Embryo Transfer Process

April 10, 2020

How Many Embryos Should I Transfer

Author Name: Dr. Prachi Tandon || Mentor Name: Dr. Kanika Kalyani on April 09, 2020

➢ What is Embryo Transfer ?

▪ Embryo Transfer is a very crucial step in IVF- In Vitro Fertilisation in which embryos are placed in the Uterus with the help of a catheter to achieve a pregnancy.

▪ Embryo Transfer Process is a very important step as success rate of IVF cycle depends significantly on how efficiently embryo transfer is done.

✓ Factors for successful implantation of Embryo –

▪ Reliable IVF Lab
▪ Experienced Embryologist
▪ Good quality embryo
▪ Healthy Endometrium with good thickness and receptivity
▪ Optimal embryo transfer process

➢ When IVF-Embryo Transfer is needed ?

In cases where conception has not taken place naturally or through repeated cycles of IUI (Intrauterine Insemination) –

▪ Females with Ovulation disorder
▪ Females with blocked or damaged Fallopian tube
▪ Uterine pathology
▪ Impaired semen parameters

➢ Types of Embryo Transfer

▪ Fresh Embryo Transfer-
When embryos formed in an IVF cycle are cultured for 3 or 5 days and the best embryos are transferred in uterus in the same cycle as ovarian stimulation.

▪ Frozen Embryo Transfer-
When good quality embryos formed in IVF cycle are cryopreserved, thawed and transferred in next month or so. Also known as “freeze all” protocol.

✓ Frozen vs Fresh Embryo Transfer ; which is better ?
Various studies suggest that frozen embryo transfer is better than fresh embryo transfer because-
▪ Pregnancy rates are better with frozen embryo transfer.
▪ If more than two embryos are formed they can be cryopreserved and could be used later instead of going for fresh IVF cycle again.
▪ Genetic testing could be done.
▪ Cryopreserved embryos have more rate of implantation.

➢ Preparation before Embryo Transfer Process

▪ During IVF , hormonal injections are given to stimulate ovaries and ovarian follicular development is monitored by ultrasonography.
▪ Mature oocytes are retrieved from ovaries , this process is called Ovum Pick-up.
▪ Retrieved oocytes are fertilized with sperm and cultured in an embryology lab.
▪ Considering day of ovum pick-up as day 0, embryos are cultured till day 3 or day 5. Day 5 embryos are called Blastocyst.
❖ Recent data suggest that blastocyst transfer has better implantation rate.
▪ In frozen embryo cycle , good quality embryos formed are frozen at either day 3 or day 5 after discussing embryo status with the patient and taking their consent for freezing.

➢ Timing of Embryo Transfer Process

▪ When frozen embryo transfer is planned, estrogen is given to the patient for endometrial preparation from day 2 to day 14 of her periods.
▪ Then endometrium assessment is done by ultrasonography . If endometrium thickness is good and endometrium looks healthy then progesterone support is added and date of embryo transfer process is scheduled depending upon which day (day3 or day5) embryo was frozen.
▪ Blastocyst transfer is done on day 6 of starting progesterone.

➢ How many embryos to be transferred

▪ 1 or maximum 2 embryos can be transferred in the uterus to avoid risk of multiple pregnancy.
▪ Decision about single or double embryo transfer depends on following factors –

a. Age
b. History of previous IVF failure
c. History of medical disorders like hypertension, diabetes mellitus ,coagulation disorders etc.
d. Patient’s will
e. Bad Obstretic history

➢ Embryo Transfer Process

▪ Embryo transfer process is short and usually painless and does not require anaesthesia.
▪ Firstly, patient’s details are checked and confirmed by Embryologist.
▪ Embryo transfer is done under ultrasonographic guidance with full bladder.
▪ Catheter containing embryos is passed through cervix into the uterus under sonographic guidance.
▪ Embryos are then released into uterine cavity.

➢ Post Embryo Transfer Process

▪ Relevant medicines are prescribed to the patient
▪ Patient is asked to follow up after 14 days to do pregnancy test i.e. beta HCG test to determine the result of IVF cycle.

➢ Post Embryo Transfer do’s and don’ts

▪ Bed rest is not required after embryo transfer; avoid lifting heavy weight and any strenuous exercise.
▪ Take healthy diet inclusive of antioxidants and avoid outside food.
▪ Avoid using public washrooms and maintain proper hydration to avoid urinary tract infection.
▪ Avoid any stress and negative thoughts.
▪ Take medications prescribed after embryo transfer properly.

Embryo Transfer is a relatively painless procedure.
Success of an IVF cycle depends on several factors including efficiency of embryo transfer process.
According to recent survey, standardization of Embryo Transfer Process is considered one of the most important factors influencing the success rates in IVF.
Therefore it is crucial to choose a centre with a reliable lab with advanced technologies and has a good success rate.

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