IVF and Embryo Transfer Process

What is IVF Embryo Transfer?

For pregnancy to occur naturally, a sperm has to travel through the uterus and fertilise the egg present in one of the fallopian tubes. The resulting embryo must be of viable quality to be implanted in the uterus and allow pregnancy to occur. Although the process sounds quite simple, fertilisation may fail to occur as there are a multitude of factors that may impede successful fertilisation, such as low sperm count, blocked or compromised fallopian tubes, a damaged or diseased uterus, or suboptimal egg or sperm production or quality. When natural fertilisation is hindered, this is where IVF facilitates a successful pregnancy.

As mentioned earlier, in the IVF process, a healthy egg and sperm are fertilised outside of the body in a laboratory, providing a conducive environment for fertilisation. Typically, more than one egg is retrieved and fertilised to increase the chances of healthy embryo formation and, thereby, of pregnancy. Upon fertilisation, the embryos are monitored carefully over the next 5 to 6 days, and within this time, the embryos progress to become blastocysts. This is the most suitable stage for embryo transfer.

At this stage, all embryos except one are frozen to be used for future embryo transfer requirements. The placement of the embryo within the uterus is of monumental importance to ensure successful implantation and pregnancy. Thus, this process is guided by a pelvic ultrasound to give clear visibility of the catheter used to transfer the embryo into the uterus. Successfully implanting the embryo significantly increases the chances of conception.

What are the Types of Embryo Transfers?

Embryo transfer can be done in a few different ways, among which one option can be chosen by the fertility doctor for optimal outcome.

1. Frozen Embryo Transfers (FETs)

Frozen embryo transfer is the most common type of embryo transfer process as it allows genetic testing of embryos before implantation, which enhances the chances of success with low risk of genetic defect or miscarriage. It involves thawing a frozen embryo and placing it past the cervix into the uterus.

2. Fresh Embryo Transfers (ETs)

After the embryos have been fertilised and monitored for five to six days, they will be transferred back into the uterus of the female patient.

3. Day 3 Embryo Transfer 

Many embryos may not survive till day 5, so fertility doctors may transfer the embryos back to the uterus on the third day to ensure that implantation can occur and the patient can conceive successfully.

4. Day 5 Embryo Transfer

This is considered the best time for embryo transfer, as this is when the blastocyst has formed.

When is Embryo Transfer Done in IVF?

Embryo transfer during an IVF cycle can be done during different milestones of an IVF cycle. Typically, two days (day 3 and day 5) out of the entire IVF cycle have been earmarked for transfer. The embryo transfer process can be done on either the third or fifth day, depending on the individual circumstances of the patient, as decided by the treating fertility doctor. Day 5 embryo transfer is the most common and suitable for IVF.

What are the Benefits & Risks of Embryo Transfer in IVF?

Before deciding upon the type of embryo transfer to be opted for, there are various factors to be considered for the best outcomes. While using frozen or fresh embryos both has its individual merits; they also have certain downsides.

You should note that mild cramping and vaginal bleeding are common after embryo transfer, but there are more severe side effects, such as infection and perforation of the uterus, which are incredibly rare.

Here are some benefits of embryo transfer that parents should know about.

• It provides the opportunity to achieve pregnancy and enjoy the journey just as with any other pregnancy.
   
• It reduces the risk of inherited genetic diseases, such as Down syndrome, sickle cell anaemia, etc., due to genetic testing before embryo transfer is done.
   
• With frozen embryos, couples can choose to undergo a subsequent pregnancy at a later time by planning beforehand.
   
• Preimplantation genetic testing before embryo transfer can also help prevent miscarriages, thereby increasing the chances of a healthy pregnancy and safe childbirth.

While embryo transfer offers the benefits of a safe pregnancy, parents should also be aware of the potential risks, which include the following:

• There is a risk of blood clot formation due to hormonal stimulation for IVF.
   
• There is a risk of losing embryos during the transfer process or even a failure of embryo implantation.
   
• Twin pregnancy is common with IVFs and is known to be a higher-risk pregnancy.

Step-by-Step IVF & Embryo Transfer Process

The embryo transfer process is quite similar to a pap smear procedure, often lasting for about 15 to 30 minutes. Here's a tentative step-by-step guide for the embryo transfer process.

• At the beginning of the process, a speculum is inserted into the intended mother's vagina with ultrasound to allow greater accuracy during the embryo transfer process.
   
• Subsequently, the doctor passes a catheter through the cervix into the woman's womb.
   
• The embryos are then passed through the tube and into the womb.
   
• After the embryo has been transferred, the patient is asked to lie down for about an hour to relax.

How Long Does the IVF Implantation Process Take?

The IVF embryo transfer process doesn't take a lot of time, and the entire procedure is completed within two to four hours, including the resting time after the embryo transfer. The process of embryo transfer itself takes only about 15 to 30 minutes to be completed.

How Many Embryos Are Transferred in an IVF Cycle?

The number of embryos to be transferred during an IVF cycle is dependent on a few factors, and the age of the woman is one of the most important determinants. Here's an approximate idea of the number of embryos that can be transferred based on the age of the woman, but it may vary based on the clinic and the individual case.

• Below 30 : Not more than one embryo transfer is recommended.
   
• Between 30-35 : Not more than 2 embryos are recommended to be transferred.
   
• Above 35 : More than 2 embryos may be transferred.

What Precautions are to be Taken Post Embryo Transfer?

While the individual aftercare instructions may vary from person to person, here is a list of general precautionary measures to be taken after embryo transfer.

• Rest : Get plenty of sleep and take enough time off after the day of embryo transfer.
   
• Avoid strenuous activities : While moderate activities like walking, driving, cooking, etc., are fine, it is important to avoid running, jogging, cycling, and other strenuous activities.
   
• Diet : Patients should eat a balanced diet and avoid processed foods. They should also take supplements on time, as recommended by the doctors.
   
• Sexual intercourse : It is recommended to avoid sexual intercourse until the pregnancy results come.

A Word of Advice from Indira IVF

If you're considering parenthood but there are fertility hurdles along the way, IVF treatment can be an answer to your questions. It is important to understand that IVF and embryo transfer processes can be different for every patient, as each couple's requirements are unique. With ART, couples have a new hope of bringing a healthy baby into the world.