Treatment Workflow for Patients at Royan Advanced infertility Center
Starting Treatment at Royan


Appointments can be scheduled via phone, online, or in person On the scheduled date, the couple should visit the clinic for consultation and medical file registration ⇒ 


Male Partner: On the scheduled day, the semen analysis will be performed in the morning, and the consultation with the male partner will take place in the afternoon Additional procedures may be required before starting infertility treatment. These may include repeat semen analysis, testicular biopsy, chromosomal analysis, or specialized treatments such as varicocele surgery.  ⇒ If no further procedures are needed, the appropriate treatment method –such as IUI, IVF, ICSI, or Ind – will be determined after the female partner’s consultation results are reviewed.   The male partner’s next visit will be on the day of the egg retrieval procedure, to provide a sperm sample after the female partner has received her prescribed medications. 


Female Partner: On the scheduled day, the medical examination and requested tests for the female partner will be conducted during the morning and afternoon shift, based on the pre-arranged appointment .   Depending on the patient’s medical history, further diagnostic evaluations such as hysteronsalpingography (HSG), Laparoscopy, Doppler ultrasound, or other specialized assessments may be necessary. / If no specialized diagnostic tests are required, the patient  will return once all test results are ready to determine the best treatment plan.  Once diagnostic procedures are complete and treatment method is determined, the next steps will be planned accordingly.    
The female partner will return on the second or third day of her menstrual cycle to begin treatment. 
Based on the woman's age and hormonal test results — which reflect ovarian function — the type and dosage of ovarian stimulation medications will be prescribed accordingly.    If the selected treatment is IVF (In Vitro Fertilization) or  ICSI (Intracytoplasmic Sperm Injection)   ⇒   The physician will recommend one of the following two stimulation protocols based on the patient’s condition: 1. Short Protocol: Duration of injectable medications is less than one month. 
2. Long Protocol:  Duration of injectable medications is approximately one and a half months.
           ⇒   During the treatment cycle, the patient must visit the center several times for ultrasound monitoring and adjustment of medication dosage based on ovarian response.
           When the ovarian follicles reach a size of 18–20 mm, the patient will be instructed to receive an HCG injection to trigger ovulation.
                Approximately 34–36 hours after HCG injection, egg retrieval is performed under anesthesia in the operating room.         
                 ⇒  On the day of egg retrieval, the husband provides a semen sample. The sperm sample is then washed, cultured, and prepared for fertilization.
                   IVF/ICSI Procedure:

IVF: The prepared sperm and mature eggs are placed together in a culture dish for natural fertilization.     
ICSI: A single prepared sperm is directly injected into the cytoplasm of each mature egg.
       ⇒  Fertilization occurs, leading to the formation of embryos.
       ⇒ The embryos are either transferred to the uterus 38–72 hours after egg retrieval, or frozen for future use.
If IUI is the chosen treatment method Once medication begins, the patient will need to visit the center several times during the menstrual cycle for ultrasound monitoring to evaluate the ovaries' response to the prescribed drugs. When the ovarian follicles reach a size of 18–20 mm, the patient will be instructed to receive an HCG injection to trigger ovulation. ⇒ In certain cases, depending on the patient's medical condition, an alternative medication may be used instead of HCG.  The patient will return to the center for the IUI procedure approximately 36 hours after the HCG injection.                       On the day of the procedure:  
•    A semen sample is collected from the husband
•    The sperm is washed and prepared in a nutrient-rich medium  
•    The processed sample is then injected into the uterus of the female partner
    14 to 17 days later, an HCG blood test will be performed to determine the outcome of the treatment.