/
Tx Cycle Management - Entering Sentinel Dates

MellowoodMedical Online Help

Tx Cycle Management - Entering Sentinel Dates

Once the patient has begun treatment, you will need to manage the IDEAS treatment plan to reflect important dates, USS and blood results, changes in stimulation drugs etc.

Sentinel dates are entered on the Treatment Plan tab of the Treatment Cycle. For further information on that, click here Tx cycle - Treatment plan tab & sentinel dates .

Tx cycle - Treatment plan tab & sentinel dates

Filed on treatment plan tab

Notes on filling this field

 

Treatment plan assigned

this will autofill when a treatment plan is added on the Intended Treatment Tab

This is the date the treatment plan was created. Usually the date the intended treatment record is created.

Baseline scan

optional - directly entered from Treatment Plan tab

This is the date the baseline scan is done or scheduled to be done.

Menstrual day 1 before down-regulation

optional - directly entered from Treatment Plan tab

This is the date of her first day of bleeding preceding her treatment with down-regulation drugs. This is usually the month before stimulation drugs are given.

Start date of stimulation medications

optional - directly entered from Treatment Plan tab

This date is the first day that stimulation medications are administered.

For most reporting agencies, this date is the 'start of treatment' for reporting purposes

Start of follicular phase (LMP) 

 

THIS IS A MANDATORY FIELD AND NOT OTHER DATES CAN BE ADDED , OR LAB EVENTS CREATED UNTIL THIS DATE IS ENTERED

Typically the date the patient begins their stimulation (eg. start date of FSH in IVF cycle or HRT in FET cycle) or is the LMP in a CC or natural cycle.  

This is considered the Cycle Start Date.

LH surge / P4 administration

optional

This date (and time) is filled in when drugs are used to convert a cycle from the follicular phase to the luteal phase. Typically this is done in frozen embryo, donor egg/embryo and surrogate treatments. This box is filled in when the patient either has a natural surge or P4 administration begins.  

Please note:
When this box is filled in the 'Date of trigger' is redundant and not filled in.

 LH surge date 

 P4 administration 

 

You may enter the surge date if HCG is not used to trigger ovulation in the cycle.

P4 would be used in an FET cycle

Date of trigger 

Populates when confirmed in the detail of the plan, in the 'Plan Details tab

Date & time of HCG administration

Luteal day 0;

 

 

 

MANDATORY If THE CYCLE REACHES THIS POINT - THIS FIELD MUST BE COMPLETED BEFORE ANY LAB EVENTS CAN BE ENTERED

autofilled once trigger or LH surge date is entered

OR

can be manually entered

The egg retrieval or ovulation date.

IDEAS will automatically calculate the date of Luteal day 0 based on the date of trigger (above) and auto-fill this date. However, the Luteal day 0 date can be manually adjusted by overwriting the date.

This date is automatically filled in when the date of trigger is entered. However, it should be manually entered in treatments where there is an LH surge or when progesterone has been administered.  In an appropriately designed treatment plan the luteal day 0 will be automatically filled out based on the date that progesterone administration is begun (eg. If P4 begins on Luteal day -2 in the treatment plan, then luteal day 0 would be calculated to be 2 days after the date of P4 administration.). 

Please note:
  It is very important that this date is set in accordance with its biological context. All laboratory/embryology events are scoped to this date. Transferring of frozen embryos or fresh donor eggs/embryos depends on this biological context, especially with regards to endometrial receptivity and the associated implantation window.

Egg retrieval and embryo transfer date ;

 

Autofilled from dates recorded in the lab events folder

Note - lab events can only be entered once the luteal day 0 is entered

Transfer date is determined based on the relative luteal day of the transfer event in the Plan Details tab.

This is the date of egg collection for fresh IVF treatment or IVM cycles. IDEAS will enter this date for you once the corresponding laboratory event has been completed.

 

Thaw date

Autofilled from dates recorded in the lab events folder

There may be a planned date here if you have a thaw included in your treatment plan

This is the date on which embryos or eggs are thawed. If further eggs or embryos are thawed, only the first thaw date is recorded although the second thaw event is recorded within the laboratory records.

Pregnancy test

This can be autofilled by including a pregnancy test in your treatment plan, or directly entered

This is the date of the first luteal phase pregnancy test. The interpretation can be Pregnant or Not pregnant and will be automatically filled in when the first luteal ß hCG is entered into Blood/Lab tests. This field should be entered for all treatments once the outcome is known as other functions within IDEAS are dependent on this information.

Clinical pregnancy date

Autofilled from gestational scan record which records a clinical pregnancy

This is the date recorded inthe of the first gestational ultrasound scan which confirms the clinical status of the pregnancy.

Estimated delivery date

Autofilled when a clinical pregnancy date is completed

When a pregnancy has been established, IDEAS calculates the estimated date of delivery and auto-fills this field.

 

 

Entering cycle start dates

If patient is being downregulated or suppressed, the date of their LMP prior to downregulation will be entered on the Treatment Plan tab in the field, 'Menstr. day 1 before downreg'.

  • Press "Set date" to enter this value.

The Cycle Start Date is entered in the 'Start of follicular phase' field. This is the date the patient starts her stimulations drugs, HRT or is the LMP in a CC or natural cycle.

Entering the Trigger Date

The trigger date can be entered into the Treatment Plan tab once the patient has been instructed to receive their HCG injection.

  • Press "Set Date" next to the Date of trigger field. 

  • Enter the date and time the patient has been instructed to take their trigger

The following message will often appear once you save the trigger date/time - this is because the patient has been assessed as ready for trigger a little earlier than the template treatment plan indicated and there are still items in the plan to happen after this date.

If you are sure the date is correct , click yes - this will remove the items in the plan for after the trigger date as they are no longer required.

The Luteal Day 0, Egg Retrieval date and Embryo Transfer date are automatically entered into the sentinel date fields once the trigger date is entered

This is the luteal phase - indicated green in IDEAS. Continue managing luteal phase events in the same manner described above for the downregulation and stimulation phases.

Laboratory Staff can begin entering lab data into the system once a luteal day 0 is entered for the cycle.

.


 

 





Related content