Even if everything went well in the other steps, the transfer can make or break the whole process.
The transfer is done 72-120 hours after egg retrieval (depending on cell division). Many clinics now are waiting until 5 days have past (120 hours) and the embryos have divided to anywhere between 30-100 cells, it is then referred to as a blastocyst.
The couple will be told the quality and grading of their embryos that are being transferred.
Usually 3-5 embryos will be transferred, depending on the age of the woman (older = more). This is where the couple must come to terms with the success rate vs. multiple pregnancy chances, as well as if any will be frozen.
The couple can decide to transfer as many or as few embryos as they want at this point, nothing should be written in stone. They can freeze some for possible later use by themselves, or for donation purposes, or to give to the clinic for experimentation.
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The woman will be asked to empty her bladder, then to come back to the room, get on the table and relax. It is very important for a woman to be relaxed during the transfer, because stress releases hormones such as adrenaline can cause the uterus to contract. Imagery, breathing exercises, and acupuncture are the most effective means to relax a woman at this time. The partner, counsellor, or acupuncturist need to be present at this time to give the proper support.
It has also been shown that an acupuncture treatment about 1 hour before the transfer helps greatly in the overall emotional tranquility of the woman during the transfer. Some acupuncture clinics also perform a treatment after the transfer to further ensure relaxation, optimizing chances of implantation.
A last resort for relaxation may be the use of a tranquilizer such as Valium.
Once the woman is in the proper position, the doctor inserts a speculum into the vagina to expose the cervix. The lab is then informed that the doctor is ready to transfer. The catheter that holds the embryos is then given to the doctor, they then guide the catheter through the woman’s cervix into the uterine cavity. When the catheter is in place the embryos are injected into the uterus, then the catheter is withdrawn.
The catheter is immediately returned to the lab where it is checked under the microscope to see if any embryos did not get transferred. If this is the case, the procedure is repeated.
This whole process will only take a few minutes.
Must Read: Treatment of Male Fertility: Questions
The woman will be asked to remain lying down for some time after the transfer.
Minor cramping is to be expected at this time.
It is also at this time that the nurse or doctor discuss follow-up self-care, and when the couple can resume normal life activities such as travel, sex, and work.
The woman will be advised on the use of hormone supplementation to sustain the pregnancy if it is needed. This is generally daily injections or vaginal suppositories of progesterone for several weeks to support the implanting embryo(s). Some clinics may also give hCG injections a few times per week until the pregnancy can be confirmed on ultrasound. Third party parenting women will recieve estrogen and progesterone injections for 8-10 weeks following a positive pregnancy test.
About 9 days after the transfer the woman will take an hCG blood pregnancy test. If it is positive, an additional test may be given a few days later just to ensure the proper rise in hCG is taking place.
Even though the hCG blood test is a good indicator, an ultimate confirmation is not made until 4 weeks after transfer when ultrasound confirms a heartbeat.
This can be due to the embryos burrowing into the endometrium, one could be attaching while another could be detaching, menses may have begun, or it may be a tubal pregnancy.
Bed rest is the first course of action. Calling your doctor is the second.
If a woman is spotting after a positive pregnancy test, the body may be reducing a multiple pregnancy.
This is thought to be a reason that many woman, natural or not, bleed after they have become pregnant.
There are techniques used in Acupuncture and Traditional Chinese Medicine that may aid in stopping uterine bleeding. Although, experience has shown that these techniques primarily aid the body in facilitating the processes that are inevitably taking place regardless of intervention.
Be sure to ask and only go to practitioners that are experienced and knowledgable in these techniques.
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