Preparing for an IVF embryo transfer usually involves medication to help your uterine lining develop, ultrasound scans and blood tests to monitor your cycle, and carefully timing your embryo transfer and the commencement of progesterone. Your fertility clinic will plan each step around your cycle, medical history and the embryo being transferred.
Reaching the embryo transfer stage is a big moment. You’re feeling hopeful, excited, nervous or a mixture of everything at once. But knowing what lies ahead can make the process feel a little less overwhelming. Read on for our guide to IVF, embryo transfers and the ways you can prepare your body and mind.
What is IVF?
In vitro fertilisation, usually called IVF, is a fertility treatment in which an egg is fertilised with sperm in a laboratory.
During IVF using your own eggs, medication stimulates your ovaries before the eggs are collected. With donor egg IVF, donated eggs are fertilised using sperm from your partner or a sperm donor. An embryo is then transferred into your uterus.
What is an embryo?
An embryo begins to form after an egg is fertilised by sperm. The fertilised egg starts dividing into more cells as it develops.
Embryos are monitored in the laboratory for several days. A day-three embryo is usually at the cleavage stage, while an embryo that develops to day five or six and reaches certain criteria is known as a blastocyst.
Read: What is an Embryo Guarantee, and how does it work?
What is an embryo transfer?
An embryo transfer is a short procedure in which a fertility specialist places an embryo inside your uterus using a thin, flexible catheter.
An embryo transfer and implantation are two separate stages. The transfer places the embryo in your uterus. Implantation happens later when the embryo attaches to the uterine lining.
What are the different types of embryo transfer?
Fresh and frozen embryo transfers
A fresh embryo transfer takes place several days after an egg has been fertilised. A frozen embryo transfer, also called an FET, uses an embryo that was frozen during an earlier stage of treatment and thawed before the procedure.
Frozen donor eggs and frozen embryos are also different. A donor egg is frozen through vitrification, warmed and fertilised at your fertility clinic. The resulting embryo is then transferred fresh or frozen for a future cycle.
Day-three and day-five embryo transfers
A day-three transfer uses an embryo at the cleavage stage. A day-five transfer usually uses a blastocyst, which has developed for longer in the laboratory. Your fertility team will recommend the timing that suits the embryo and your treatment plan.
Single and multiple embryo transfers
A single embryo transfer places one embryo in the uterus. In some circumstances, a specialist may discuss transferring more than one. The decision considers factors such as embryo quality, age, treatment history and the health risks associated with a multiple pregnancy.
How to prepare for your embryo transfer
Follow your treatment cycle
A natural cycle follows your own ovulation. A modified natural cycle may use medication to help control the timing. A medicated or programmed cycle uses hormones to prepare your uterus.
Medicated cycles are often used for donor egg treatment because they allow the clinic to carefully coordinate your uterine lining with the embryo’s development.
Take your medication at the prescribed time
Oestrogen can be prescribed as tablets, patches or another form. It helps the endometrium, or uterine lining, grow in preparation for a possible pregnancy.
Progesterone is then started at a carefully chosen time. It changes the lining so that it becomes receptive to an embryo. The number of days you take progesterone before the transfer is matched to the embryo’s stage of development.
Taking each dose at the prescribed time is important. Ask your clinic about any vitamins, supplements, herbal products or other medicines that you may use.
Attend your monitoring appointments
Your clinic may use ultrasound scans to measure your uterine lining and blood tests to check your hormone levels. The results help your fertility team decide when your body is ready and when to do the transfer.
Care for your general health
Regular meals, gentle movement and restful sleep can support your wellbeing during treatment. Follow your specialist’s advice about exercise, alcohol, caffeine and any health conditions you manage.
Your clinic will also give you instructions for transfer day. Many clinics ask you to arrive with a comfortably full bladder because this can help the ultrasound provide a clearer view of the uterus.
How to prepare emotionally for an embryo transfer
The emotional side of an embryo transfer deserves care too. A study of 1,000 couples seeking fertility treatment found anxious symptoms in 14.7% of women and depressive symptoms in 17.9%. So whatever you’re feeling during treatment, many other women have felt it too.
You may find it helpful to:
- Decide who you feel comfortable telling about the transfer.
- Let trusted people know how they can support you.
- Plan work, meals and appointments ahead of time.
- Choose some distractions for the wait before your pregnancy test.
- Speak with your clinic’s fertility counsellor.
You can also find a fertility counsellor through the Australian and New Zealand Infertility Counsellors Association.
What happens during the embryo transfer procedure?
Getting ready
When you arrive, your clinic will confirm your details and the embryo being transferred. You may be asked to arrive with a comfortably full bladder to help your specialist see your uterus more clearly on the ultrasound.
Placing the catheter
You will lie on an examination bed while your specialist gently inserts a speculum into your vagina. A thin, flexible catheter is then passed through your cervix and into your uterus.
Transferring the embryo
The embryo is carefully released through the catheter into your uterus. Your specialist will usually use ultrasound guidance to confirm the catheter’s position.
An ASRM review involving thousands of patients found that ultrasound-guided transfers were associated with higher clinical pregnancy and live birth or ongoing pregnancy rates than transfers performed using clinical touch alone.
Completing the procedure
After the transfer, the embryologist checks the catheter to confirm that the embryo has been released. The procedure is usually brief, and anaesthesia is rarely needed. You may feel some pressure from your full bladder or experience mild cramping.
What happens after an embryo transfer?
Your clinic will explain how long to continue your medication and when to have your pregnancy blood test. If you have a blastocyst transfer, the wait for your pregnancy test may be a few days shorter than it would be after an earlier-stage embryo transfer. Most people can return to gentle everyday activities after the procedure. Your clinic will let you know what is right for you.
Cramping, spotting, bloating and breast tenderness may occur during the wait. You may notice symptoms that feel like early pregnancy, although these can also be caused by progesterone. Your pregnancy test will give you a clearer answer.
You don’t have to navigate this alone
Every embryo transfer follows an individual treatment plan. Your fertility specialist and clinic will guide you through your medication, monitoring and procedure. If you are considering donor egg IVF, contact us to learn more about accessing donor eggs and undergoing treatment through one of our partner clinics.
