One cycle, from stimulation day one to the beta

The cycle record as the spine of the attempt

Everything a clinic does in an ART attempt needs a single anchor, and in FertiliCore that anchor is the treatment cycle. It fixes the patient, the attempt number, the modality and the stimulation protocol family, names the responsible physician and embryologist, and holds the landmark dates: cycle start, retrieval, transfer and the beta-hCG draw. The cycle cannot be reassigned to another patient once created. Its status moves through planned, active, in progress, completed or cancelled, and a lock flag freezes the record when the episode closes.

• Modalities offered on the form: IVF, ICSI, FET, IUI, donor egg, donor sperm, natural, cryo donation
• Protocol picker: long agonist, short antagonist, mini IVF, natural, modified natural
• Optional cycle group for batching related cycles
• Detail drawer with General Info, audit History and Files tabs

Stimulation and trigger timing

The cycle's protocol label says which family of regimen was chosen; the detail of the drug exposure is modelled separately. The record captures the gonadotropin agent and dose, the total ampoules consumed across the cycle, the number of stimulation days, and the trigger agent and dose. It also holds the trigger date and the exact trigger time, which matters because retrieval is scheduled roughly 34 to 36 hours afterwards and an hour of drift changes what comes back from the follicle. A clinic-wide catalogue of nine induction protocols is seeded for administrative use.

Daily monitoring during stimulation

Serial monitoring is where dose decisions are actually made, so each monitoring visit is one row on a sheet rather than a note. The row carries the cycle day, the hormone panel and the transvaginal ultrasound findings side by side: oestradiol as the marker of follicular response, LH watched for a premature surge, progesterone for endometrial timing, FSH and beta-hCG. Alongside them sit endometrial thickness and pattern, follicle counts for each ovary, and the individual follicle diameters per side. Medication notes and the next visit date close the row, so the sheet reads as a decision trail rather than a data dump.

• Hormone panel: E2, LH, FSH, P4, hCG with units
• Endometrial thickness in millimetres, plus coded pattern
• Right and left follicle counts with individual diameters
• Dose-adjustment instructions and scheduled next visit
• Rows can be locked once reviewed

Oocyte retrieval

The OPU record documents the theatre event and the harvest. It holds the procedure date and time, the anaesthesia description and anaesthetist, the operating physician and the embryologist receiving the oocytes. The yield is recorded as more than a single number: follicles aspirated and oocytes recovered per ovary, then the maturity breakdown into mature MII, immature MI and germinal vesicle, and degenerate, along with the count of empty follicles. That breakdown is what makes the difference between a poor retrieval and a poor stimulation visible after the fact. The sperm source for the cycle and any complications are recorded on the same header. Beneath it, the system models a per-follicle aspiration grid — one row per follicle with side, sequence number, measured diameter, whether an oocyte was obtained and its maturity grade — and a dated theatre worklist of patients booked for retrieval.

Cancellation recorded as a reason, not a status

A cancelled cycle is a clinical event with a cause, and treating it as a coded value rather than free text is what makes cancellation rates analysable. FertiliCore seeds ten cycle-level cancellation reasons — poor response, OHSS risk, no follicle development, patient request, medical, financial, premature LH surge, endometrial problem, freeze-all and other — and a separate five-value list at retrieval level for premature ovulation, patient refusal, no follicle on follow-up, anaesthesia risk and other. Freeze-all sits in the cycle list deliberately: it is a planned deviation, not a failure, and should not be counted as one.

Closing the loop, and what came before

The cycle outcome is held as exactly one record per cycle, which makes it the single source of the result. It carries the quantitative beta-hCG value and date, the positive, negative or borderline interpretation, whether a clinical pregnancy was confirmed on ultrasound, fetal cardiac activity, the gestational sac count and the eventual outcome. Adjuvant medication and luteal-phase support are modelled with drug, dose, route, frequency and treatment window, and post-transfer monitoring tracks progesterone, beta-hCG and oestradiol through the early luteal window. Prior attempts made at other clinics are held against the patient with year, modality, clinic, treating doctor and result, so protocol choice is informed by what has already been tried.