What is embryo transfer?
Embryo transfer refers to the process of introducing the planned number of embryos into the uterine cavity through a thin, elongated catheter inserted through the cervix. Embryo transfer is a painless, simple procedure and rarely requires anesthesia. At this stage, it is crucial to place and secure the embryo in the appropriate position within the uterus. The IVF specialist works meticulously to ensure the successful transfer of the embryo, planning each step carefully.
What does fresh embryo transfer mean?
Fresh embryo transfer refers to the transfer of newly created embryos into the uterine cavity three to five days after egg retrieval.
What does frozen embryo transfer mean?
Frozen embryo transfer, on the other hand, involves the freezing of embryos three to five days after egg retrieval, followed by their placement into the uterus in subsequent menstrual cycles. Frozen embryos can be stored indefinitely. In our country, this period is 5 years, and after the expiration of the period, with the approval of the Ministry of Health, the period can be extended for couples who wish. Frozen embryo transfers are the most commonly performed type of transfer because they allow genetic testing of embryos before transfer, resulting in higher success rates and a lower chance of genetic defects or miscarriages.
How is embryo selection made?
Embryo selection is meticulously conducted in the laboratory environment. Typically, a system called “embryo scoring” is used to determine when embryos will be transferred and which embryos will be transferred. The European Society of Human Reproduction and Embryology (ESHRE) has developed an embryo scoring system to assess embryo quality based on criteria such as the number of cells in the embryo, the presence of fragmentation, and the percentage of the embryo’s size, as well as whether the cells are of equal size.
Embryo selection can also be supported by genetic testing. A method called preimplantation genetic testing (PGT) can analyze the genetic structure of embryos to detect the presence of genetic diseases and help select the healthiest embryo.
The number of embryos to be transferred and the day of transfer are usually determined by the embryology team and the IVF doctor.
What are the stages of embryo development?
After the egg retrieval process, fertilization control is performed 12-18 hours after microinjection (ICSI) in IVF. In normal fertilization, 2 pronuclei (PN) and the first and second polar bodies are observed. The simultaneous occurrence of events in both nuclei during PN formation is important for fertilization and subsequent embryo development. Zygotes with asynchronous fertilization activities may have a high rate of chromosomal anomalies, abnormal division, and developmental blockage, resulting in fewer blastocyst formations.
The period from the zygote stage to the formation of a 4-8 cell embryo (2-4 days) is defined as the cleavage period. During this period, the zygote undergoes two to three consecutive divisions that do not show structural changes. When evaluating embryos during the cleavage period from 2 to 4 days, the criteria considered include the number of blastomeres, blastomere morphology, the rate of fragmentation contained in the embryo, and cytoplasmic structure. An embryo with a normal cleavage rate will have 2 cells at 24-25 hours after the ICSI procedure, 3-4 cells at 42-44 hours after the ICSI procedure (2 days), 6-8 cells at 66-68 hours after the ICSI procedure (3 days), and 10 or more cells at 90-92 hours after the ICSI procedure (4 days) depending on the signs of fusion.
Embryo Transfer: 3 Days vs. 5 Days?
Embryo selection before embryo transfer is of great importance. Selecting the healthiest and strongest embryo can increase the chances of a successful pregnancy. Transferring embryos at the cleavage stage, i.e., on day 3, can provide the same benefits as transferring blastocysts, i.e., on day 5. However, in this case, more embryos may need to be transferred. Until recently, doctors typically transferred embryos at the cleavage stage, i.e., on day 3. In recent years, there has been a trend towards transferring embryos at the later blastocyst stage.
Researchers believe that only embryos capable of surviving can progress to the blastocyst stage. In other words, viable embryos will self-select. Therefore, it is believed that a 5-day embryo transfer may increase a woman’s chances of getting pregnant and having a healthy baby.
How is the number of embryos to be transferred determined?
In our country, embryo transfer is carried out in both public and private IVF centers according to the regulations of the Ministry of Health Implementation Regulation. Accordingly, in women under 35 years of age, single embryo transfer is allowed in the first two attempts, and two embryo transfers are allowed in the third attempt; while in women aged 35 and over, a maximum of 2 embryo transfers are permitted. The aim here is to prevent triplet and higher-order multiple pregnancies.
How long does the embryo transfer process take?
Embryo transfer is a short procedure, similar to a gynecological examination. The entire procedure takes between 15 and 30 minutes. Your doctor will insert a speculum, a medical tool used for examination, into the vagina and will then guide a soft, thin catheter containing the embryos through the cervical canal into the uterine cavity.
Fresh or frozen embryo transfer?
Freezing embryos has become an integral part of IVF, and the process of freezing with the vitrification method has increased the effectiveness and safety of IVF. The vitrification method has led to a higher survival rate of embryos after thawing. This has resulted in a significant increase in the preference for frozen embryo transfer in recent years.
There are various considerations when deciding whether to use fresh or frozen embryos. Both have their benefits and drawbacks.
Stages of embryo implantation after embryo transfer:
Day 1 and 2: The blastocyst hatches from its shell and attempts to implant into the uterine lining.
Day 3: Implantation begins as the blastocyst moves deeper into the uterine lining.
Day 6: Production of the HCG hormone begins.
Day 4 and 5: Implantation continues and is completed. Cells that will form the placenta and fetus begin to develop.
Day 6: Production of the HCG hormone begins.
Day 7 and 8: Development continues, and more HCG is secreted into the bloodstream.
Day 9: HCG levels reach levels that can detect pregnancy.
How long does it take for the embryo to implant after transfer?
Blastocysts start to implant into the uterus 1 to 2 days after the transfer, and the process is completed around 9 days.
What are the common symptoms observed after frozen embryo transfer?
If any of the following symptoms become severe, please seek medical help:
Experiencing cramps after embryo transfer may be a positive sign that the transfer was successful, but it can also indicate that menstruation is imminent. Medications taken during IVF can also cause cramping, making it a common symptom. Additionally, some women are sensitive and may experience cramps after any pelvic procedure.
IVF medications increase the body’s progesterone levels, which can cause bloating. While bloating can be a positive sign of pregnancy due to hormonal effects, there are many other reasons for bloating as well.
Breast tenderness can be an early sign of pregnancy, but it can also be due to the medications used while waiting for the test results. Progesterone can cause breasts to swell, ache, become sensitive, and soften, making it a common symptom after embryo transfer.
Many women feel tired and exhausted after embryo transfer, especially during the first seven days after the transfer. Fatigue and exhaustion can be normal signs of pregnancy, but an increase in progesterone levels can make patients feel sleepier than usual and experience dizziness.
Changes in vaginal discharge after embryo transfer
Changes in discharge are possible within the first seven days after embryo transfer due to medications used. Any type of gel, vaginal suppository, or tablet can cause burning, discharge, yeast infections, or itching. A positive result can also alter vaginal discharge.
Frequent urination after embryo transfer
Frequent trips to the bathroom can be an early sign of pregnancy due to an increase in progesterone and hCG hormones. A successful embryo transfer resulting in pregnancy will increase blood circulation in the body, leading to more frequent urination. However, frequent urination can also be a sign of a urinary tract infection, so proper differentiation is necessary. If you experience additional symptoms such as fever, nausea, vomiting, bleeding, or pelvic pain, you should consult your doctor immediately.
Delayed period after embryo transfer
If you have a regular menstrual cycle, a delayed period after embryo transfer can be a positive sign of pregnancy.
What symptoms suggest pregnancy after embryo transfer?
Spotting seen 7 days after embryo transfer is quite common and can be a sign of pregnancy. This can be referred to as implantation bleeding. Implantation bleeding is a typical occurrence for the embryo attaching to the uterine wall, both naturally and in IVF pregnancies. While spotting and bleeding may cause negative feelings and stress, it can be a perfect sign for hopeful parents. Many women describe experiencing lower back pain similar to their period seven days after transfer. In 10% to 15% of cases after transfer, there may be no symptoms at all.
When is the pregnancy test performed after embryo transfer?
Detection of pregnancy can take approximately 9 to 12 days after the transfer is completed. It is recommended that patients do not take early pregnancy tests before completing these periods.
Is bed rest necessary after embryo transfer?
Various methods have been tried to increase the success rates of IVF. Among these practices, bed rest has been extensively studied. In the early years of IVF, patients were advised to have two weeks of bed rest. Recent studies have shown that bed rest for up to 24 hours after embryo transfer is sufficient. The purpose of bed rest is to prevent uterine contractions and, consequently, the “early expulsion” of embryos from the uterus. Prolonged immobility can lead to increased blood clots and decreased blood flow to the uterus. Gentle activity can improve blood flow.
What should be considered after embryo transfer?
Avoid sexual intercourse until the pregnancy test result after embryo transfer. Additionally, avoid heavy exercise, taking hot baths, sunbathing, or being in a hot environment after the transfer.
What should be done to increase the chances of pregnancy after embryo transfer?
Several things can be done to maximize the chance of a successful embryo transfer: A diet rich in antioxidants, healthy fats, and whole grains will help increase fertility. If you are underweight or overweight, adjusting your body mass index to the normal range will also help increase your fertility. Generally, maintaining a healthy lifestyle is ideal when trying to conceive. Reduce stress, stay hydrated, add electrolytes, reduce caffeine intake, exercise regularly, and get plenty of rest. Prioritizing mental health and mind-body connection is critical during this process.
What does recurrent IVF failure mean?
One of the most critical steps in the IVF process is embryo transfer. The attachment of the blastocyst embryo requires harmony between the embryonic tissue and the mother’s uterine lining. Despite the use of blast embryos of good quality and confirmed to be genetically sound, implantation failure occurs in approximately 32-51% of all embryo transfers.
What are the reasons for recurrent IVF failure?
Recurrent IVF failure, known as repeated IVF failures despite multiple transfers of morphologically (externally viewed shape) good quality embryos, is believed to be a complex and multifactorial process. The frequency of recurrent IVF failures varies approximately between 10% to 20%. Potential underlying reasons include intrauterine pathologies, tubal pathologies, immunological factors, genetic abnormalities, thrombophilia (blood clotting disorders), and unexplained IVF failures.
Embryo transfer is generally a painless procedure. There may be slight discomfort, but it typically does not cause pain.
Embryo selection is usually based on the morphological features and developmental stages of the embryo. Selecting the highest quality embryo is important.
After embryo transfer, it is important to rest and reduce stress. Avoiding sexual intercourse is necessary. Heavy exercise, taking hot baths, sunbathing, or being in a hot environment may be detrimental and is not recommended. By following your doctor’s recommendations, you can have a healthy process.
By filling out the form, you can make an appointment with Gynecology and Obstetrics Specialist Prof. Dr. Ebru Çöğendez.
IVF treatment prices usually include factors such as tests, medications, laboratory procedures, doctor examinations, etc. during the treatment process.
IVF treatment is applied to couples who are determined by taking certain factors into consideration.
Factors such as age, health status, choice of treatment center and treatment process can affect success rates.
The stages of IVF treatment usually consist of four main stages. The first stage is the preparation stage.
As with any medical intervention, IVF treatment has potential risks and possible complications.
