What are the Do’s and Don’ts after Embryo Transfer?

Do’s and Don’ts After Embryo Transfer

• Bed rest: Bed rest is advised while at the clinic after the embryo transfer is performed. Implantation takes place between 1 and 5 days after a blastocyst transfer. If you had a day-3 transfer, your implantation window is 6 to 10 days after egg retrieval. Take that week off. Get plenty of sleep and listen to your body. You may resume your routine activities but make sure you avoid any strenuous activity during that time.
• Avoid strenuous physical activity: Avoid strenuous activities such as aerobics, running, jogging, cycling on hills, etc. Instead you can do moderate physical activities such as walking, driving, cooking, etc. You may also go to work but only if your work does not involve heavy lifting or vigorous exercise.
• Diet: Eat as if you’re already pregnant. Avoid processed foods, limit your sugar, eat good carbohydrates, add in oily fish twice a week, don’t neglect proteins, take a daily multivitamin with folic acid.
• Sexual Intercourse: It is recommended to avoid sexual intercourse until you get your pregnancy test results. Sex can cause uterine contractions, which in turn may interfere with the implantation of the embryo in the uterine lining.
• Medication after transfer: Once the transfer is performed, our fertility doctor will provide instructions concerning the type and dosage of the medication to be used until the pregnancy test result.
• Avoid baths: It is important to avoid tub baths, swimming pool, or beaches to protect yourself from potential infections. Have quick, warm showers instead and abandon the bubble bath for a few weeks.
• Drink plenty of fluids: Fluids help regulate cell hydration, which is essential for proper cell functioning (including the endometrial cells).
• De-stress: You can explore relaxation techniques such as yoga, meditation or Tai Chi.
• Take progesterone: Progesterone prepares your uterine lining for a pregnancy. Progesterone creates an optimal environment for implantation of the embryos.
• Pregnancy test: Avoid taking a pregnancy test at home! You might get a false-negative or false-positive. You should wait for about two weeks post transfer before you take your first hCG test. Our fertility doctor will schedule a date for your official pregnancy tests.

What is Embryo Transfer?

The embryo transfer is the last step in the IVF process. The success of IVF in Cyprus will depend on the embryos and their ability to implant in the uterus. The patient will have to wait for about two weeks to know if a pregnancy has occurred. Embryo transfer is a procedure in which embryos are transferred to the woman’s uterus to establish a pregnancy. Embryo transfer is performed at our clinic in Cyprus usually on day three or day five after the egg retrieval. During IVF in Cyprus, fertility drugs are used to stimulate the ovaries to release multiple eggs. These eggs are then removed from the woman’s ovaries and fertilized in our lab. The fertilized eggs (now embryos) are left to culture for 1-2 days. On day 3 or day 5, embryo transfer will be performed at our clinic.

Types of Embryo Transfer

There are two types of embryos that are transferred to the uterus during IVF in Cyprus:

1. Fresh embryos are embryos that have been produced during the same IVF cycle.
2. Frozen embryos are embryos that have been produced in a previous IVF cycle and have undergone embryo freezing. Before transfer, frozen embryos are first thawed and then transferred as a regular, fresh embryo to the woman’s uterus.

Depending on the number and quality of embryos, our fertility doctor will decide the date for your transfer. At this stage, two options are possible – embryo transfer on day 3 or day 5. Embryo transfer on day 5 after fertilization is also known as blastocyst transfer. If many good quality embryos develop, you can always freeze the remaining embryos for future use or for embryo donation.

Blastocyst Transfer Cyprus

A blastocyst transfer in Cyprus is an embryo transfer of one or more embryos on day 5 after the egg retrieval. Embryos that reach the day-5 stage of development are called blastocyst embryos. Embryos are monitored and graded for quality by our embryologist. After five days, the best embryo(s) will be selected for the transfer. When there is a good number of developing embryos, the embryo transfer procedure is carried out on day 5.   Prior to the transfer, the EuroCARE IVF fertility specialist may decide to perform assisted hatching, a process of weakening the membrane of the embryo (zona pellucida) to facilitate implantation. Any remaining good-quality blastocyst embryos may be frozen for future use.

Frozen Embryo Transfer (FET) in Cyprus

If you will be having a frozen embryo transfer (FET) in Cyprus, the transfer will take place as scheduled by yourself and our fertility specialist. There is more flexibility in FET procedures, as the embryos are already available. Before the procedure, you should discuss the quality and number of embryos that will go to your womb. The biggest advantage of FET in Cyprus is that embryos can be used for additional transfers whereas fresh embryos cannot. If there are more good-quality embryos, our fertility doctor may consider freezing them for another cycle at a later date.

Why is Embryo Transfer Done?

Embryo transfer in IVF is needed in cases where natural fertilization is not possible or has difficulty occurring. Some of the reasons for embryo transfer are medical conditions that cause male and female infertility including:

• Ovulation disorders
• Damage or blockage to Fallopian tubes
• Endometriosis
• Premature ovarian failure
• Uterine fibroids
• Genetic disorders
• Impaired sperm production

What is the Process of Embryo Transfer?

The embryo transfer is performed under sterile conditions. Unlike egg retrieval, patients don’t need any sedation or anesthesia during the procedure. Some women may feel some discomfort during the insertion of the speculum, but many of them report that this isn’t too different from a smear test. However, you may be prescribed sedation upon request if this makes you feel more comfortable. Additionally, you may be prescribed medication prior to the procedure to help relax your muscles. Using ultrasound for visualization, our fertility specialist will pass a catheter through the cervix and into the uterus. From there, the embryos are moved through the tube and into the uterine cavity. Embryo transfer is a painless procedure that takes only a few minutes. Side effects of embryo transfer are rare, although you may experience some mild cramping. Some women may feel discomfort because of the insertion of the catheter or for having a full bladder, which is required for the ultrasound. The bladder can be emptied immediately after the procedure. Once the transfer is over, you will rest for 30 minutes to one hour in the recovery room, before being released. Implantation of the embryos occurs up to 72 hours after the embryo transfer, so it is important to remain as relaxed as possible during that time.

How many Embryos to Transfer?

Embryo transfer is an important step, and choosing the optimal number of embryos will help prevent medical complications. The transfer of many embryos can result in multiple pregnancies, which is considered high risk. A multiple pregnancy is when you are pregnant with twins, triplets or more. Multiple pregnancies are associated with a wide range of possible complications such as gestational diabetes, high blood pressure, and early labor. In addition, multiple pregnancies may cause premature birth, leading to respiratory complications, feeding problems and increased chances of miscarriage. As a rule of thumb, we transfer 2 to 3 embryos per cycle. The number of embryos that will be transferred depends on multiple factors including maternal age. Usually, more embryos are transferred with an increase in the woman’s age. Additionally, the number of embryos to transfer is decided depending on the stage of their development.

What to Do Before Embryo Transfer?

• Consider blastocyst transfer: Blastocyst embryos are embryos at an advanced stage of development. By Day 5, the embryos are about 70-100 cells. Transferring blastocysts give our embryologists more time to grade them for quality. This allows our fertility specialist to choose the best embryos for transfer, which significantly improves the chances of implantation. Blastocyst transfer is close to natural pregnancy as this is the time when the embryo is leaving the fallopian tubes and is moving into the uterus. The uterine lining is at its most receptive to accept the embryo.
• Embryonic screening: Preimplantation genetic screening (PGS) is a technique used to screen embryos for chromosomal abnormalities. This allows the embryologist to check for abnormalities in the number of chromosomes, which is one more or one less than the normal 24 chromosomes within an embryo. Preimplantation genetic diagnosis (PGD) is another technique used to screen chromosomes 13, 18 and 21, and the sex chromosomes, X and Y, which are the causes of almost 90% of all genetic-linked abnormalities such as Down’s syndrome.
• Assisted hatching: Before the embryos implant, they first must “hatch” from their covering (zona pellucida). Assisted hatching is a technique that facilitates the implementation of the embryos into the uterine lining. The procedure involves creating a tiny hole in the zona pellicuda, which improves the implantation of the embryo.

What Happens After the Embryo Transfer?

12 days after the embryo transfer, you will need to take a beta hCG test to check whether the procedure worked. Beta hCG is a hormone secreted by the placenta during pregnancy. The beta hCG test is a blood test that measures the amount of the hormone in the blood. The hCG level doubles every 2 days in the first trimester. During the two week wait, It is very important to resist taking an early pregnancy test at home because it can give you misleading results. This is because the hormone used to trigger ovulation before the egg retrieval, hCG, is the same hormone used to measure pregnancy. The hCG hormone may stay in your body for some time and can give false positive results. During the two week wait, you may experience some of the following symptoms:

• Slight bloating
• Fatigue
• Mood swings
• Sore breasts
• Light spotting

These symptoms are a positive sign after the embryo transfer and may indicate pregnancy.

Embryo Implantation

Implantation occurs when an embryo attaches to the uterine lining. This usually occurs six to ten days after the egg retrieval, which is one to five days after the embryo transfer. Embryo implantation depends mostly on two factors: embryo quality and receptiveness of the uterus. Most implantation failures are due to chromosomal abnormalities within the embryo. Another reason for failed implantation may be an unreceptive uterus, which usually occurs when the uterine lining is less than 7 mm.

Positive Signs After Embryo Transfer

If implantation is successful, you may experience some of the following symptoms:

• Vaginal discharge
• Missed period
• Breast changes
• Increased desire to urinate
• Nausea
• Fatigue
• Nausea
• Sore breasts
• Morning sickness

Pregnancy Test After Embryo Transfer

If the test is positive, your pregnancy will be monitored via blood tests and ultrasounds by your GP. If the test is negative, you will discuss the reasons for IVF failure and plan your next steps.

Embryo Transfer Success Rates

Embryo transfer success rates depend on a number of factors including age, pregnancy history, previous IVF cycles, cause(s) of infertility, using donor eggs, etc. The chance of getting pregnant with IVF Cyprus with own eggs is:

• 78% for women 20-29
• 67% for women 30-34
• 49% for women 35-39
• 29% for women over 40

**Please note that this is statistical data for IVF cycles performed only at the EuroCARE IVF center in Cyprus.

Failed Embryo Transfer

Unfortunately, embryo transfer does not always work. Younger women have a higher chance of IVF success, with success rates of 70% for women under 35. A failed embryo transfer may be due to implantation failure or embryonic cause. Here are some of the reasons for failed IVF:

• Embryo quality: One of the most common reasons for an unsuccessful IVF cycle is poor embryo quality. Many embryos are unable to implant after transfer to the uterus due to defective genes. This may cause embryos to die rather than grow. Defective embryos may cause implantation failure, miscarriage or birth defects.
• Egg quality: As a woman gets older, the quality and quantity of her eggs begin to decline. This will greatly affect her chances for pregnancy with (and without) IVF. Older women have higher chances of IVF success when using donor eggs.
• Ovarian response: Sometimes a woman’s ovaries do not respond to the fertility drugs used during IVF in Cyprus to stimulate egg production. This may result in a lack of viable eggs for fertilization or poor egg quality that may affect your chance of pregnancy success. For women over 37, or for those with high follicle-stimulating hormone (FSH) levels, producing enough eggs may difficult or impossible. Our fertility doctor will discuss your treatment options and any changes that will need to be made to your medication protocol.
• Chromosomes: Embryos with chromosomal abnormalities can cause a failed embryo transfer. Chromosomal abnormalities are the most common reason for miscarriages and implantation failure during IVF. Women over 30 are more likely to experience chromosomal abnormalities in their eggs, and this increases as the woman gets older.
• Lifestyle: Lifestyle factors may interfere with your ability to conceive. You will need to quit smoking up to three months before the start of your IVF treatment in Cyprus. Smokers often need up to twice as many IVF cycles compared to non-smokers. If you are overweight or underweight, this too may affect your chance for pregnancy success. In this case, you should work on reaching a healthy weight to increase the chances of a successful IVF treatment.