Everything You Need to Know About Embryo Transfer

Did you know the first IVF baby was born in 1977 in Greater Manchester, UK?

When we talk about embryo transfer, we are referring to an essential step of the assisted reproduction technology (ART) process where embryos are implanted in the uterus to help increase the chances of pregnancy. An embryo is the early stage of human development after fertilization occurs.

Many factors can determine how and when the embryo transfer will be carried out. 

The embryo transfer technique is considered the final part of in vitro fertilization (IVF). Every step of any assisted reproduction process is delicate. 

Let’s talk about what is involved in the embryo transfer process.

The Embryo Transfer Process

The embryo transfer generally occurs between Day 2 and Day 3 post egg retrieval after the embryos have been cultured in the lab during this time. However, some clinics allow the embryo to reach the blastocyst stage before transfer. The blastocyst stage occurs around Day 5 and is when the embryo has developed into a complex cell structure of 100+ cells. 

This final stage in the entire process, after all the medication and preparation, can be extremely emotional and exciting.

The transfer technique can be done in the clinic, and anesthesia is not usually required, but a sedative may be administered. The process does not take a lot of time, around 10 minutes with a post procedure hospital stay of 2-4 hours, and you can expect to be discharged shortly after.

Your doctor will use ultrasound as an aid to guide the thin transfer catheter through the vagina and cervix into the uterus. You will be asked to lie on your back for 30 minutes. It may be advised to rest for 24 hours following the procedure.

What Happens After Embryo Transfer?

You can resume regular activity or decide to take it easy. It is important to do what feels right according to how your body feels. The waiting period until an official pregnancy test is tough, and it is reasonable to feel anxious, but take steps to limit stress.

There is a two-week wait before testing to find out if the treatment was successful. Taking a pregnancy test too early can provide false results, which takes an emotional toll on you. This is because, during the treatment process, to stimulate ovulation, you are required to take the hormone hCG, which is the same hormone used to indicate pregnancy. Your hCG levels can fluctuate post embryo transfer and, therefore, not providing an accurate result. 

Although embryo transfer is a very safe and routine procedure, you may experience some of the following symptoms: 

  • Mild Cramping
  • Slight Bloating
  • Tender/Sore Breasts
  • Light Spotting
  • Mood Swings

If any of these symptoms become severe, then you should immediately consult your doctor.

Single vs. Multiple Embryo Transfer 

The number of embryos transferred depends on various factors, including age, egg quality, and if the couple has a desire for twins. 

Single Embryo Transfer (SET) and Double Embryo Transfer (DET) are the more commonly used approaches as they are considered safer and have seen favorable success rates.

The Society of Assisted Reproductive Technology (SART) advises that for each IVF cycle, 1 or 2 embryos should be transferred in younger females with a higher chance of pregnancy. However, in some instances, multiple embryo transfer of up to 4 embryos, may be recommended for older women in their late 30s and 40s who have a lesser chance of conceiving.

There continues to be research and studies carried out on the challenges faced with multiple pregnancies and a correlation between the number of embryos transferred for a successful pregnancy. No research suggests that transferring three or more embryos increases the chance of conceiving. In fact, not only does the chances of multiple births increase, there are higher chances of health risks to the baby and pregnancy complications.

SET is considered a safer option to choose from during IVF, especially for women who are 35 years or younger, who are trying IVF for the first time and those who have good quality eggs and embryos.

Transferring more than one embryo is recommended to women who have had previous unsuccessful IVF attempts, and are over the age of 38.

Benefits of Frozen Embryos 

Advancement in ART has seen more and more couples decide to freeze embryos. Embryo freezing, also known as cryopreservation, has drastically improved over the years, and patients are experiencing impressive success rates. 

Advantages of using frozen embryos during IVF include:

  • Increased Pregnancy Rates: Research suggests that using frozen embryo transfer is similar to the natural conception process, which increases implantation, pregnancy, and live birth rates and lowers miscarriage rates.
  • Healthier Pregnancies and Babies: Choosing to transfer frozen embryos usually occurs quite sometime after ovulation stimulation. This allows the hormone levels to return to normal, lowering the chances of pregnancy complications like ovarian hyperstimulation syndrome. Studies have also found a lower risk of preterm labor.
  • Cheaper Treatment Costs: Frozen embryo transfer (FET), eliminates quite a few steps in the IVF treatment cycle like egg retrieval and embryo culture, reducing medication and treatment costs. In case the first attempt of embryo transfer is unfortunately unsuccessful, we have surplus embryos, which drastically brings down the physical discomfort, need for injections, as well as cost of treatment.
  • Genetic Testing: Couples who have a higher risk of passing genetic conditions onto their baby can have their frozen embryos tested for specific genetic mutations. This process is called Preimplantation Genetic Diagnosis (PGD). The fertilized eggs are retrieved, and an embryologist will do a biopsy of each embryo and send it for testing. 

Before & After Embryo Transfer Tips

There are different parameters to the embryo transfer process, which means you should take your time to do your research on the different options available and also ask your doctor about any concerns you have.

Here are a few tips to help you.

Before Embryo Transfer:

  • Find out more about blastocyst transfer, which gives the embryologist more time to monitor the quality of the embryo as it allows the embryo to develop further.
  • Consider embryo screening, PGS, or PGD is a safe way to find out more about the embryo’s DNA and structure to determine if there are any inconsistencies. Whether or not it is useful in your case, should be discussed with your IVF specialist
  • Look into assisted hatching, which is a technique used to improve implantation rates by making a tiny hole in the fragile membrane of the embryo known as zona pellicuda. Not everyone benefits from assisted hatching, hence you should discuss with your doctor if it would help in your particular case.
  • Talk to your doctor about hormone supplements like estrogen and progesterone to help support the embryo development and prepare the endometrial lining for implantation.

After Embryo Transfer:

  • Listen to your body and try to slow down for a few days. Although you can go back to your daily tasks, the waiting period can be stressful. Your body and mind have gone through a lot in the weeks leading up to embryo transfer; get plenty of sleep and try to settle your nerves.
  • Avoid high-impact exercise and sexual intercourse, which can cause uterine contractions. Although there is a debate about the connection, it is better to be safe until it is time to take a test.
  • Eat a well-balanced diet as if you are pregnant to ensure you are getting the necessary nutrients for a healthy pregnancy and baby. This can include more protein, fiber, oats, nuts, and vegetables.
  • Avoid extreme temperatures, which can raise your body temperature. This can be from sauna rooms or hot tubs. It is also a good idea to avoid swimming pools or baths, which can increase your chances of infection.
  • Do not consume meals, which include fish, alcohol, processed meats, trans fat, and soft cheeses. Try and focus on whole foods that do not use artificial sweeteners, coloring, and ingredients.

How successful is embryo transfer?

As mentioned above, we talk about the different embryo transfer approaches you can take based on your individual requirements. 

There is ongoing research to support the success of embryo transfer, taking into account several factors like age, embryo quality, fresh or frozen embryos, number of embryos, and blastocyst transfer. Based on this, the success rate for each embryo transfer can vary between anything from 5% to 70% depending on your medical reports, assessment and embryo quality.

However, what we are seeing are all favorable to the different techniques now available to help achieve success and healthy pregnancies. There are a lot more resources and knowledge available to help ensure IVF treatment plans address your individual needs.

If you want to know about your options and the various innovative techniques available to support IVF treatment, you can book a consultation with Dr. Shweta Goswami at Zeeva Clinic.

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