Luteal phase support
Following the egg retrieval, you have to start taking progesterone medication to prepare the uterus for embryo implantation.
If you are preparing for a frozen embryo transfer, your fertility consultant will inform you when and by what medication the luteal phase support should be started.
Typically the medication is administered as vaginal suppositories following a treatment schedule.
You may be prescribed additional medication to prepare your body for the forthcoming embryo transfer at your doctor’s discretion, such as folic acid or estradiol pills.
You have to continue taking your prescribed medication until the day of the pregnancy test.
Suppose your embryo is developing normally and reaches the stage of two to eight cells after a series of cleavage divisions (typically in about 48 hours). In that case, it can be transferred to the uterus (embryo transfer) on the third day after the egg retrieval. Alternatively, embryo transfer can be done on days four or five when the embryos have reached the blastocyst stage.
Embryologists place the embryo(s) in a very thin catheter, which is then introduced by the gynaecologist into the uterus under ultrasound guidance so that the embryos can be placed at the best position for implantation. The procedure is entirely painless and feels similar to having a PAP smear. You will be in the same position as during a regular gynaecological exam.
When you have more embryos available, your fertility consultant will decide how many and which to transfer to the uterus after discussing with the embryologist. The excess embryos can be frozen or discarded according to your wish. If you and your partner have decided to freeze the leftover embryos, please remember to sign the embryo cryopreservation agreement. You can receive the documents at the Information desk immediately after the embryologists have confirmed freezing was completed.
NB! The chances of attaining pregnancy are better when a greater number and higher quality embryos are transferred. On the other hand, the more embryos are transferred and the better their quality, the higher the risk of twin pregnancy. It is an undesirable complication because it holds risks for normal pregnancy development, for the babies (premature birth occurs four times more often), as well as for the health of the pregnant woman. For all those reasons, our medical team is always looking to balance the wish to improve the chances of successful implantation against limiting twin pregnancies in embryo transfer. Your fertility consultant will discuss with you the proposed number of embryos to transfer and the advantages and risks ensuing from that.
The embryologists will inform you when your transfer will be and give you detailed instructions on preparing for it.
- In contrast to egg retrieval, embryo transfer does not require that you make any specific preparations (like fasting) – on the contrary, please come full, well-rested and calm.
- You have to start drinking liquids (approx. half to one litre of water) about an hour and a half before the procedure. It requires a full bladder.
- If you have booked an acupuncture appointment (you will be offered one before the transfer), you will be guided to the specialised office on level -1, where the session will take a couple of minutes.
- Before proceeding to embryo transfer, you will be given a muscle-relaxing anti-anxiety injection. Your relaxation at this moment is of utmost importance. It will facilitate the passing of the catheter with the embryos past the cervix and prevent uterine contractions that could displace the embryo just transferred to a wrong location in the uterus.
Embryo transfers are performed by the fertility consultants in dedicated premises (manipulations offices) located on level 1 (the same are used for egg retrievals).
- After being called for your transfer, you will have to leave your clothes and personal belongings in the locker. You will be given single-use disposable shoes, a gown, and a bonnet.
- In the manipulations room, together with you will be your fertility consultant and a midwife. In the embryo box next door, the embryologist who has prepared the embryos for your procedure will be waiting.
- The manipulation itself does not cause any pain, so no anaesthesia is necessary. The only discomfort you may feel could be from the full bladder and the extra pressure of the ultrasound transducer.
- You will be informed if there are high-quality leftover embryos that can be cryopreserved.
When the procedure is finished, you will rest on the gynaecological chair for about 20 minutes. Those will be your moment of complete relaxation after the long series of injections, manipulations and different emotions you have endured in those several weeks of the adventure called IVF.
After the embryo transfer, you will receive the embryo report for the procedure, and your fertility consultant will assign you the necessary medication and give you lifestyle advice for the time until the pregnancy test.
Our advice for the days until the test:
This is the moment when we will know if we have succeeded if together we have attained the most cherished goal – to have a new life growing inside you.
We know that emotions can be too much and very diverse – from fear to euphoria, from sunny thoughts to faith shaken. We know that you are watching closely for every sign from your body that could give out the procedure has been successful.
Two weeks after the embryo transfer, you will make the pregnancy test – a urinary (dipstick) one or a blood test.
The blood pregnancy test is done at the clinical lab. Blood will be drawn from a vein in your arm and analysed to determine the level of beta-human chorionic gonadotropin (beta-hCG).
The urinary test is done at home. You mustn’t hurry to do it before day 12 after the transfer.
No matter the result, you have to call our IVF hotline (you will have it from the manipulations office) to receive guidance and recommendations on what to do next according to the case.