Embryo Transfer-Procedure & precautions after treatment

The final and perhaps the most critical step of In vitro fertilisation (IVF) treatment involves the transfer of the embryo into the mother’s womb. An IVF doctor conducts the process with ultrasound guidance using a transfer catheter. It’s a delicate procedure that requires a careful hand and a highly skilled doctor.

As stated by Dr Richard Sherbahn, MD, of the Advanced Fertility Centre of Chicago, USA that “The entire IVF cycle depends on the delicate placement of the embryos at the proper location near the middle of the endometrial cavity – with minimal trauma and manipulation.” Also, went on to add that: “The importance of proper embryo transfer technique for successful IVF cannot be overstated.”

What Is Embryo Transfer?

Embryo transfer refers to the final step in In vitro fertilisation in which the embryos are placed into the uterus of a female to help in conception. The process of transferring embryos is a simple procedure and is done on an outpatient basis. Usually three to five days after the egg retrieval process, the embryos are transferred back into the uterus. The process does not require anaesthesia and is almost painless, but a patient might feel discomfort only during the insertion of a vaginal speculum as they might have felt while taking a pap smear.

When Is Embryo Transfer In IVF Done?

The main stage at which embryo transfer is done is at the cleavage stage that is Day two to Day three after incubation or the blastocyst stage that is day five after incubation. However, some clinics like to wait to allow the embryos to reach the blastocyst stage before transferring. This is because transferring embryos at blastocyst stage has shown to increase the significant live birth rate per transfer.

Read more: Bulky Uterus

What Are The Steps That Precede The Embryo Transfer Process?

The steps that precede the transfer of the embryo are listed below:

  • Ovarian stimulation – the ovaries of the female patient are stimulated with medication in order to make them grow more eggs.
  • Trigger administration – an injection, or trigger, is given to help the eggs complete maturation and loosen from the follicular wall.
  • Egg retrieval – the eggs are retrieved or extracted from the ovaries with ultrasound guidance. The patient is sedated for the procedure and does not experience any discomfort or pain.
  • Sperm Retrieval – the male partner provides a semen sample from which sperm are extracted. If necessary, the sperm can be extracted in a separate procedure. The sperm is processed.
  • The eggs are fertilised with the processed sperm. Fertilised eggs are referred to as embryos.
  • The embryos are cultured in an incubator for several days.
  • The best embryo (or embryos) are selected for transfer into the female partner’s uterus.

Quite a lot happens before the embryo is transferred, but the transfer process, if not handled properly, can put the entire process at risk. That is why it is very important to choose a highly qualified and experienced fertility specialist for the procedure. Placing the embryo too close or too far from the uterus will interfere with implantation. Ideally, the embryo should be placed roughly one centimetre from the uterus.

How Is Embryo Transfer Performed?

After the egg retrieval process, the patient needs to revisit the clinic to get her embryo transfer done. No anaesthesia is required for the procedure of embryo transfer. The patient is made to lie on a bed. The doctor then using a vaginal speculum, exposes the cervix and under ultrasound guidance, he transfers the embryos. A fixed number of embryos (as per age and guidelines of ART) are loaded into a fine transfer catheter that passes through the vagina, cervix, and then into the uterus. The process should be done carefully and usually takes 5-10 minutes of your time.

The embryos are deposited from the catheter into the uterus. After the procedure, the patient remains in a recovery room resting on her back and is discharged 20-30minutesafter the procedure. There are no risks associated with the process, but some patients might complain of mild cramping after embryo transfer, other than that the procedure is painless. After the embryo transfer procedure comes the 2WW (two weeks wait) where the couple will wait and hopefully watch for early pregnancy symptoms. There is no role of bed rest after embryo transfer.

How Many Embryos Are Transferred?

We in Medicover Fertility transfer two good quality embryos either on Day 3 or Day 5. The grading of Embryos is done according to their appearance and rate of cell division, and good quality embryos are categorised as those who have 4-8 cells, of equal size, with clear cytoplasm, and with few fragments. These are called Grade A embryos. Embryos that have more fragments are specified as low grade, and usually, have a lower chance of implanting. However, if they implant successfully, the babies born will be completely normal.

What Medications Are Given After The Embryo Transfer Procedure?

After the embryo transfer, the embryos need to implant for a pregnancy to occur. In a natural cycle the embryo transfer takes place in the luteal phase, but in a stimulated cycle or a cycle when frozen embryo transfer is recommended the woman should be given oestrogen supplements for about two weeks, and then a combination of oestrogen and progesterone is given so that the lining becomes receptive for the embryo.

After embryo transfer progesterone is the main medication which will continue after the transfer, taking progesterone supplements will not only increase the chances of pregnancy, but progesterone is also helpful in sustaining a pregnancy for at least the initial three months.

What Precautions Are Needed To Be Followed After An Embryo Transfer?

Some precautions can increase the likelihood of your pregnancy:

  • Swimming or steam baths should not be done for 48 hours after embryo transfer.
  • It is advised not to have intercourse until a foetal heartbeat in an ultrasound confirms the pregnancy or the pregnancy is negative.
  • Limit excessive physical activities like going to the gym, lifting weights, doing aerobics, jogging. Stick to light walks.
  • Increase your intake of protein-rich foods.
  • Don’t take any medications without asking your doctor.
  • Stop smoking and taking caffeinated drinks.
  • You can return to your daily activities after 2 days of rest in the house.

Note: There may be some vaginal spotting or bleeding before you take your Beta HCG blood test. However, it is still recommended to get the blood test done because there may be no symptoms or signs so early, which may be able to tell you whether you are pregnant or not.

What Happens After The Embryo Transfer?

With the embryo transfer, the procedure of IVF is complete and then comes the two weeks waiting period. As discussed, most of the clinics provide luteal phase support after the transfer to increase the chance of implantation. These two weeks wait period is the most crucial time and determines the outcome of the whole IVF treatment that you have undergone all these months. It is essential for patients to be very cautious about their health during these two weeks and obediently follow the doctor’s instructions.

Pregnancy can be determined by a blood test (beta HCG), which measures the level of the hormone HCG (human chorionic gonadotropin) in the blood after just 14 days after the embryo transfer. These 14 days often seems the longest days in a patient’s life. A positive beta HCG level that is a count more than 10 mIU/ml would mean that you are pregnant. The doctor will then confirm and monitor the pregnancy with an ultrasound to confirm whether it is healthy, intrauterine pregnancy and to check how many embryos have implanted.

Why Choose Medicover Fertility For Infertility Treatment?

Medicover Fertility is one of Europe’s best fertility clinics, with over 23 years of experience in the field of infertility. The doctors here are sufficiently skilled and capable of using advanced technology and modern equipment to do all kinds of procedures which need skill and experience. Embryo transfer is one such delicate process that requires a careful hand and a highly skilled doctor. If not performed correctly, it can make the whole procedure of IVF unsuccessful.

Medicover Fertility has done many successful treatments of ICSI and IVF, from which many people had the pleasure of becoming parents. The skills and expertise of our IVF doctors have allowed us to achieve superior pregnancy results. We here in Medicover keep your personal information confidential. If you want any information related to the topic of embryo transfer, you can contact us on this number +917862800700 or mail us at contact@medicoverfertility.in.

Frequently Asked Questions

How Is Embryo Transfer Done?

An embryo transfer is a final step in the process of IVF. Once the fertilised eggs now called embryos start multiplying, they are transferred to the woman’s uterus on Day 3 or Day 5. A fixed number of embryos are loaded into a fine transfer catheter that passes through the vagina, cervix, and then into the uterus. The doctor transfers the embryo under ultrasound guidance to ensure the proper placement of the embryos in the uterine cavity. For pregnancy to occur, the embryo must attach itself to the uterine lining.

How Long Does It Take For Implantation After Embryo Transfer?

After a Blastocyst transfer implantation usually occurs between the first to the fifth day of transfer. Implantation window is usually 6-10 days after the egg retrieval process.

Can You Feel Implantation After Embryo Transfer?

Yes, if you read your body carefully, you can feel the signs of implantation. You may have cramping, and there might be some kind of spotting when the embryo goes and implants in the uterine lining. This spotting is called implantation bleeding.

Does Embryo Transfer Hurts?

The transfer of the embryos is almost painless, and no anaesthesia is required in this procedure. But you may feel discomfort only during insertion of a vaginal speculum to dilate your cervix as you may have felt while taking a pap smear.

Is Bed Rest Necessary After Embryo Transfer?

Immediately after an embryo transfer, the attending doctor might tell you to take 4-6 hours of rest. But bed rest is not necessary until recommended. Implantation does not take place immediately but happens at day 7th or 8th. So, bed rest is not going to improve your chances of getting pregnant.

Can Embryo Fall Out After Transfer?

Many patients are worried that if they jump, cough, sneeze, the embryo can fall out. This is not possible, if the embryo is going to implant, it will implant no matter how much you exert yourself physically. The uterus is a cavity where once the embryos are placed will not fall out.