical record and clicking OK will save this record.

To view previously saved freeze information, select the relevant record from the Embryo Tracking table and click the Freeze Details Button.

Thaw

 If Thaw is selected from the Cycle Type drop-down menu, the Select Embryos to Thaw and Thaw Details button will become available.

If the patient has frozen embryos which were previously added through a different cycle, click the Select Embryos to Thaw button and a list of previously frozen embryos will appear.

Tick the checkbox to the left of the embryo that you have thawed and click OK. The Embryo Thawing Form window will now appear.

Again, the Name, Aetiology, Male DOB, Stim this Cycle, Freeze Date, Freeze No, Freeze Scientist, Taken From Cycle, Freeze Machine and Stim when Frozen fields will automatically populate with data if it was entered into the relevant fields. When selecting a user from the Thaw Scientist field, you will be required to enter the password of the user you are choosing in order to link them to this record. The Thaw Scientist field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences.

The Print button will allow you to print the details entered into this record, the Delete button will delete this thaw record from the patient's clinical record and clicking Save will save this record.

To view previously saved thaw information, select the relevant record from the Embryo Tracking table and click the Thaw Details Button.

The National Perinatal Epidemiology Statistics Unit (formerly the National Perinatal Statistics Unit), conducts national reporting of reproductive and perinatal health information and statistics in Australia. The NSPU tab allows you to mark if information from this patient's record will be included in the data to be exported and sent to the NPESU.

For this cycle to be included in the report, the NPSU Reportable check box must be ticked. When you tick this option, you will be asked to enter the Reportable Cycle Date. You can either manually type the date or use the Calendar  icon to select the relevant date. All other fields can be filled in as relevant.

Treatment cycle records for all patients can be view by going to Open > IVF Treatment Cycles.

You can refine what treatment cycles are displayed by using the Cycle Completed, NPSU Reportable and Pregnant drop-down menus. 

To export treatment cycles into a Excel spreadsheet, click the Excel  icon.

A window will appear allowing you to select the date range of the report you wish to generate. In the Period drop-down menu, select the Custom option to then type in the From and To fields.

When you click OK a browser window will appear. Type a name for the document in the File Name field, navigate to the location where you want to save your document and click Save.

The Pregnancy tab is used to record the outcome of the treatment cycle and any resulting pregnancies.

You can mark the cycle as either Cycle Complete or No Embryo Transfer Made by selecting the relevant checkbox.

The Embryo Thawing Form allows you to access the embryo thawing details that were recorded in a treatment cycle. The Embryo Thawing forms cannot be added directly from this section as they can only be added in a Thaw treatment cycle.

The Embryo Thawing table will display the Cycle, Frz Date, No. Frozen, Thaw Date, Thaw Type, Thawed, Survived and Discarded information from the records.

To view a record, double-click on the relevant record.

The Semen Analysis window allows you to record the results of a semen analysis. To add a Semen Analysis record, click the Add Record  button.

 

The Production Date and Analysis Date fields will automatically populate with the date and time that the record was created. However, you can override the information by typing in the field. Also, the Referring Dr field will automatically populate if a referring doctor has been entered into the patient's Demographic window.

When selecting a user from the Performed By or Approved By fields, you will be required to enter the password of the user you are choosing in order to link them to this record. The Performed By field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences.

When you have entered the relevant data into the available fields, click OK to save the record. A record will now appear in the Semen Analysis table displaying the Date and Scientist who performed the analysis.

The Semen Prep form allows you to record how the semen was prepared for the relevant treatment. To add a Semen Prep record, click on the Add Record  button to the right of 'Semen Prep'.

 

The Select... drop-down menu allows you to specify how the semen will be used. Either for artificial insemination (AI), donor insemination (DI), or in-vitro fertilisation (IVF). The appearance and fields available in the Semen Prep form will differ slightly depending on which option is selected.

The Female Name, Male Name and DOB fields will be automatically be populated with patient's name, DOB and partner details from the Demographics window. If the patient does not have a partner, or they will be using donor sperm or eggs, you can click the Select Donor button and search for the relevant person in your database.

The drop-down menu arrow  icons to the right of some fields allow you to select an option to populate the field rather than type it. If the drop-down menus have the option to Add to Menu, you can customise what appears in this menu by selecting Add to Menu, typing what you would like to appear in this list and clicking OK.

The Scientist field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences. Once selected you will be required to enter the password of the user you are choosing in order to link them to this record.

When selecting a user from the Scientist or Approved fields, you will be required to enter the password of the user you are choosing in order to link them to this record. The Performed By field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences (see The Details Tab).

The Print button will allow you to print the details entered into this record, the Delete button will delete this Semen Freeze record from the patient's clinical record and clicking OK will save this record.

Once it has been saved, a record will now appear in the Semen Prep table displaying the Collected Date and Partner/Donor for this record.

The Semen Freeze form allows you to record details of a semen specimen that has been selected to be frozen. To add a Semen Freeze record, click on the Add Record  icon to the right of 'Semen Freeze'. This will open the Semen Freeze form:

Clicking the Load Data from Semen Analysis button will allow you to select a record that has been previously added into the Semen Analysis table. If there is more than one entry in this table, a prompt will appear allowing you to select the relevant record.

Highlight the relevant record and then click the Select button.

If you do not wish to populate this information from an existing record, or you have not yet added a record in the Semen Analysis section, you can add information manually by typing in the relevant fields.

The Scientist field will only populate users who are marked as a 'Medical Lab Technician' in their User Preferences. Once selected you will be required to enter the password of the user you are choosing in order to link them to this record.

The Print button will allow you to print the details entered into this record, the Delete button will delete this Semen Freeze record from the patient's clinical record and clicking OK will save this record.

Once it has been saved, a record will now appear in the Semen Freeze table displaying the Freeze Date and Reason for this specimen.