If you’re considering in vitro fertilization (IVF) to help you and your partner conceive, you’ll want to learn as much as possible about the process. That’s where we come in!
This article will walk you through the embryo transfer process step-by-step.
What is an embryo transfer?
In vitro fertilization (IVF) is a fertility treatment where eggs are retrieved from the ovaries and fertilized with sperm in a lab to create embryos. An embryo transfer is a procedure where an embryo is placed in a woman’s uterus to help her conceive.
When is embryo transfer done?
The exact timing of the embryo transfer depends on the type of transfer and the fertility specialist’s recommendations. But in general, the goal is to transfer the embryos when the lining of the uterus is most receptive to implantation, which occurs on the sixth day of progesterone exposure.
Types of Embryo Transfer
There are several different ways to do an embryo transfer. Here’s a quick overview of each type:
Fresh Embryo Transfer
A fresh embryo transfer occurs 3 or 5 days after the eggs have been retrieved and fertilized. The benefit of a fresh embryo transfer is timing, as the transfer is done shortly after the IVF cycle. However, waiting and doing a frozen embryo transfer in some patients may lead to a higher success rate.
Frozen Embryo Transfer (FET)
A frozen embryo transfer (FET) is done after the embryos have been frozen. Often, at the time of embryo freezing, genetic testing of the embryo is performed to confirm the embryo has a normal number of chromosomes. At RMA, most patients undergo an FET because it has been shown to increase implantation rates and improve pregnancy outcomes.
Cleavage Stage Embryo Transfer
Cleavage-stage embryos are transfers that occur very early in embryo development when the embryo has 4-16 cells. They were once the most common type of embryo transfer, but now fertility specialists (including RMA) recommend blastocyst-stage embryo transfers instead. This is because blastocyst-stage embryos are more developed and have a higher chance of implantation, resulting in a successful pregnancy.
Blastocyst Stage Embryo Transfer
When an embryo is at the blastocyst stage, it’s more developed and can have as many as 200-300 cells. At RMA, we grow embryos in the IVF lab for up to seven days to reach the blastocyst stage before we transfer them.
Single Embryo Transfer (SET)
A single embryo transfer (SET) involves transferring just one high-quality embryo into the uterus. Genetic testing of embryos, called preimplantation genetic testing for aneuploidy (PGT-A), can allow us to choose the embryo with the highest chance of success for transfer. This can increase the chance of a successful pregnancy and reduce the risk of having twins or triplets.
Multiple Embryo Transfer
Multiple embryo transfers are when two or more embryos are placed in the uterus at the same time. The American Society of Reproductive Medicine (ASRM) doesn’t recommend routine multiple embryo transfers because they increase the risk of multiple gestations and associated complications. A single embryo transfer is recommended for most patients.
Embryo Transfers: What to Expect
After weeks of fertility treatments and excitement, embryo transfer is the moment when our patients take a big step toward getting pregnant. Below, we’ve covered the embryo transfer process and what to expect before, during, and after the procedure.
For a frozen embryo transfer, you can either do a natural cycle transfer or a medicated cycle transfer.
In the natural cycle, we time your transfer based on when you ovulate in your own natural cycle. In this case, you only use a trigger shot (on the day that we detect ovulation) and vaginal progesterone tablets 2x/day. The downside of this approach is there is less certainty about when the transfer happens (because it depends on your own natural ovulation). The pregnancy rates are the same.
In the medicated approach, you take estrogen pills alone for two weeks, then you add progesterone injections, and the transfer happens on the 6th day of progesterone injections. The good thing about this cycle is that it is more planned. The downside is the progesterone injections.
The success rates between the two are the same.
The embryo transfer procedure takes 10-15 minutes. It doesn’t require sedation, and there’s minimal downtown afterward. You should arrive for your embryo transfer with a full bladder, as this will help the doctor see clearly using an abdominal ultrasound. You will have a speculum exam with the doctor during the procedure while an ultrasound is performed. Your embryo is then transferred into the uterus using a thin, flexible tube called a catheter.
The Embryo Transfer Process: What to Do Before and After Embryo Transfer
To prepare for a FET, there are a few steps to follow before and after the embryo transfer. It’s important to be both physically and mentally prepared for this step of the IVF process, as it marks a pivotal moment in the journey towards pregnancy.
Before Embryo Transfer:
- Eat a healthy diet
- Avoid smoking, excessive caffeine consumption, and alcohol.
- Get plenty of rest.
- Take all medications prescribed by the fertility specialist as directed.
- Stay hydrated by drinking plenty of water.
After the Embryo Transfer:
- Take it easy and avoid strenuous activities for the next few days (including sex, exercising, heavy lifting, and vigorous physical activity).
- Get plenty of rest and prioritize self-care.
- Avoid baths and hot tubs.
- Take prescribed medications as directed by the fertility specialist.
Embryo Transfer Cost
The cost of embryo transfer varies depending on several factors, including the fertility clinic and the patient’s insurance coverage. However, the average cost of embryo transfer in the United States is around $3,000-$5,000.
This cost doesn’t include additional expenses such as medications, follow-up appointments, and necessary diagnostic tests. Using donor eggs or a sperm donor can also increase the cost of the procedure.
Learn more about the cost of IVF in our guide, “The Real Cost of IVF.”
FAQs
Below, we answer some of the most common questions about embryo transfer and the IVF process, including success rates and who is a good candidate for embryo transfer.
How many days after egg retrieval is embryo transfer?
A frozen embryo transfer typically occurs about 1-2 months after your egg retrieval. However, the exact timing will depend on the development of the embryos and the recommendations of the fertility specialist.
Age, embryo quality, and other medical factors may also influence the timing of the transfer.
Is embryo transfer painful?
Embryo transfer is a minimally invasive procedure that generally causes little to no pain. Most patients report feeling only mild discomfort or pressure during the procedure, similar to a pap smear.
What are the odds of getting pregnant with embryo transfer?
According to the Society for Reproductive Technology (SART), success rates vary on a variety of factors, including age, embryo quality, and the number of embryos transferred. (Remember, transferring more embryos doesn’t exactly increase the chances of a successful pregnancy, but it does increase the risk of multiple pregnancies.)
Here’s a quick breakdown:
- Age: In untested embryos, the success rates of embryo transfer decline as a woman ages. When embryos are euploid, they have a high success rate regardless of age.
- Embryo quality: High-quality embryos are more likely to implant and result in healthy pregnancy.
- Sperm quality: Poor sperm quality can reduce the chances of success.
- Medical history: Certain medical conditions, such as endometriosis and uterine fibroids, can make it harder to get pregnant.
- Lifestyle factors: Smoking, obesity, and excessive alcohol consumption can also reduce the chances of a successful embryo transfer.
What can I do to increase the chances of a successful embryo transfer?
There’s never a guarantee of success with any medical procedure, but there are some steps a person can take to improve their chances of a successful embryo transfer:
- Follow the fertility doctor’s recommendations, including any lifestyle changes or medications prescribed.
- Maintain a healthy lifestyle by eating a balanced diet and getting enough sleep.
- Stay positive and recruit a strong support system.
- Prioritize mental and emotional well-being throughout the process.
How much progesterone should I take after embryo transfer?
You will do the transfer on your 6th day of progesterone. The dosage and duration of progesterone supplementation after embryo transfer vary depending on the fertility specialist’s recommendations and individual factors.
How long after embryo transfer can you take a pregnancy test?
It’s recommended to wait 10-12 days after embryo transfer to take a pregnancy test. Taking a pregnancy test too early could give a false negative result.
Speak with Our Fertility Specialists
If you want to learn more about IVF or other fertility treatments, our team is here to help guide you. They can answer your questions, help you develop a treatment plan, and provide the support and guidance you need.
At RMA, we understand that infertility can be a challenging and emotional experience. That’s why we’re dedicated to providing compassionate and personalized care every step of the way.
