IVF Blog Detail

As we are all familiar, no matter how things were prior to becoming parents, relationships are frequently strained. In vitro fertilisation (IVF), a type of assisted reproductive technology (ART), can enable intended parents who are experiencing infertility to become parents. 

The final IVF procedure for intended parents will be an embryo transfer, which will be followed by a blood pregnancy test. But what does an embryo transfer entail for you, and what choices do you have when the time comes for this eagerly anticipated day?

What does embryo transfer actually mean?

An embryo transfer, in its simplest form, entails taking the fertilised egg and sperm and inserting the newly formed embryo into the woman’s uterus. Your fertility doctor will use an ultrasound to guide this transfer in order to ensure the precise placement of the embryos within the uterus.

What happens during an embryo transfer?

Even though embryo transfer is a relatively easy process, sedation or anaesthesia are infrequently necessary. The embryo or embryos are released into the uterus through the cervix using a long, thin catheter that is filled with the agreed-upon number of embryos and a small amount of fluid.

Why do would-be parents choose embryo transfers?

Even though the cause(s) of infertility may not be known with certainty, your fertility clinic and reproductive endocrinologist will work with you to determine the cause(s) of your infertility and the best way to get pregnant.

Intentional parents who suffer from:

•  Fallopian tube damage or obstruction: They should strongly consider embryo transfers. The egg will have a difficult time ovulating and travelling to the uterus if it is damaged or blocked.
•  Issues with ovulation: Natural conception becomes more challenging when menstrual cycles are irregular because fewer eggs are available for fertilisation.
•  Endometriosis: The function of the ovaries, uterus, and fallopian tubes are impacted when uterine tissue implants and spreads outside of a woman’s uterus.
•  Fibroids in the uterus: The implantation of the embryo, which is necessary for a successful conception, may be hampered by these benign tumours on the uterine wall.
•  Tubal ligations: IVF and an embryo transfer can help women who have had their fallopian tubes permanently cut or removed conceive a child.
•   Amorphous or poorly motile sperm: A third of all cases of infertility in couples are due to the common male factor. An implantable embryo can be produced successfully through ICSI when the egg is fertilised.

How many types of embryo transfers are there ?

During IVF, you can choose from a few different methods. These are the following types of embryo transfer:

with either a fresh or frozen transfer the endometrium or lining of the uterus needs to be prepared so that the embryo can more easily implant. The endometrium is usually checked with an ultrasound to see if it has an appropriate thickness and quality. With a fresh transfer the estrogen made by the ovarian follicles helps to prepare the endometrium. With a frozen transfer, patients may use estrogen patches, pills, or shots to help the endometrium. Sometimes patients may not use any medications.

Frozen embryo transfers are very common. There are several reasons why a patient may choose or be encouraged by their IVF clinician to consider a frozen embryo transfer. One of the most common reasons for a frozen embryo transfer is that the patient has leftover embryos from a fresh cycle. If a patient doesn’t get pregnant, has a pregnancy loss, or has had a baby but would like another, they can use the extra embryos that have been previously created. We’ve learned over the years that there may be other factors that may lower the chance of getting pregnant with a fresh transfer, thus making a frozen transfer a good option. These factors may include concern for worsening ovarian hyperstimulation syndrome if a patient conceives with a fresh transfer, elevation of progesterone during ovarian stimulation, leading to concern that the embryo and the uterus are out of sync. Patients planning genetic testing of the embryos usually need to freeze the embryos while waiting for test results. Finally, if there is an issue with the endometrium, such as a polyp or a thin endometrium, the transfer may be cancelled until the uterus can be evaluated completely.

How to prepare yourself for embryo transfer?

If this is your first transfer of embryos, you don’t need to worry because you’ll be in the optimum hands. Three to five days after the fresh egg retrievals, or longer if you’re employing frozen embryos, the embryo transfer will take place. These are the some of the best tips that should follow before undergoing embryo transfer:

1) Adhere with all medication instructions. Progesterone and other supportive medications will probably be prescribed to you whether you are having a fresh or frozen embryo transfer, so make sure you have enough of them and take them according to your clinic’s instructions. Traveling? Keep them with you at all times (do not pack in checked bags due to the unpredictable temperatures in the plane’s cargo area).

2) Plan ahead for getting to the clinic on time: Consider traffic, the weather, and other factors that could delay your arrival at the clinic when making a plan to get there on time. Consider staying in a hotel close to the clinic the night before the transfer if you have a long drive to the clinic to reduce your risk of being late.

3) Ask about the specifics of the day of the procedure: This includes what time you should arrive, who is allowed to accompany you (typically, one adult is allowed in the room at a time), and how long you can expect to be at the clinic. If you wait until the day of the transfer to ask questions, you risk forgetting what you wanted to ask because it is an exciting and emotional day. Try to ask questions in advance.

4 ) Read the clinic’s instructions once more: It’s easy to become confused and make assumptions, so use caution and have a partner or friend read them with you.

5) Get ready for a restful evening after the transfer: Prepare your favourite meal (or arrange for delivery), buy a new book to enjoy, choose a few movies you’ve been wanting to see, and generally just make plans for pampering. (We’ll talk more about post-transfer instructions later.)

The Day of the Embryo Transfer

1) Continue taking oestrogen and progesterone and other supportive medications as prescribed.

2) Have a full bladder when you arrive. If you don’t drink enough water in advance, you might have to wait while your bladder fills. A full bladder aids in changing the uterus’s angle to facilitate the transfer and aids your doctor in clearly seeing the catheter during trans-abdominal ultrasound to ensure the embryo is placed exactly where it should be.

3) You will be advised pre-medication for the procedure.

4) Be prepared to undress completely in the transfer room, wrap up in a warm blanket or sheet, and lie down on an exam table. With feet in footrests and hips at the edge of the exam table, the transfer is performed in the gynaecological exam position. Ask ahead of time if you can bring your own music, and the room might be dimly lit to encourage relaxation. In most cases, you have a companion, friend, or member of your family sitting next to you. You are now prepared to start working and meet the team!

5) Talk to the embryologist in person who will talk about the embryo(s) and answer your questions.

6) Introduce yourself to the sonographer, who will perform a trans-abdominal ultrasound to verify excellent visualisation. The ultrasound waves can clearly see the uterine cavity through a full bladder because the uterus is located beneath the bladder.

7) Prior to starting the procedure, the doctor will go over it with you and address any additional questions you may have.

8) We will perform your embryo transfer in a two-step procedure. First, a prep catheter is gently inserted through the cervix while being guided by ultrasound (the ultrasound is on the abdomen, and the patients can watch the catheter being placed on the ultrasound screen along with team members).

9) The embryologist loads the embryo(s) into a smaller catheter once the prep catheter is prepared. The patients can view the embryo prior to transfer and watch it being loaded into the catheter thanks to a camera mounted on the microscope in the embryology lab. It’s amazing every time!

10) The embryologist enters the room with the catheter containing the embryo(s), and the doctor inserts the catheter into the prep catheter.

11) Upon placing the catheter in the appropriate location, the embryo or embryos are implanted, and we all observe a flash on the ultrasound screen within the uterine lining. The embryo is too small to be visible on the screen; the flash we’re seeing is a combination of a tiny air bubble and media that help push the embryo through the catheter and place it safely in the uterus. When this happens, I wish I could create a fireworks display for patients to see on the ultrasound screen. It’s really just black and white, and the flash can be so subtle that patients might miss it, but it is genuinely magical.

12) After the embryo(s) have been inserted and the catheter has been placed in the proper location, we can all see a flash on the ultrasound screen within the uterine lining. Because the embryo is too small to be visible on the screen, the flash we are seeing is actually a combination of a tiny air bubble and media that assist in pushing the embryo through the catheter and into the uterus in a secure manner. When this happens, I wish I could create a fireworks display for patients to see on the ultrasound screen. Although the display is primarily in black and white and occasionally has a subtle flash, it is nonetheless incredibly magical.

Immediately After the Transfer

1) The embryo can’t come out! After the embryo transfer, patients frequently prefer to unwind for a few minutes, but studies do indicate that success is unaffected by how long patients spend lying down.

2)  We go over medications and dosage instructions before giving the patient or couple some privacy to consider the transfer—such it’s a special day—for a short while. After that, we advise the patient to get dressed, go to the bathroom (patients love to relieve themselves, you cannot pee out the embryo – promise!), and then relax at home.

I wish you luck if you’re planning to transfer embryos. The achievement of reaching that point is the result of a great deal of effort. It can be difficult to wait and anticipate the result, but keep in mind that you’re doing everything you can to prepare for it, so just take each day as it comes.

After the egg extraction, you might also experience some minor discomfort, cramping, and bleeding. The embryo’s implantation, on the other hand, is probably the IVF procedure’s least uncomfortable step. But don’t worry our IVF Specialist Dr. Rashmi Sharma will take care of you very well. Eager to consult her, then book your appointment now with Origyn IVF or contact us @8080809084.