How to prepare for embryo transfer

When it comes to the embryo transfer it is the cornerstone of any fertility treatment. It is the final step of the IVF process, and after weeks of being monitored and taking medication to help the process this is the moment when all your work and effort come to and end; the transfer will either take resulting in pregnancy or the transfer will be unsuccessful requiring another round of IVF treatment. This is the point where it becomes a waiting game with fingers crossed hoping for implantation.

Implantation is what occurs when the embryo attaches to the wall of the uterus into the endometrial lining. With IVF this usually occurs one to five days after the embryo transfer. During an IVF cycle a woman takes medication to make her endometrial lining as thick as possible to help increase her chances of successful implantation.

There are two major factors that affect the chance of successful implantation, the first is the quality of the embryo and the second is the receptiveness of the uterus.

Embryos are at their healthiest state when the eggs used are young, which is why we see a decrease in the number of successful transfers as the eggs used come from older women. Poor egg quality results in embryos that are often not healthy enough to complete implantation resulting in a non-successful pregnancy. In many cases a woman whose eggs are not healthy enough for the IVF process can use an egg donor to help increase their chances.

The human body is a complex organism and so many factors contribute to how receptive the uterus is to implantation. Which is often the case when it comes to women who have spent years attempting to become pregnant to no avail. Among the many factors that contribute are hormones, autoimmune disorders, thyroid function, trouble with building a uterine lining as well as the shape and position of the uterus. In some cases, these issues can be solved with medication to help increase, decrease or stabilize the issues, in other cases this is where a surrogate becomes a necessity to complete a successful IVF cycle.
The clinic will run a series of diagnostic tests and images to help determine the problem in order to attempt to solve it. Unfortunately, once following the doctor’s recommendations on medication and health there is little a woman can do to ensure implantation, the process is out of the woman’s control and all she can do is wait and see, stressing too much can cause more problems, it is best to relax and wait and give the process a chance to work.

Embryos are transferred three to seven days after being monitored in the lab. Blastocysts are embryos that have been monitored for at least 5 days which allows for more testing of the health of the embryo which allows for transfer of the healthies and most viable embryos which is known to increase the rate of successful implantation.

This is a technique that is used to ensure that the embryos have the right number of chromosomes. It is where the embryologist screens for genetic mutations that could cause implantation failure.

PGD is a screening test used to screen for single-gene disorders where parts of chromosomes are rearranged. This test is used primarily when a patient is concerned about specific disorders or genetic abnormalities such as Cystic Fibrosis, Tay Sachs or other severe genetic disorders.

Both tests are done in a lab and pose very little risk to the embryos.

In the case where genetic testing is not performed there are other techniques that can offer insight into both the health and development of the embryo.

Embryos in the early stage of development are surrounded by a thin membrane that is known as the zona pellicuda. In order for an embryo to complete successful implantation the embryo must ‘hatch’ from this membrane. In the technique known as assisted hatching the embryologist uses a microscope to create a tiny hole in the membrane which can help to improve the chance of implantation.

With this technique the embryo is placed in an incubator called the EmbryoScope which takes photos of the embryo every few minutes and then creates a time lapse video that the embryologist can watch to determine how the cells are dividing and developing. These patterns in development can help the embryologist to determine the health of the embryo and ensure that the best embryos are chosen for transfer.

In most IVF cycles medication is used to manage and control your hormones both before and after transfer to help prepare your endometrial lining to ensure that most ideal uterine environment for implantation and embryo development.

Your doctor will discuss the best treatment plan as well as the number of embryos to transfer.

With eSET the healthiest embryo is chosen for transfer, with other viable embryos frozen for future use with cryopreservation, this procedure is often used when the embryos are at the healthiest state or when there may be more risks involved with carrying multiples.

When more than one embryo is transferred it is most often for one of two reasons; the health of the embryos is not ideal so transferring multiple embryos will increase the chance of at least one embryo implanting or when the parent(s) are hoping to increase their chance of multiple birth.

You will be given the opportunity to both confirm your identity and the number of embryos to transfer. You may be asked to arrive at the clinic with your bladder half full which can help to improve visibility of the abdominal ultrasound when it comes to transfer.

The embryos transfer will feel much like a Pap Smear. The entire process is a quick procedure that will only take about 15 minutes, with the transfer itself being under a minute. During this procedure a speculum is placed in the vagina and your cervix is washed and cleansed to prevent infection. The embryos are placed into a catheter and passed into the uterus. You will be able to watch the transfer take place on the ultrasound screen.

In most cases the woman is asked to relax with her legs slightly elevated for about 15 to 30 minutes following transfer, this is not always the case but it is good practice to relax and allow your body to do the work.

Not really, our bodies are largely out of our control. However, there are some ways to help the health of your uterus.

Try massage, gently massaging your abdomen can help with digestion and to remove toxins from your body. You may also want to try fertility yoga which can help to relieve stress.

Try to avoid being cold, cold hands and feet can mean poor circulation and at this point you really want to ensure blood is circulating to your uterus.

Get your rest, now is not the time to exhaust your body, your body needs its rest to ensure that is has the energy to do what you need it to do in the upcoming weeks.

Try not to stress, stress always has negative impacts on your body and can cause unnecessary problems. If your struggling watch a movie that will make you laugh or even try some laughing exercise. Laughter is always the best medicine for stress.

After transfer there is no set way to ensure implantation. It is recommended that you take it easy and relax. Bed rest can be beneficial in the days that follow and maintaining a low stress environment can be vital, which can be hard in the dreaded two weeks wait following transfer before taking that official pregnancy test to determine whether the transfer was a success or not. It is important not to overwork yourself with vigorous exercise which can lead to uterine contractions which is not something you will want to risk at this point.

When it comes to your diet, it is important to eat healthy, there are no superfoods to ensure implantation success, but it is important to eat as though you are already pregnant to ensure that should the transfer result in successful pregnancy that the baby is getting the proper nutrition right from the start. The clinic will most likely have you taking folic acid and prenatal vitamins when transfer takes place.

Act as if you are pregnant so the same rules would apply as though you were 5 or 6 months pregnant, you will want to avoid things like hot tubs and saunas as these are not healthy for your body during pregnancy.

In the weeks following transfer you will want to avoid things that could cause infection, transfer entails a procedure that can leave your lady parts sore and sensitive, but also susceptible to infection so it is important to avoid submerging yourself in water for a few weeks to allow yourself a little time to heal and prevent infection.

Waiting can be hard but remember good things are worth the wait