Understanding the Process of Embryo Transfer

Embryo transfer can be denoted as a significant step in many assisted reproductive technologies (ARTs), especially in in vitro fertilisation (IVF). During the procedure, a healthy fertilised egg, which is now converted into the blastocyst stage in the IVF laboratory, has been placed inside the woman’s uterus. The process is done using ultrasound guidance and a special catheter.

The successful implantation of the embryo transferred signifies the beginning of the pregnancy. Certain hormonal medications are given to assist the embryo in getting implanted inside the thickened endometrium (lining of the uterus). The thickened endometrium creates a supportive environment for the transferred embryo to attach and develop. This endometrium is also thickened by hormonal medications right before the embryo transfer. The process of thickening is closely monitored by your fertility specialist using ultrasound scans. Once the lining reaches an ideal thickness (typically 7-14 mm), the embryo transfer is scheduled.

Furthermore, unlike egg retrieval, embryo transfer is a painless process, which may also sometimes be done without anaesthesia.

Let’s have a quick look at what happens after embryo transfer day by day.

Types of Embryo Transfer (Frozen vs Fresh)

Embryo transfer may generally be done using either frozen (cryopreserved) or fresh embryos. Women with the reduced risk of OHSS (ovarian hyperstimulation syndrome) and stable hormone levels are largely considered suitable for fresh embryo transfer. Whereas, women with a higher level of hormones, those who require more time to improve uterine lining, or require preimplantation genetic testing (PGT) are recommended for frozen embryo transfer.

However, many fertility specialists prefer to use frozen embryos for their improved pregnancy outcomes when compared to fresh ones. In a nutshell, the choice between frozen and fresh embryo transfer basically depends on the patient’s hormonal status, medical condition, and the quality of the embryos.

The types of embryo transfer, their processes and advantages may include:

Frozen Embryo Transfer (FET)

Process

The fertilised egg is frozen using the cryopreservation method. The preserved embryos are thawed for use right before the transfer.

Advantages

• The process provides the flexible time to plan for the embryo transfer.
• Allows more time to improve the uterine receptivity (thicken endometrium) for better implantation outcomes.
• Reduces the risk of complications during pregnancy.
• Increases the live birth success rates.
• When needed, preimplantation genetic testing can be done on the embryos before the embryo transfer procedure.

Fresh Embryo Transfer

Process

The fertilised and developed egg from the IVF laboratory, around day 5 – 7 after the egg retrieval, is used during the embryo transfer. This procedure skips the freeze-thaw process (cryopreservation) altogether. The 5-to-7-day window is a standard timeframe to analyse and choose the potential embryo for the embryo transfer procedure.

Advantages

• Using fresh embryos during embryo transfer can make the process quicker, as the transfer can be done in the same cycle.
• Helps to reduce the cost of the cryopreservation technique.

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What Happens After Embryo Transfer?

Here comes our showstopper!

After embryo transfer, a woman’s body may undergo several changes day by day. The listed below is the detailed breakdown of what happens to the embryo after transfer.

The process begins with placing a healthy blastocyst (embryo) inside the woman’s uterus.

Day 1:

On day 1, the transferred blastocyst initiates to hatch out of its outer membrane. The membrane is known as the zona pellucida. In the meantime, it remains free-floating, trying to locate the right spot for implantation.

Some women may notice bloating or mild cramping at this stage. This could specifically happen because of the embryo transfer procedure.

Day 2:

On day 2, the transferred blastocyst remains to divide and grow further. During the process, the endometrium supplies sufficient nutrients to nourish and support the embryo for potential implantation.

Day 3:

Around this time, the embryo might have located the right spot for implantation inside the endometrium (the lining of the uterus). Some women notice a slight vaginal bleeding during the process. The bleeding is medically termed as implantation bleeding. This is generally considered a positive sign of the procedure.

Day 4:

At this stage, the outer layer of the blastocyst grows into an amniotic sac and placenta. While the inner layer of the blastocyst grows into an embryo, which further digs inside the lining of the uterus to settle firmly. The moment it starts to grow a placenta, the woman’s body starts to release essential pregnancy hormones like hCG (human chorionic gonadotropin). The process is significant to create a connection between the mother and the embryo for blood circulation, oxygen supply, and necessary nutrients.

Day 5:

Around day five, the transferred embryo is firmly settled by implanting deeply inside the wall of the uterus. The woman’s body continues to produce more hCG hormone, which is recognised in the pregnancy tests to confirm the conception. However, doing pregnancy tests at this stage can be considered the earliest detection. The tests may require more hCG levels to be detected, which would double every other day. That is the reason why many fertility specialists recommend waiting for two weeks after embryo transfer to take a pregnancy test.

Day 6:

On day 6 of embryo transfer, the successful implantation continues to trigger the hCG hormone to gradually enter the bloodstream. This significantly signals the maternal body to remain nourished and maintain the pregnancy. Around this time, some women may notice early pregnancy symptoms like morning sickness, nausea and vomiting, breast tenderness, and mild cramping.

Day 7 onwards:

The beginning of the pregnancy may trigger sudden hormonal fluctuations. This leads to intense early pregnancy symptoms from day 7 of embryo transfer onwards.

Day 14:

Around this time, your two-week waiting period is considered to be completed to confirm the pregnancy. Many fertility specialists recommend performing the pregnancy test on day 14 of embryo transfer. The higher levels of hCG hormone in the pregnancy test may denote a successful pregnancy.

Note that the entire process may not exactly happen on the same day as mentioned above. The days may vary slightly from woman to woman depending on their uterine lining’s receptivity, age, hormonal status, and medical conditions.

What are the Things to Do After Embryo Transfer?

After embryo transfer, it is important to follow certain things. They may include:

Stay hydrated

Staying hydrated after embryo transfer may increase the chances of successful implantation. This is because the hydration can enhance the blood flow in the uterus, establishing a supportive environment for the implantation.

Never skip medications

The prescribed hormonal medications, like progesterone and estrogen, are significant after embryo transfer. This is because they may contribute to support implantation by thickening the lining of the uterus and embryo development.

Eat a balanced diet

A balanced diet is essential after an embryo transfer for successful implantation. This is because a healthy pregnancy requires a healthy uterine lining, balanced hormone levels, and immunity. All of these can be attained from a nutritious and balanced diet.

Ensure Proper Rest

Rest is important after embryo transfer. This is because they may help in managing stress and focusing on the pregnancy. However, complete bed rest is not necessary to encourage the implantation. Rather, you may prioritise having quality sleep and practising stress-reducing activities like yoga and meditation. You may also avoid doing heavy lifts or workouts, specifically after embryo transfer.

Avoid alcohol and Smoking

Alcohol consumption and smoking can certainly have a negative impact on the implantation process. These harmful habits may interfere with the endometrial thickness. This may possibly reduce the chances of successful implantation and pregnancy development.

Summary

When it comes to embryo transfer, staying positive is the key. Even if you come across several negative attempts, the next one has numerous chances to fix it. Having open communication with the healthcare provider on both your emotional and physical struggles can help ensure personalised care and informed decision-making.

Remember that all these struggles may vanish once you see those two lines on the pregnancy test.