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What Happens After Embryo Transfer? Key Details Inside

An embryo transfer is a common procedure in fertility treatment. It’s a safe and routine procedure that is performed under ultrasound guidance in a hospital-like environment.

During an embryo transfer, your doctor will insert a catheter into your uterus. A syringe attached to the catheter contains the embryo.

Women are asked to avoid sexual intercourse and heavy exercise after the transfer. These activities can trigger uterine contractions, which may interfere with implantation.

Preparation

After countless appointments, tests, and treatments, embryo transfer is the final step on the infertility roller coaster. While the process can be emotional and exhausting, it’s important to remember that making it to this point is an accomplishment in and of itself! If everything goes according to plan, the next phase is pregnancy.

Your fertility team will have already made extensive preparations to ensure your success. Whether you’re working with your own eggs or using the help of an egg donor or surrogate, it’s essential to have all of your ducks in a row prior to embryo transfer. By ensuring that all of your medical records, genetic screening results, and insurance information is up to date, you can rest assured that everything will run smoothly on the day of your procedure.

When your eggs arrive in our embryology lab, they will undergo a battery of tests to make sure they are mature enough for fertilization. Then, they’ll be combined with sperm in a process called intracytoplasmic sperm injection (ICSI).

If you are using the help of a surrogate, your surrogate will receive her own sperm sample to be injected into each of your eggs during the ICSI procedure. This is done to ensure that the sperm are of the highest quality possible and increase your chances of a successful fertilization.

Once the sperm and eggs have been successfully combined, it’s time for the embryo transfer. The entire procedure usually takes no more than 2 to 4 hours and is a painless, relatively non-invasive process. To perform the procedure, a doctor inserts a speculum into the woman’s vagina with ultrasound for accuracy and then uses a catheter to pass it through the cervix and into the uterus.

Once the doctor has confirmed that the catheter is in the correct place, they’ll then “load” the selected embryo or embryos into it by drawing them into the tube from the vial. Then, the doctor will use real-time images from an ultrasound to carefully insert the catheter into the uterus in the location that is best suited for implantation.

Procedure

Once your eggs have been retrieved, they will undergo fertilization in the laboratory. This process is called intracytoplasmic sperm injection (ICSI). Each mature egg will be injected with sperm, and on average, about 70% of them will fertilize. The fertilized eggs are known as embryos.

Once all of your embryos have been fertilized, we will schedule the day of the embryo transfer. This usually takes place three or five days after your fresh egg retrieval, or longer if you are using frozen embryos.

The procedure itself is relatively simple and does not require anesthesia or sedation. During an embryo transfer, your doctor will use a speculum to see your cervix (the same instrument used during a Pap smear). A long catheter containing the agreed-upon number of embryos is then inserted through the cervix and into your uterus. An abdominal ultrasound is performed at the same time to ensure the tip of the catheter reaches the right spot within your uterus, typically 1 to 2 cm from the top of the endometrial cavity.

When the embryo transfer is complete, the physician will remove the catheter and confirm that all of the embryos have been successfully inserted (see a video of an embryo transfer here). If one or more of the embryos is retained in the catheter (uncommon), the procedure is repeated with a fresh batch of embryos until the appropriate number of embryos has been transferred.

After the embryos are transferred, your OB/GYN will perform a hysterosalpingogram to evaluate the condition of your uterus and pelvic ligaments. This will help to prevent complications such as infection, twisting of the ovaries and ovarian hyperstimulation syndrome.

In some cases, when a woman’s uterus and endometrium are not receptive due to the stress of ovarian stimulation, it may be recommended that you do a frozen embryo transfer cycle (FET). FET cycles involve freezing all of the fertilized eggs prior to the egg retrieval and then transferring only those that have successfully reached the blastocyst stage upon thawing. This allows the uterus and endometrium to recover from the fertility medications that are administered during the ovarian stimulation phase.

Recovery

When you are ready to move forward after egg retrieval and have a number of healthy embryos to choose from, the next phase in your fertility journey is embryo transfer. If you’re curious about what happens after embryo transfer, understanding the recovery process and following your doctor’s recommendations can significantly impact your chances of success. The process is quick and straightforward, and the recovery period is not as long as you might expect.

Prior to a fresh or frozen embryo transfer, your doctor may give you hormone medications to prepare your uterus for the procedure. The medications may be delivered via a pessary that is placed inside your vagina or as an injection or gel. This step is a crucial part of the process as it can make a big difference in how well the implantation takes place.

Once the lining is ready for a new embryo, you will go to your physician’s office for the transfer. The procedure itself is very similar to having a Pap smear and should not be painful or uncomfortable. The doctor will use a speculum to wash the cervix with sterile fluid, and then a catheter is inserted into the uterus. A syringe with the embryo(s) is then attached to the catheter, and the embryo(s) are transferred into your uterus.

The process typically takes less than 10 minutes and can be performed without the need for anesthesia. We encourage our patients to keep their bladder full before the transfer, as it allows for better ultrasound visualization of the uterus and facilitates a more successful implantation. In addition, keeping your bladder full can help prevent a miscarriage by ensuring that the lining is thick enough to support a healthy pregnancy.

hand holding an ultrasound - What Happens After Embryo Transfer? Key Details Inside

It is important to remember that even a high-quality embryo (both from a morphological and genetic standpoint) may not implant if the endometrium is not receptive. This can happen due to uterine pathologies or a premature increase in progesterone levels.

During the two weeks following your embryo transfer, it is important to avoid any activity that might cause uterine contractions, including sexual activity and heavy exercise. This is because these activities can cause the embryo to become dislodged from its position in the uterus, and it is important for the implantation to take place in the most ideal location for pregnancy to occur.

Follow-up

Once the embryos have reached the blastocyst stage, our team will select the healthiest ones for transfer. Once the selection process is complete, we will notify you. At this point, we will schedule an appointment to perform the transfer at a time convenient to you.

The procedure is relatively quick, simple and doesn’t require sedation. The embryos are loaded into a catheter that is then inserted into the uterus using real-time ultrasound guidance to ensure it is in the correct position. After that, a speculum is used to wash off the cervix with some sterile fluid. This will feel like a Pap smear and shouldn’t be painful for most women.

A few days after the embryo is transferred, it’s important to avoid vigorous activity. This gives the lining a chance to recover. If a patient is taking fertility medications, it’s also important to follow the doctor’s instructions regarding the use of these drugs and how long they should be used for.

Many factors influence the success of an embryo transfer, including a woman’s age and the quality of the embryos. A single embryo is transferred in a majority of cases as this offers a better rate of pregnancy compared to transferring multiples.

If a patient is at a high risk of developing Ovarian Hyperstimulation Syndrome (OHSS), it may be advisable to freeze all the embryos and pursue a Frozen Embryo Transfer (FET) cycle in the future when the uterus is more likely to be receptive. This will allow the body to recover from the ovarian stimulation process and give the doctor more control over when to transfer embryos.

Typically, patients are recommended to have just one embryo transferred when the embryos reach the blastocyst stage. This can offer a very similar pregnancy rate to transferring two embryos and also reduces the chance of a multiple gestation, which can be extremely dangerous for both mother and fetuses.

We encourage all of our patients to consider this option. However, if you are interested in discussing how many embryos are right for you, please don’t hesitate to contact us for more information. We will be more than happy to help!

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