IVF: What to Expect During Embryo Transfer? The ‘Glance Inside’ the Procedure

Embryo Transfer day is that day you have been waiting for so long. You may literally ‘GLOW’ from inside. You may have already envisioned in your mind this day. You may consider that this day is unique. But you won’t feel this way that day. You will be thrilled and scared. ‘What if…’ questions will whirl in your mind and make you nervous.

If you knew that you would have to go through IVF cycle, this day means you have the transfer of your perfect 5–day embryos. The five–day wait for your transfer will feel so long and you will experience  a bundle of nerves. The only thought you will have will be the phone call from your doctor. And when your doctor finally calls you, it will be a blow to your heart. You will be so emotionally overwhelmed that nothing would bother you.

Even if your doctor retrieved 10 oocytes, only several of them would be fertilized correctly. Even if they fertilize 6 of them correctly, you know the odds of all 6 of them making it to day 5, may slim to none. If you are lucky, you will have one, and if you are super lucky, you will end up with 2 or 3 of them. Actually, three embryos would have been amazing to have. Three embryos would have meant the chance that maybe, just maybe, one of them would grow to full term.

After the phone call with your doctor on day 3, you will feel less anxious. At least you will know that 4 of them are still growing and doing well. At least three of them will make it to day 4. Surely you know in your heart that they aren’t all going to make it to day 5, but you will hope. Your doctor would tell you that if any of them made it to day 5, you would get a phone call. Your Embryo Transfer would be scheduled. This phone call will be the confirmation ‘to be or not to be’.

It would be another agonizing two days of waiting for that phone call. That unique morning will come. And you will nervously wait for your doctor’s call. This call will be the so–called ‘Confirmation’ that they have at least one perfect 5–day embryo for your Embryo Transfer. Eventually, your doctor will call you and tell you that they have one perfect 5–day embryo. You will ask what has happened with your other embryos but no one will answer. Because they JUST don’t want to frustrate you before the Embryo Transfer Procedure. Later, if you insist, you will be told that all those embryos had stopped growing between 4–5 days.

Excitedly, you will go to your appointment knowing there is a perfect 5–day embryo waiting for you. You will come to the clinic and wait near your doctor’s office for the appointment. You will be asked to drink lots of water because you need full bladder so your doctor can see what he/she is doing on ultrasound. You doctor even can show you a picture of your little embryo. It would be one of the most intriguing and beautiful things you have ever seen in your life. You won’t believe that is your future [possible] small bundle only 5 days old now.

You will wait for the Reproductive Embryologist to come and bring your embryo into the room. Finally, the Reproductive Embryologist will come into the room holding a long tube with a plunger at the end. And it will be the time to replace this small embryo–bundle from the tube inside your uterus. The procedure of Embryo Transfer takes only several minutes. It takes all of three minutes to insert a weird kind of catheter, get it to where it needs to be, accurately place your little embryo inside your uterus, and that is all.

Your doctor may give or not give you the pain medications before the Embryo Transfer. This procedure is usually painless and a little uncomfortable. You will have to lie for 30–40 minutes after the embryo implantation to let everything accurately settle. You will want to pee so bad it hurt. In your medical history, your doctor will note down the weird term ‘PUPO’ (pregnant until proven otherwise). In 5 days past the day of the embryo implantation, you will have to do a pregnancy test. If your pregnancy test is positive, there will be nothing left to do but wait for a visible positive ultrasound scan, indicating the heart activity of your little embryo at around 7 weeks.

CONCLUSION

Basically, there are two possible options for the Embryo Transfer. You may be proposed a Fresh Embryo Transfer or a Frozen Embryo Transfer. Fresh Embryo Transfer means that they transfer one or two perfect embryos back into your uterus on Day 5. Sometimes they transfer one or two perfect embryos back into your uterus on Day 3 if they consider that one embryo–bundle or both your little perfect embryos will grow better in your uterus, during this same IVF Treatment cycle.

Frozen Embryo Transfer means that they will freeze all the perfect embryos that make it to Day 5 or 6. And they will do a Frozen Embryo Transfer (FET) in a month or two later when your hormonal levels will be normal. Frozen Embryo Transfer may be recommended you if your doctor suspects you will have OHSS and opts for a Lupron trigger, or if you do an HCG trigger and it does cause OHSS. Since OHSS is caused by HCG (the pregnancy hormone), pregnancy makes it much, much worse than you can imagine. Abnormal hormonal levels can be very dangerous, both for you and your tiny embryo. It’s worth it to wait it out if you are at risk for it.

If you’re doing a Fresh Embryo Transfer, you will start progesterone supplements a few days after your Oocyte Retrieval (that means more shots, yay for you if you are a Needle–Phoebe). And means that you will head to your clinic on Day 5 with a full bladder because it helps the ultrasound tech and your doctor to see your uterus. First, you will meet with the Reproductive Embryologist, who will show you your little embryo [embryo–bundle, or embryo–baby], ask you to sign the papers about how many embryos they are going to transfer, and then give you the gown to put on before heading back to your doctor’s room or Operating Room.

When you get back to your doctor’s room or the Operating Room, it’s exactly like the mock transfer you had before. You will even literally glance inside the Procedure and watch your tiny embryo be implanted into your uterus.

Then you will have to wait. Two–week wait. During all this time you will be anxious and nervous about your tiny embryo. During all this time, you are considered “Pregnant Until Proven Otherwise” (PUPO). Nine days post Embryo Transfer procedure you will need to go to your clinic for the pregnancy beta blood draw. This blood test will show whether you are pregnant or not.

If your beta blood draw is negative, you still have a lot of treatment options for your next step. You can try again with a Frozen Embryo Transfer cycle if you had frozen embryos leftover. If not, you can do another round of IVF Treatment cycle. And you may also discuss with your reproductive Endocrinologist such options as ICSI or PGS Testing.

If you want to start a Frozen Embryo Transfer cycle, you will wait for a period to start. Once it does, you will start taking oral estrogen daily, to help thicken your uterine lining. You will take this for three or four weeks, with a couple of external ultrasounds to see how it is coming along.

Once your uterine lining is all cushy, you will start taking progesterone supplements, likely in the form of Progesterone-In–Oil (PIO) injections. Since you are not going to be ovulating, you will be completely dependent on the supplements for your progesterone. Needles and syringes again, yay!

Your Reproductive Embryologist will defrost your chosen tiny embryo, and then they will place it in your uterus. You will continue doing the PIO shots throughout your 9–day two week wait, and likely throughout your first trimester if it’s successful. If it doesn’t work this round, you can keep doing more Frozen Embryo Transfer cycles with any perfect frozen embryos you have, or do another round of IVF Treatment cycle (with PGS or ICSI, if needed).