PRESCRIPTIONS TEMPLATES PER CLINIC

FCC – CANCUN

WITH ESTROGEN PATCHES

• Folic Acid – 5mg/ day # 30 – to start now

• Marvelon – 1 box: To start on day 2 of next menstruations

• Lupron Depo 3.75mg – one injection on [date] (Day 21 of her next cycle)

• Prometrium 100 mg - #180 - Vaginal administration. Start one day before the day of egg collection from donor. Take it 3 times a day (3 in the AM, 2 in the afternoon, 3 in the PM).

• Vivelle Dot 0.05mg Transderm Patches- #180 - Replace every other day, starting on day 3 of the period following injection of GnRh analog. Start with 2 patches on day 3 and 5, and then increase to 4 patches every other day from day 7

OR

• Estradot/Estraderm skin patches, 50 mcg - Replace every other day, starting on day 3 of the period following GnRh analog. Start with 2 patches on day 3 and 5, and then increase to 4 patches every other day from day 7

WITH ESTRACE 2 mg

• Folic Acid – 5mg/ day # 60 – 5 mg to start now

• Marvelon – 1 box – To start on Day 2 of next period

• Lupron Depo 3.75mg – one injection on [date] (Day 21 of her next cycle)

• Estrace 2 mg - #180 - Starting on day 3 of the period following GnRh analog. Start with 1 pill per day (2mg/day) for 4 days. Then increase to 1 pill every 12 hours (4 mg/day) for the next 4 days. Then increase to 2 pills every 12 hours (8mg/day) and continue with this dosage.

• Prometrium 100 mg - #180 - Vaginal administration. Start taking one day before the day of egg collection from donor. Take 3 times a day (3 in the AM, 2 in the afternoon, 3 in the PM).

IN MATER – MEXICO CITY

Dr. Asch

• Marvelon – 1 box – To start on Day 2 of next period

• Lupron Depo 3.75mg – one injection on [date] (Day 21 of her next cycle) • Baby Aspirin - # 60 – 1 daily to start on Day 1 of next menses

• Folic Acid 5 mg - # 60 – 5 mg daily to start on Day 1 of next menses

• Omega - 3 - # 60 – 1 daily to start on Day 1 of next menses

• Estrace 2 mg - #180 – Take a follows:

 Days 3-4 and 5 of menses = 2mg of Estradiol Valerate orally (in the morning)  Days 6-7 and 8 = 4 mg of Estradiol Valerate (2mg every 12 hrs.)  Days 9-10 and 11= 6 mg of Estradiol Valerate ( 2mg every 8 hours)

• Utrogestan 200 mg - #180 - Vaginal administration.

Dr. Cervantes

• Folic Acid – 5mg/ day # 30 – to start now

• Lupron Depo 3.75mg – one injection on [date]

• Estradot/Estraderm skin patches, 50 mcg - Replace every other day, starting on day 3 of the period following GnRh analog. Start with 2 patches on day 3 and 5, and then increase to 4 patches every other day from day 7

• Prednisone 20 mg – 20 mg a day. Take for 4 days, starting 3 days before embryo transfer

• Prometrium 100 mg - #180 - Vaginal administration. Start 3 days before the transfer day. Take 3 times a day (3 in the AM, 2 in the afternoon, 3 in the PM).

GENESIS – CYPRUS

• Folic Acid – 5mg/ day # 60 – to start now • Lupron Depo 3.75mg – one injection on [DATE] • Premarin 1.25 mg - # 180 – Take 3 times a day, orally. Day 1 and Day 2: 2 pills every 8 hours, from Day 3: 3 pills every 8 hours • Baby Aspirin - # 60 – Take 1 tab a day, orally starting on Day 1 of estrogen intake. • Prometrium 100 mg - #180 - To start one day of egg collection from donor. 4 in the AM and 4 in the PM. Vaginal administration • Prednisolone 25 mg - # 30 - must be commenced as from day 5 of Estrace administration at a dosage of 25 mg daily and not to be discontinued until otherwise advised.

GENESIS – CYPRUS – PATIENTS FROM ISRAEL

• Folic Acid – 5mg/ day # 60 – to start now • Decapeptyl 3.75 mg – one injection on [DATE] • Progynova 2 mg- # 180 – To start on Day 3 of menses following the injection of Decapeptyl. Take 1 pill every 8 hours then increase to 2 pill every 8 hours starting on Day 3 of treatment. • Baby Aspirin - # 60 – Take 1 tab a day, orally starting on Day 1 of estrogen intake. • Utrogestan 200 mg - 2 in AM and 2 in PM starting on the day of egg collection from the donor • Medrol 16 mg – 1 tab daily starting on Day 5 of Progynova intake.