What to Know About an IVF Embryo Transfer Process
So many people ask me if the transfer itself hurts. Believe it or not that’s the number one question I get! The answer is no. It actually feels like a pelvic exam, just a lot longer. I started thinking about the whole transfer process and how much goes into it! To be honest, the transfer itself is the easiest part of all this!
What to Know About an IVF Transfer Process
I personally have only done frozen embryo transfers, or as most people using the IVF lingo call them, FET’s. Some people, along with their doctors, decide to do a fresh embryo transfer (although now that I’m reading this, they have the same lettering so now I’m confusing myself LOL). Anyway, the fresh transfer is done 3 to 5 days after the eggs are collected from a retrieval. Usually this makes sense if a woman has high progesterone during and after retrieval and or if they don’t want to further test their embryos through PGS or PGD. Both fresh and frozen transfers have very similar success rates.
After the eggs are collected, we usually wait until day 5 to see how many eggs fertilized and made it to blastocyst stage.
A day 5 embryo is typically preferred in terms of the embryo quality. Once we get these little ones to this stage, the embryologist will biopsy the outer cell wall, not the actual embryo mind you, and send it off for PGS testing (pre-implementation genetic screening) to make sure it is considered “normal.” Then the embryos that were biopsied are frozen for a future transfer. There is a lot of new studies around this and I have my own personal feelings on this as well, however doctors usually prefer that the embryos are tested primarily if you have multiple embryos post retrieval so that they can better determine which embryo to transfer first.
So, where does that leave me? Well in waiting mode.
Usually then I have to get back on birth control pills since, hi, I don’t ovulate on my own and thus don’t have a period on my own. So back on BCP I usually go as I wait for the results. My clinic takes about 7-10 business days to get back to us with results. PGS testing also allows you to find out the gender of the embryo should you chose to want to know (we always opt out of this knowledge since we try to not get too attached). although that never works regardless.
Once we have the information and obviously if we receive good news that we have at least one embryo that is PGS normal (meaning all of the necessary chromosomes are present and none are duplicated), we can begin prepping for FET. Usually, I begin by stopping BCP and getting a period. We want to shed the lining and create a fresh new one for this future embryo to hopefully stick to! So, once you get your period, that’s termed cycle day 1 (CD1). This is the day that the clinic will have you call in and then usually come in for what’s called a baseline appointment where the doctor will check your uterus and ovaries for cysts or any abnormalities before proceeding with the transfer prep. Your lining should also be very thin at this point and your estrogen levels should be low as well. If all these factors are in line, then you’re ready to move forward. Best news ever!
My protocol has always been different. In the past, I’ve been on estrogen patches. The patches produce estrogen which is absorbed by your body when placed on your lower abdomen below your belly button. They’re not too bad other than the fact that they rip your skin off (I had to change them every 4-5 days). I also had to be on a vaginal estrogen supplement which wasn’t bad either other than creating a blue mess in my undies. TMI?? Sorry!
Anyway, this time, transfer number 7, I am on estrogen injections.
Yep, I needed more than 6 patches and a vaginal pill could give me! So, every three days, I inject my upper buttocks and push in some estrogen in hopes that my lining will get nice and thick!
After about a week of estrogen you go in for your lining check. Basically, most clinics like to see the lining between 7-8mm. If they believe you’re ready, then transfer usually happens within the next week! Every clinic is different so keep that in mind, however my clinic then wants me to be on progesterone in oil injections for 6 days prior to the actual transfer date. So yes, more shots in the upper buttocks. These are the infamous PIO shots. They hurt, they make your leg twinge and with every shot, your back side feels like someone kicked you with high heels on. But we do what we got to do right? These shots will continue with you until about you’re 9 weeks pregnant. So as much as we hate them, we also want them to stick around!
So here we are, almost ready for transfer. My clinic then has me take doxycycline and prednisone for 6 days. This allows the body to prepare for a “foreign object” and not reject the embryo. Needless to say, those two are not the best combination for weak stomach. But again, we pull through.
Transfer day is finally here!
Warm socks are a must (just an old wives’ tale that keeping your feet warm help keep your body and uterus warm for the embryo). We arrive at the clinic with a full bladder so that your bladder pushes your uterus to a more horizontal angle so that the embryo is easier to be placed in. We go back to the room where this procedure is done. The embryologist has thawed our embryo, and this is when they usually let you know if it made it or not. I’ve luckily never had one not make it but it’s still so nerve wrecking!
So, we put on our scrubs, my husband is always with me, and the nurse comes in with some warm blankets. Then I’m told to take a Valium (seriously best part). It clams my nerves, but it also allows for your muscles to relax which causes your uterus to avoid contracting for an easier embryo transfer. The room is quiet and calm. The nurse puts my legs in stirrups, and we wait for the doctor and the embryologist to arrive with the embryo.
This is my husband’s favorite part.
He usually gets to look in the microscope and see our little embaby! Once everyone is back in their spots the doctor proceeds. They call out my name and time of day (as if I died) and start the process. The doctor puts in a long tube through my vagina and into my uterus. He makes sure he finds the right spot as to where he wants to drop the embryo. Once he does this, he signals for the embryologist to prepare the embryo. The embryo is then taken out and sucked into this tiny tube. The doctor then takes that and with the long tube places it in my uterus. I usually don’t know what I’m looking for, but we are able to see tiny bubbles that are used for him to know if the embryo went in or not. It’s so amazing really, getting to see your potential baby being implanted! The embryologist checks the little tube in the microscope to make sure the embryo is out and if it is then the transfer was complete. We have a successful transfer.
I then have to lay there for about another 10 minutes. My bladder is so full, but I’m also petrified of using the restroom. Obviously, that does nothing to the embryo, but I still worry.
We get dressed and after emptying my bladder I’m wheeled chaired down to the lobby, and we are good to go. (Valium makes for a loopy state of mind so hence the wheelchair).
And that’s it! Now the dreaded two week wait commences to see if this embryo stuck (although my clinic checks blood work after 11 days).
So, you see, this transfer process is basically your finish line. And yet the actual transfer doesn’t really mean you’ve made it. The embryo has to stick! And for those of us who have miscarried before, even if the embryo sticks it’s still so scary. We still don’t know if this embryo will be our baby. But we pray and we hope because that’s all we can control in this entire process!!
Medical Disclaimer:
The information provided in this blog is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider or qualified medical professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog.
