The Complete Guide to IVF Embryo Transfer [Success Rates, Procedures and Preparation]

Embryo Transfer

If IVF treatment is recommended as a consequence of tests conducted on individuals who applied because they were unable to conceive, the expecting mother's eggs are first expanded and then collected once they have reached a particular stage. Then, in a laboratory setting, healthy eggs are selected from these eggs. The father-to-be also provides a sperm sample, which is examined under a microscope to select the healthiest sperm with the cleanest tail and head structure possible. After then, the two cells are joined and stored in the lab for one day. It is determined the next day which of these baby embryos have been fertilized.

Composed baby drafts are embryos that are retained and monitored for a minimum of 3 days and a maximum of 5 days in a laboratory setting. Their growth is monitored, and the healthiest are chosen and implanted into the womb of the expectant mother. This is how embryos are transferred. Only one embryo is supplied in the first trial if the person is under the age of 35, according to the law. It has the right to give one embryo in the following attempt if a pregnancy does not materialize. If this does not work, the patient can be given two embryos in each consecutive trial. This is applicable to all patients. Patients above the age of 35 can have two embryos implanted. The most beautiful and exciting aspect of the process begins once the embryos are implanted. The status is determined after a 12-day waiting period.

Is it necessary to take a pregnancy test 12 days after the embryo transfer?

We advise  patients to avoid having a test within 2-3 days of the transfer. Because it takes time for the embryo to come into contact with your body and then release the pregnancy hormone, Beta HCG, into your bloodstream. It is more accurate to test after this 12-day interval has passed.

EMBRYO TRANSFER – WHEN AND HOW IT IS DONE – CONDITIONS TO BE CONSIDERED:

Embryo transfer time - Usually on the day of egg retrieval, the couple is informed on which days the embryo transfer process will take place.  Usually after the egg collection, the egg collection day is not counted and the countdown for the transfer starts from the next day (ie the day of fertilization) and the transfer is applied on one of the 3rd, 4th or 5th days.

In order for the embryo to be selected correctly, the transfer process is usually performed on the 5th day (blastocyst). Good laboratory conditions and the availability of the latest embryoscope monitoring system in ivf center make the process even easier. Good embryo selection affects pregnancy outcomes positively. Embryoscope can be used in embryo selection in cases where it is not possible to go to the 5th day in the last days.

However, sometimes, even if the number of eggs is low and there are enough eggs, embryo transfer is not always possible on the 5th day, since egg quality negatively affects embryo development. The day of embryo transfer can be estimated by an experienced IVF specialist on the day of egg retrieval. This is especially important for those who will come from out of town and those who work, and it helps the couple to adjust themselves.

The embryologist and the doctor review the status of the embryos and decide when to transfer according to the patient's condition. After the doctor and embryologist determine the transfer time, the embryo transfer information is given by phone by the relevant nurses one day before the transfer.

The criteria for this are;

1- Age of the woman

2-Number of eggs taken

3-The quality of the egg

4-Sperm quality (affects the embryo quality of the fertilized egg)

5-Experience of the embryologist performing the ICSI (micro-injection) procedure

6-Laboratory conditions

In IVF centers, 72% of good patient groups can be transferred to DAY 5, which is considered quite high.

The History of IVF

The first known case of embryo transplantation in rabbits was reported in the 1890s by Walter Heape, a professor and physician at the University of Cambridge, England, who had been conducting research on reproduction in a number of animal species. This was long before the applications to human fertility were even suggested.

Aldous Huxley published 'Brave New World' in 1932. Huxley realistically detailed the technique of IVF as we know it in this science fiction story. Five years later, in 1937, the New England Journal of Medicine published an editorial that is noteworthy (NEJM 1937, 21 October).

"Aldous Huxley's 'Brave New World' may be closer to becoming a reality than we think. Pincus and Enzmann took the rabbit one step further by extracting an ovum, fertilizing it in a watch glass, and reimplanting it in a doe other than the one who provided the oocyte, thereby initiating pregnancy in an unmated mammal. If we could achieve the same feat with humans as we did with rabbits, we'd be 'going somewhere,' in the words of 'flaming youth.'"

Pincus and Enzmann of Harvard University's Laboratory of General Physiology presented a study in the Proceedings of the National Academy of Sciences of the United States in 1934, suggesting the potential that mammalian eggs could develop normally in vitro. Miriam Menken and John Rock extracted almost 800 oocytes from women during procedures for various diseases fourteen years later, in 1948. In vitro, one hundred and thirty-eight of these oocytes were exposed to spermatozoa. Their findings were reported in the American Journal of Obstetrics and Gynecology in 1948.

Chang (Chang MC, Fertilization of rabbit ova in vitro. Nature, 1959 8:184 (suul 7) 466) was the first to produce births in a mammal (a rabbit) through IVF, and it wasn't until 1959 that irrefutable evidence of IVF was achieved. The newly ovulated eggs were fertilized in vitro by incubation with capacitated sperm for 4 hours in a tiny Carrel flask, paving the path for assisted reproduction.

Microscopists, embryologists, and anatomical scientists set the groundwork for future breakthroughs. The recent rapid rise of IVF-ET and comparable treatments around the world is bolstered by a social and scientific context that encourages their continued use.

Many changes have been made in the development of IVF-ET in humans over the years, including refinement of fertilization and embryo culture media, earlier embryo transfer, improvements in equipment, use of a smaller number of spermatozoa in the fertilization dish, and embryo biopsy, among others.

The objective of this introduction is to thank individuals who pioneered novel treatment protocols and techniques that we currently use to facilitate such straightforward and hopeful IVF-ET procedures.

1961 - Palmer of France described the first laparoscopic oocyte retrieval.
1973 - Professors Carl Wood and John Leeton of Monash University in Melbourne, Australia, revealed the first IVF pregnancy. Unfortunately, this resulted in a miscarriage at a young age (dDe Kretzer D, Dennis P, Hudson B, Leeton J, Lopata A, Outch K, Talbot J, Wood C. Transfer of a human zygote. Lancet, 1973 29;2:728-9).

1981 - The birth of the first IVF baby in the United States was announced by Howard and Georgianna Seegar Jones. The usage of hMG was used to achieve the first IVF birth in the United States.

Wood and a colleague developed a foot-controlled fixed aspiration pressure control system (Wood C, Leeton J, Talbot JM, Trounson AO. Technique for harvesting mature human oocytes for in vitro fertilization. The British Journal of Obstetrics and Gynaecology, vol. 88, no. 7, pp. 756-60, was published in 1981.

Clomiphene Citrate and hMG were added to the IVF treatment protocol (Trounson AO, Leeton JF, Wood C, Webb J, Wood J. Pregnancies in humans by fertilization in vitro and embryo transfer in the controlled ovulatory cycle. Science 1981 8;212:681-2).

Testart J, Frydman R, Feinstein MC, Thebault A, Roger M, Scholler R. Interpretation of plasma luteinizing hormone assay for the collection of mature oocytes from women: definition of a luteinizing hormone surge-initiating rise (Testart J, Frydman R, Feinstein MC, Thebault A, Roger M, Scholler R. Fertil Steril, vol. 36, no. 1, pp. 50-4, 1981.

1983 - Donor egg: The Monash IVF team used donor eggs to create artificial menstrual cycles and a special hormonal formula for the first 10 weeks of pregnancy in a woman without ovaries (Trounson A, Leeton J, Besanko M, Wood C, Conti A. Pregnancy established in an infertile patient after transfer of a donated embryo fertilized in vitro). 286(6368):835-8 in Br Med J (Clin Res Ed) on March 12, 1983.

The first frozen embryo baby was born, according to the Monash IVF team. (embryo freezing was created in Cambridge, England on cattle, with minimal human adaptations) (Trounson A and Mohr L. Human pregnancy after cryopreservation thawing and transfer of an eight-cell embryo. Nature 305:707–709)

In an IVF procedure, morphologically immature human eggs are matured and fertilized (Veeck LL, Wortham JW Jr, Witmyer J, Sandow BA, Acosta AA, Garcia JE, Jones GS, Jones HW Jr. Maturation and fertilization of morphologically immature human oocytes in a program of in vitro fertilization. Fertil Steril 1983;39:594-602).

1988 - The technique MESA was named after the first two babies born after epididymal sperm aspiration for men with congenital absence of the vas deferens (Patrizio P, Silber S, Ord T, Balmaceda JP, Asch RH. Two births after microsurgical sperm aspiration in congenital absence of the vas deferens. Lancet. 1988, 10;2(8624):1364).

The first IVF surrogate birth in Australia.

At the National University of Singapore, the first baby was born with subzonal sperm injection (Ng SC, Bongso A, Ratnam SS, Sathananthan H, Chan CL, Wong PC, Hagglund L, Anandakumar C, Wong YC, Goh VH). Lancet. 1988; 1;2:790). Pregnancy following sperm transfer under zona.

Micromanipulation employing zona drilling or mechanical partial zona dissection was used to obtain pregnancy (Cohen J, Malter H, Fehilly C, Wright G, Elsner C, Kort H, Massey J. Implantation of embryos after partial opening of oocyte zona pellucida to facilitate sperm penetration. Lancet, 1988;16;2:162).

Dr. Patrick Steptoe died on March 21, 1988. (Dr. Patrick Steptoe, 74, Dies; Pioneered Test-Tube Baby Field, March 23, 1988, The Washington Post).

The first preclinical study of pronuclear development using human spermatozoa microinjected into human oocytes. A preclinical evaluation of pronuclear formation by microinjection of human spermatozoa into human oocytes. Fertil Steril. 1988 May;49(5):835-42). (Lanzendorf SE, Maloney MK, Veeck LL, Slusser J, Hodgen GD, Rosenwaks Z. A preclinical evaluation of pronuclear formation by microinjection of human spermatozoa into human oocytes. Fert

Process of Embryo Transfer

On the day of the procedure, the patient does not need to be hungry (except for those who need anesthesia due to vaijnusmus or similar reasons). Ultrasonography is used during the transfer process to get a clear view of the uterine cavity and to determine the best location for the embryo to be implanted. For a decent image using ultrasonography, the bladder must be completely full. As a result, the bladder is full by raising the desire for urine in the bloodstream with water or tea.

 
BECAUSE THE EMBRYO TRANSFER PROCESS IS VERY IMPORTANT, THE DOCTOR'S EXPERIENCE IS VERY IMPORTANT.

As a result, embryo transfer is the last process taught even during the IVF trainee time. The operation is painless, and it is frequently painless enough for the patient to ask if he or she has been transferred. The patient is escorted to bed and rests for 1-2 hours after the treatment.


After the transfer, the lady should not be afraid of menstruation on days when her regular cycle is under control and alters as a result of the medications. My patients should rest for a maximum of one or two days, according to me. For couples visiting from out of town, I recommend staying for one day. This, they believe, boosts the chances of conceiving. In my opinion, it would be best for the transferred woman and the doctor to discuss one other and make a choice based on the woman's situation.

I believe that paying attention to a woman's sleeping posture, especially if she has too many eggs owing to polycystic ovary, stops the ovary from rotating around its own axis and saves her from ovarian torsion and laparoscopy. It will be easier to return since the ovaries grow and double or triple their typical size. This problem may become simpler in situations of fluid collection in the abdomen due to OHSS, hence it is recommended that the lady not lie on her side at 90 degrees. It is suggested that you sleep on your back or on your side (supporting the back with a pillow). As a result, ovarian torsion can be reduced.
Nutrition after embryo transfer - Post-transfer nutrition is largely unchanged. It is critical to avoid ready-made foods in favor of a more natural diet, to limit foods with a lengthy shelf life as much as possible, and to abstain from smoking and consuming alcohol. Women with extra eggs due to polycystic ovary should follow a slight salt restriction or avoid adding salt to their diet and drink plenty of water.

Symptoms of post-transfer embryo implantation (attachment of the embryo to the uterine lining)-Symptoms and results of implantation can indicate that we will become pregnant.

Fresh vs Frozen Embryo Transfer

Embryo transfer is the gentle placement of an IVF embryo into the uterus of the intended parent or, in some situations, a gestational carrier. Transfers are one of the most critical processes in the in-vitro fertilization (IVF) process, and there are many distinct types and classifications of transfers. However, the contrast between a fresh and frozen embryo transfer is likely the most significant of all embryo transfer kinds.

It's critical to understand the benefits and differences between fresh and frozen embryo transfers because they affect your treatment schedule, success rates, cost, and the opportunity to undertake add-on services like genetic testing.

Fresh embryo transfers were regarded as preferable during the first couple decades of IVF treatment and had much higher success rates. The process of freezing and thawing embryos, known as vitrification, has vastly improved since then.

The decision between a fresh vs. frozen transfer is significantly more subtle nowadays.

To help you have an informed conversation with your fertility doctor, this article will explain the differences between fresh and frozen embryo transfers, look at the success percentages for each transfer type, and break down the benefits of both treatments.

How Many Embryos Should You Transfer?

When a patient has a large number of embryos, they must decide how many to transfer for each transfer. The decision has far-reaching repercussions for the health of the person giving birth, the health of the offspring, the possibility of a live birth, and, yes, the family's future income. In this chapter, we'll go through each of these topics.

To begin, we'd like to emphasize that we believe nearly every doctor and clinic has the same aim in mind: to assist women have a successful pregnancy and birth. It's simple for us to assume additional intentions as patients without fully considering the situation. Some of us question whether our doctor insists on a single-embryo transfer to increase the chances of us needing to pay for a second transfer to conceive. There are important medical grounds for such a recommendation, as you'll learn in the next session. Our objective is that this course will assist you and your doctor in having a fruitful conversation about this sometimes misunderstood but crucial topic.

The Risks of Multiple Embryo Transfer

According to the CDC, there is a 1% possibility of a twin or multiple gestation birth when a single embryo is transferred. When many embryos are transplanted, twins or multiple gestation account for 27% of all births. The likelihood of a multiple-gestation delivery after a multiple-embryo transfer is higher in younger women (say, under 35) than in older women (e.g. over age 38).

Carrying multiple babies is risky because infant mortality and cerebral palsy rates skyrocket to the mid-teens per child. Miscarriage, stillbirth, premature birth, developmental delay, hypertension, and gestational diabetes are all elevated risks with twins. Complications for the mother during birth are also increasing at an alarming rate. Based on big datasets, this is a well-known phenomena.

Fresh vs. Frozen Embryo Transfer Success Rates

There has been a lot of discussion about the success of frozen and fresh embryo transfers, as well as the advantages of each. Frozen embryo transfers, according to several fertility professionals and treatment providers, have a greater pregnancy success rate than using fresh embryos through assisted reproductive technology.

However, success rates are not the only element to consider. Depending on your circumstances, a fresh embryo transfer may be preferable to a frozen embryo transfer. Let's look at what you should think about while deciding between fresh and frozen embryo transfers during your IVF process.

When frozen embryos are used instead of fresh embryos after embryo transfer, many fertility clinics and the CDC have found higher success rates. Here's what we discovered:

Women with reproductive concerns related with polycystic ovarian syndrome (PCOS) had greater live birth rates with frozen embryo transfer, according to a study published in the New England Journal of Medicine in 2018.

This year, the British Medical Journal published a study. Based on regular periods and gonadotropin-releasing hormones, they found no greater rates of continuing pregnancy or live birth in women who used FET.

A study also discovered that using high-quality, viable embryos on older women during embryo transfers has no negative impact on implantation or live birth rates, which contradicts earlier findings.

How Do You Prepare for Embryo Transfer?

Embryo transfer is a procedure in which one or more cultivated embryos are returned to the mother's womb. In most cases, only one embryo will be transferred, while other viable embryos will be saved for future use.

Your transfer can happen two to five days (sometimes even six) after you harvest your eggs (if going through a fresh cycle). When this is likely to happen, your Apricity advisor will keep you informed. You'll have been on medicine to assist prepare the lining of your womb for the best likelihood of implantation throughout this time.

Embryos are chosen and placed into the womb through a tiny, flexible tube passed through your vaginal and cervix during the embryo transfer procedure. Embryo transfer is typically a rapid and painless operation performed under ultrasound guidance.

Your Apricity advisor will keep you informed about what to expect during embryo transfer, but here are some of the most frequently asked questions about the procedure.

What need I do in order to be ready for the embryo transfer?

You'll already be taking all of the necessary pills and vitamins, so there won't be much else to do. Embryo transfers are usually performed without sedation, so you can eat and drink normally before the procedure. You may have an embryo transfer under anesthesia if your situation is exceptionally problematic or for other reasons, and you must strictly adhere to the fasting instructions given to you by the clinic or your Apricity advisor.

We will normally request that you have a full bladder because this helps the ultrasound physician see the uterus better and pushes the uterus into a desirable position for embryo transfer.

What will my symptoms be during and after the embryo transfer?

A speculum is put into the vagina to better visualize the cervix, and a fine, soft tube is passed into the cervical os (the small opening in the cervix) to deposit the embryo into the womb, similar to a smear test. Some women find it to be absolutely painless, while others find it to be rather unpleasant.

Following the surgery, you may suffer crampy aches and minor bleeding; to minimize this, we recommend using a sanitary pad rather than a tampon. This type of discomfort or spotting does not indicate that something is amiss.

Is it necessary for me to take time off work?

We don't typically recommend that individuals take time off work for egg collection, but we do advocate avoiding severe or unusual exercise, so it depends on the nature of your job. Your Apricity adviser can provide you with specifically tailored assistance if you have any concerns regarding your work or day-to-day activities around this time.

Is the technique for transferring embryos painful?

Although the embryo transfer itself should not be uncomfortable, some women do suffer discomfort during the process. Please notify your clinician if you have any unusual discomfort.

How long does it take to transfer an embryo?

The operation itself can take as little as five minutes, but it usually takes around 15 minutes. It'll usually take an hour to complete the appointment.

Is it okay if I bring my boyfriend, a friend, or someone else?

Absolutely. It's very normal for a spouse to be present at this point. Women have also brought their sister, mother, or a friend. Bring the person with whom you are most at ease. It's also acceptable if you wish to attend these appointments alone.

I'm not sure how I'll know whether my embryo transfer was successful.

You could hear a variety of stories about how someone knew they were pregnant without even trying. The truth is that you won't know unless you take your pregnancy test at the clinic's recommended time. We understand that the first two weeks following transfer can feel like the longest two weeks of your life. The best advise we can give is to live your life as if you could be pregnant by eating well, not smoking, and not drinking alcohol while presuming nothing. This article offers further information about the two-week wait.

Is there anything I can do after the embryo transfer to increase my chances of success?

This is a frequently requested question, and we have a few answers below.

The best way to proceed is to use common sense and the guidance provided by your Just IVF team. Be careful what you read on the internet, and try to relax as much as possible.