The final stage of IVF has arrived!
Human Embryo Transfer
• What Is An Embryo Transfer?
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|What Is An Embryo Transfer?
Embryo transfer is considered the final step of IVF treatment. This procedure involves inserting embryos created in the laboratory into the womb of the recipient woman. When you arrive for your transfer you will be taken to the same IVF suite where your egg retrieval process was done. Your partner can accompany you, but both of you will need to wear sterile gowns because it is a sterile area.
Embryos can be transferred anytime between day 1 and day 6 after egg retrieval. A day 3 embryo transfer is more common, although day 5 embryo transfer is also possible (it is called a blastocyst transfer).
Anesthesia is not used, although a sedative like valium may be given to help you relax and prevent cramping. Studies show that reducing cramps to the point where you can't feel them improves your chance of pregnancy by 50 percent. You will be asked to lie on a bed that tilts. You may be slightly uncomfortable because your doctor will have instructed you not to empty your bladder. A full bladder makes it easier to spot your womb (uterus) with ultrasound scan. An ultrasound probe will be placed on your tummy so that the uterus can be seen. The doctor will insert a speculum into the vagina and wash your cervix removing any mucus. The speculum is left in place and the embryologist is told you are ready. Your doctor will insert a long thin tube called a catheter through your cervix. The ultrasonographer will let the doctor know when the tube is near the top of the uterus. Once in place, the embryos are slowly injected through the catheter. The catheter is removed slowly and handed back to the embryologist who checks it under a microscope to make sure no embryos are stuck to it.
No, although you may experience some mild cramping. You will remain awake throughout the procedure.
If a transfer is traumatic in any way (for example if there is bleeding or severe cramping), your chance of pregnancy decreases. For this reason, a mock transfer may be carried out before the real procedure. This is where a soft catheter is inserted into the uterus and the depth of the womb and angle required to get to it is recorded (mapped). Mapping your cervical canal makes it easier to see the curves of your canal, and this information is used to ease the passage of the catheter during the actual transfer.
You may need to stay on the table with your legs tilted up for about half an hour. When you return home you will be recommended 2 or 3 days complete bed rest. This gives your embryos a better chance of implanting. Activity diverts blood to other organs in the body, whereas lying down allows it to flow to the womb. Don't worry, you cannot dislodge your embryos by having a bowel movement, urinating, coughing or sneezing.
It depends how 'old' the embryos were that you transferred. At the blastocyst stage (5 day embryos), they start to break out of their shell in the following 48 hours. Only then can they implant. If your embryos are 3 days old when they are transferred, it will take a few days longer to implant. The following is a more detailed timeline:
Ideally the embryos will be of good quality, the lining of the womb (endometrium) needs to have thickened and your body must not reject the embryos (known as an immulogical reaction). If an embryo sticks to the womb, it is said to have implanted, and pregnancy occurs.
Many couples anxiously wait for some of the early signs of pregnancy after transfer. However, you will need to wait at 12 to 14 days before testing. The results are not considered accurate if done before this because there could still be some HCG in your system from the injection you received before egg retrieval. An estimated 10 to 15 percent of women become pregnant, for the rest, the cycle needs to be repeated.
Most clinics will prescribe progesterone to help prepare the lining of the womb to accept the fertilized eggs. You will probably need to take this daily in pill or injection form until your pregnancy test. If you test positive, you may need to continue it for another few weeks until your body is producing adequate amounts on its own. You may also be prescribed aspirin, heparin or ritalin to help blood flow.
The more embryos that are transferred the higher the risk of multiple pregnancy and miscarriage. For this reason most clinics do not allow women under 30 to transfer more than 2 embryos. Between 30 and 35 they allow 3 embryos, and 4 embryos after 35 and up to 6 or more if you are aged over 40. In England you are only allowed to transfer 2 embryos if you are under the age of 40.
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