Medically Reviewed by: Leyla Bilali BSN, RN

You’ve made it through all the preliminary fertility tests, days or weeks of injections, and the egg retrieval procedure — IVF is moving right along. Next on the agenda is the embryo transfer, which hopefully leads to a positive pregnancy test and a healthy live birth!

The embryo transfer isn’t a surgery like the retrieval is, but it’s still a big moment in the IVF process that can cause anxiety—truthfully, it all leads up to this day. But at least for me, the more I knew going in, the more prepared I felt on transfer day. Here’s what to know about embryo transfers:

What is an embryo transfer?

An embryo transfer is when the fertilized egg (embryo) is transferred (get it?) into the female partner’s uterus. The embryologist will place the embryo in a catheter and carefully hand it to the doctor, who will gently push the embryo through your cervix into the uterus via a very thin catheter.

In order to make sure you’re getting your embryo, the medical team in the procedure room will ask you your name and your DOB—maybe multiple times—and confirm which embryo(s) they’re putting in (each embryo is labeled too). You may even be able to see your embryo in its little incubator before it goes in, as well as the tiny embryo and your ID info magnified up on the screen.

The procedure itself only takes a few minutes, and you’ll be awake for the whole thing and able to watch it on the ultrasound screen. The embryo transfer is not painful, and you shouldn’t feel any more bloating or discomfort than you would during a routine pap. 

The timing of the embryo transfer

Doctors plan the timing of an embryo transfer very meticulously—your endometrial lining needs to be at least 7mm, and your estrogen and progesterone levels, detected via blood work, need to be optimal for pregnancy before a transfer can be performed.

There are two types of embryo transfers

  • Fresh transfer, which means you’ll transfer an embryo that hasn’t undergone PGT testing 3-5 days after an egg retrieval
  • Frozen embryo transfer (FET), which you can do either with medication or with your natural cycle, depending on your situation and your doctor’s recommendation. In a natural or modified natural FET, your doc will monitor your natural cycle, and may or may not prescribe a trigger shot as you approach ovulation to release that egg. The embryo is then transferred 5-7 days later.

A medicated FET involves:

  • 2-3 weeks of oral birth control pills to suppress your natural cycle and ovulation
  • About two weeks of estrogen, either vaginally or orally, to thicken your uterine lining
  • Daily intramuscular progesterone injections or vaginal suppositories starting about five days before transfer (when lining is more than 7mm) to prepare your body for implantation

How to prepare for an embryo transfer

If you’re going the medicated transfer route, the most important thing to do before transfer is to follow your fertility clinic’s instructions throughout the entire cycle on exactly which meds to take and when. But for all types of transfers, you’ll want to:

  • Get a good night’s sleep the night before. Research suggests good sleep can improve reproductive outcomes for both men and women.
  • Eat healthy foods. Try not to consume too much caffeine that’ll make you jittery or foods that make you feel gross and nauseous on the day of.
  • Wear loose, comfortable clothing (though you’ll be in a hospital gown and cap for the actual procedure). And don’t forget your lucky transfer day socks!
  • Arrive at the clinic with a full bladder. This helps the doctor better visualize the uterus on ultrasound, which they’ll use to guide the catheter containing the embryo into the right spot. 

What to expect after an embryo transfer

Since you’re not under anesthesia for an embryo transfer, there aren’t as many physical restrictions post-procedure. Still, you may experience mild cramps and/or bleeding on the day of and/or a few days following the transfer, so take it easy. If you do experience extreme side effects, call your doctor ASAP.

If you’re doing a medicated FET, your doctor will instruct you to keep taking all medications as prescribed up until the pregnancy test, and doing so is key to help improve implantation rates.

But any IVF patient will tell you the hardest part of the embryo transfer is not the procedure itself nor the meds, but the two-week-wait afterwards leading up to your pregnancy test. On 9 or 10 days post transfer (DPT), you’ll go into your clinic for a HCG beta blood test to determine your HCG level, which is a hormone found in the blood during pregnancy. Technically, an HCG level of 25 or higher is considered pregnant, but ask your clinic what number they’d like to see on your first beta.

If all goes well, your HCG keeps rising as it should and your early pregnancy scans show great growth. No matter what the result though, be proud of yourself—not everyone makes it to transfer day, so you should feel proud!

And no, an embryo transfer is not the same as  “embryo implantation.” Find out the differences in this Reel (featuring yours truly!) @dandifertility.


References:


https://www.medicalnewstoday.com/articles/314571


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5920727/


https://www.sart.org/patients/fyi-videos/fresh-and-frozen-embryo-transfers/


https://ivf.org/treatments-and-services/advanced-ivf-techniques/fet#:~:text=Medicated%20FET,the%20thawed%20embryo(s)


https://www.sciencedirect.com/science/article/pii/S0015028220321889


https://americanpregnancy.org/getting-pregnant/hcg-levels/#:~:text=An%20hCG%20level%20of%20less,rise%20to%20confirm%20a%20pregnancy.




Back to blog

Read Next

Fertility Treatment Embryology
How Does Embryo Grading Work in IVF?

How Does Embryo Grading Work in IVF?

You’re finally at the end of your IVF egg retrieval cycle, but now you’re left with a confusing embryology report. Reading that report can be daunting, and going down the Google rabbit...

How Does Embryo Grading Work in IVF?

Alease Daniel Barnes, BS

You’re finally at the end of your IVF egg retrieval cycle, but now you’re left with a confusing embryology report. Reading that report can be daunting, and going down the Google rabbit...

Fertility Treatment Fertility Planning
What is Infertility? Definition, Testing, and Diagnosis Explained

What is Infertility? Definition, Testing, and D...

At Dandi, we talk so much about the infertility community and how important it is to feel supported on your journey to growing your family. But what exactly is infertility?...

What is Infertility? Definition, Testing, and D...

David E. Reichman, MD

At Dandi, we talk so much about the infertility community and how important it is to feel supported on your journey to growing your family. But what exactly is infertility?...

Fertility Treatment Fertility Planning
5 Steps to Choosing a Fertility Doctor

5 Steps to Choosing a Fertility Doctor

If you are trying to get pregnant or considering freezing your eggs, you’ve probably started researching the best fertility doctors in your area.  Of course, you want to feel like...

5 Steps to Choosing a Fertility Doctor

Claire O'Neill

If you are trying to get pregnant or considering freezing your eggs, you’ve probably started researching the best fertility doctors in your area.  Of course, you want to feel like...