For some couples, natural conception becomes a struggle. They turn to home remedies and many non-invasive procedures, but nothing seems to work. For these couples, in-vitro fertilization (IVF) serves as a strong ray of hope. Did you know that around 12 million babies are born with IVF and other ART procedures?
IVF has many stages. The last one is embryo transfer, which is scheduled after your fertilized egg reaches the blastocyst stage. You might wonder what exactly embryo transfer is, how it’s conducted, and what its success rates are. In this post, we’ll take a detailed look at the embryo transfer procedure, what to do after embryo transfer to increase success, the timeline, and other important aspects.
Understanding Embryo Transfer
The most crucial yet intense step in your IVF journey is embryo transfer. By the time you reach this stage, you have already had multiple injections, a minimally invasive retrieval procedure, medications, and ultrasounds. You have also completed the waiting period for the embryo to be ready for transfer.
Embryo transfer is a crucial step in which the fertilized egg and sperm that have formed an embryo are transferred into the woman’s uterus using a catheter. The entire procedure is guided by a pelvic ultrasound, allowing the embryo to be transferred to the spot where it can attach to the uterine lining.
The fertilization takes place outside your womb, in an embryology lab that mimics the environment of the woman’s uterus. However, the actual growth of the embryo takes place inside your womb. So, this step is indispensable for increasing your chances of a successful pregnancy.
Types of Embryo Transfer
Not every couple chooses to have their embryos transferred on the fifth day of embryo culture. Some have it earlier, also called day 3 embryo transfer, while others choose to freeze it for a certain period or until they are physically and mentally prepared to have a baby. Let’s understand the two common types of embryo transfers.
Fresh Embryo Transfer
The embryologist carefully monitors the fertilized eggs in the petri dish and selects the most viable embryo (that is highly likely to implant successfully) for transfer. The transfer can be performed on either the third or fifth day after egg retrieval.
On the fifth day, the embryo develops into a blastocyst, consisting of over a hundred cells and surrounded by fluid. This is the most common period for embryo transfer (in couples who choose fresh embryo transfer).
If your fertility specialist believes the embryo might not survive beyond day 3, they might schedule transfer on the third day of egg retrieval. If a woman is overall healthy, a fresh embryo transfer can be a good choice.
Frozen Embryo Transfer
Couples can freeze their embryos through a process called vitrification. These embryos are thawed and transferred when you are prepared for pregnancy. Usually, the leftover embryos from the previous egg retrieval process are stored for later use. If IVF fails, these frozen embryos can be used for another IVF cycle.
This saves couples the time to undergo hormone injections and retrieval for future IVF cycles. There’s no specific frozen embryo transfer timeline. You can rest easy knowing that your embryos are safe and can be used whenever you want.
Fresh vs Frozen Embryo Transfer Success Rate
If you are hormone levels and uterine lining (where the embryo implants) seem normal after egg retrieval, a fresh embryo transfer might work for you. However, in most cases, frozen embryo transfer is considered a better alternative, as it allows your embryologist the time to test embryos for genetic disorders or chromosomal abnormalities through Preimplantation Genetic Testing (PGT).
Once the test results are in, they can select the most viable embryos for transfer. While both options are great, the best one for you depends on your health, age, hormone balance, and other factors.
When is Embryo Transfer Recommended?
Here’s when embryo transfer is recommended:
- Blocked Fallopian Tubes: Fertilization happens in the fallopian tubes. If these are blocked, sperm won’t reach the egg. If it does, the fertilized egg won’t travel down the tubes and enter your uterus. Either way, natural conception is not possible with blocked tubes.
- Ovulation Disorders: Irregular ovulation makes it difficult to time your intercourse for pregnancy. It also means fewer eggs are available to be fertilized.
- Endometriosis: It’s a medical condition in which your endometrial tissues grow outside your uterus. Depending on the growth and location of these tissues, they might make pregnancy difficult.
- Other Causes of Infertility: Embryo transfer is recommended for women with unexplained infertility.
- Male-Factor Infertility: Poor sperm morphology or quality can make the fusion of egg and sperm difficult. In such cases, IVF with embryo transfer is needed.
Step-by-Step Process of Embryo Transfer
Before embryo transfer, you go through multiple stages of IVF. Let’s explore each:
Step 1: Ovulation Stimulation
To collect multiple eggs through your ovaries, your fertility specialist will prescribe medicines to trigger your ovaries to release many, instead of a single egg, per ovulation cycle. Gonadotropins (follicular-stimulating and leuteinizing hormones) are administered for 8-14 days. During this period, ultrasounds and blood tests are scheduled to test follicular growth. Once they have reached maturity, egg retrieval is scheduled.
Step 2: Egg Retrieval (Oocyte Collection)
A trigger shot is administered 34-37 hours before egg retrieval. This shot helps the egg reach maturity. Retrieval is conducted under sedation. The surgeon uses a fine needle that’s inserted into the ovaries through your vagina. The mature eggs are suctioned from the follicles. It lasts 20-30 minutes.
Step 3: Fertilization
The collected cells are kept in a culture dish with your partner’s sperm for fertilization. Alternatively, the sperm is injected into the egg through Intracytoplasmic Sperm Injection (ICSI) in certain cases.
Step 4: Embryo Culture and Development
Fertilized eggs are stored in an incubator that has a controlled environment, just like a woman’s uterus. The goal is to give embryos the same warmth, temperature, oxygen, pH, and nutrients as the mother’s womb so they can have the best chance at survival. These embryos are monitored closely for the next few days. Embryologists check cell division, symmetry, and overall quality of the embryo.
Step 5: Embryo Transfer
Embryo transfer is a quick procedure that lasts around 10-20 minutes and is quite similar to a pap smear. Your gynecologist uses an ultrasound to guide the catheter into the womb through your cervix. They then pass the selected embryo/s through the catheter and transfer them to the womb.
The process is painless for most women and doesn’t require anesthesia. You can rest for a short while before returning home and resuming your routine activities. Your fertility specialist may prescribe progesterone supplements to thicken your uterine lining to support implantation. IVF involves a waiting period of 10-12 days before you can take a pregnancy test.
Step 6: Post-Transfer and Monitoring
As mentioned above, you can go home the same day, usually shortly after transfer. You are encouraged to perform light activities, like walking or working, but avoid strenuous tasks. Here’s what else to do to boost your chances of conception after embryo transfer:
- Take progesterone medication as prescribed by your doctor
- Do not drink, smoke, or eat foods rich in caffeine
- Have a diet full of fiber, vitamins, omega-3 fatty acids, iron, calcium, and other nutrients
- Take rest
- Stay hydrated
- Practice meditation and yoga to relieve stress
Do not take a pregnancy test immediately or before 2 weeks of transfer. You might experience breast tenderness, cramping, and spotting during this period. You can take a home pregnancy test 14 days after transfer or visit your fertility clinic in Lahore for a blood test.
Your doctor will schedule an ultrasound between the 2nd and 3rd week after the pregnancy test to check the yolk sac, heartbeat, and other vital signs.
Factors Affecting the Success Rates of Embryo Transfer
The factors that affect the success rate of your pregnancy after embryo transfer include the natural biology of reproduction, the clinic you choose, the doctor’s expertise, and your lifestyle habits.
- Age and Health of the Woman: The egg quality and quantity diminish with age. Women under 35 have a better chance of conception after embryo transfer, while those above 40 might have slightly lower chances.
- Embryo Quality: Your embryologist will review the embryos under a microscope and grade them based on how they appear. If their chromosomal makeup appears normal and they have reached the blastocyst stage, the chances of the embryo implanting successfully in your uterus are good.
- Clinic’s Condition: Not every clinic offers a high success rate for pregnancy after embryo transfer. A ventilated lab with time-lapse monitoring and advanced technology might offer a higher success rate than labs with outdated technology or a poor environment.
- Uterine Conditions: For the embryo to implant successfully, your uterine lining might be 7 to 14 millimeters thick. If needed, your doctor may prescribe medication to prepare your uterine lining for transfer.
Cost of Embryo Transfer in Lahore
Embryo transfer is not priced separately. It’s part of the IVF, and its cost is included in the package. In Lahore, Pakistan, the cost of an IVF package can range from Rs 830,000 to Rs 970,000, approximately, but these are average numbers.
At Australian Concept, the most recognized fertility clinic in Pakistan, the cost of embryo transfer and the entire IVF package depends on factors such as the woman’s age, the types of procedures the couples go through, and if they request additional services, such as PGT or embryo freezing.
For more details about the cost breakdown, please consult an IVF specialist in Lahore. They will be able to provide you with the individual prices for consultation, medication, lab tests, and other procedures.
Legal and Ethical Considerations in Lahore
Embryo transfer is not just a medical procedure for couples in Lahore. A majority of them want to be certain that each practice—from ovarian stimulation to embryo transfer—is conducted following Islamic guidelines.
Certain actions, such as using donor gametes and surrogacy, are considered unlawful, and in some regions, legally unacceptable. Many fertility clinics in Lahore, including ACIMC, adhere to Islamic principles. Rest assured that you are not crossing Shariah’s boundaries by choosing IVF.
Post-Embryo Transfer: What Happens Next?
Your IVF journey doesn’t end with embryo transfer. In fact, the emotional struggle begins here. Let’s see what changes your body goes through after embryo transfer.
The 2-Week Wait
The most difficult phase of the entire IVF journey is the two-week wait period. You don’t know if the embryo has implanted successfully, whether you are pregnant, or how long until you can take the pregnancy test.
You may experience symptoms that mimic pregnancy, such as breast tenderness, cramping, and spotting, but you must never get your hopes up until you take the test, as the symptoms are present in those who are and who are not pregnant. These symptoms are caused by hormone medication, like progesterone.
Managing stress is important at this point. Be relaxed, continue breathing exercises & meditation, be active, and talk to your loved ones. There’s no need to overanalyze by Googling everything. While it may seem overwhelming, this is your only option. Wait for two weeks and head to your fertility center for a blood test.
Signs of Pregnancy After Embryo Transfer
It’s hard to tell whether or not you are pregnant without a pregnancy test, but a few symptoms in women might point to pregnancy. You will notice them in the second week of embryo transfer.
- Cramping
- Fatigue
- Breast tenderness
- Frequent urination
- Mood swings
When to Take a Pregnancy Test
You must take a blood beta-hCG test 10–14 days after embryo transfer to confirm pregnancy. The results are positive if the embryo attaches itself to the uterine lining. If your pregnancy results are positive, the doctor will schedule ultrasounds to check your baby’s vitals.
If the Transfer Fails: What Are the Next Steps?
If your pregnancy test is negative, don’t panic. There’s still hope. If you froze leftover embryos, you can use them any time. Your fertility specialist might adjust the fertility medication dosage and procedures based on what may have caused the failed implantation.
They might recommend PGT (if you didn’t get in the first cycle) to rule out chromosomal defects as the cause of failed implantation. In the meantime, join counselling groups or talk to people who have undergone IVF and other assisted reproductive technologies to get mental relief.
Common Myths About Embryo Transfer
If you ever hear someone say exaggerated stories about embryo transfer, consult your fertility specialist before trusting them. You may have heard of these often:
Myth 1: Transfer Hurts
Fact: No, it does not. Embryo transfer is painless. Mild cramping is normal, but the process is never extremely painful.
Myth 2: Successful Pregnancy is Guaranteed
Fact: While some couples are lucky to conceive on the first cycle, it’s not the case for all. Some need multiple IVF cycles before they hear the good news. Success is never guaranteed with any ART procedure.
Myth 3: You Need Multiple Embryo Transfers
Fact: Multiple embryo transfers will only increase your risk of multiple pregnancies. Many Lahore-based fertility clinics offer single embryo transfer. If you choose a healthy, viable embryo, there’s a good chance it will implant successfully, even if it’s just a single embryo.
How to Choose the Right Fertility Clinic in Lahore
The environment of the IVF clinic and the fertility doctors’ expertise can make a big difference to the success rate of your embryo transfer. If you are sure about seeking fertility treatment, consider these factors in the clinic before choosing.
Experience: The IVF clinic in Lahore you are considering should have board-certified fertility specialists with several years of experience in helping couples conceive through ART.
Technology: Check the embryology lab, its cleanliness, and technology to ensure it’s well-equipped and clean enough to support the embryo’s growth. Check if they offer time-lapse embryo monitoring, Preimplantation Genetic Testing, embryo freezing, and blastocyst culture systems.
Patient Reviews: Read patient testimonials or ask the clinic to share reviews of their recent patients. This gives you a better picture of the clinic’s success rate, its approach, and whether people leave the clinic satisfied.
Questions to Ask the Fertility Specialist
If you are still not sure about a clinic, feel free to ask these questions:
- What experience and qualifications do your fertility specialists hold?
- How many patients from your clinic have had a live birth after embryo transfer?
- Could you please share the cost breakdown for IVF?
- Do you offer counseling?
- How many IVF cycles do you think are needed?
Final Words
Lahore has ISO-certified clinics, a team of professional fertility specialists, and advanced technologies that make pregnancy possible for many. Whether it’s choosing between fresh or frozen embryos or getting counseling during the 2-week wait period, you can get everything under one roof.
FAQS
- How many days does the IVF embryo transfer process take?
Embryo transfer itself takes a few minutes, although the entire IVF procedure can last between 4 and 6 weeks.
- Is embryo transfer painful?
No, embryo transfer is a quick, painless procedure.
- On which day of the menstrual cycle is embryo transfer done?
It’s scheduled between days 19 and 22 of the menstrual cycle.
- How can I increase the chances of a successful embryo transfer?
Follow your doctor’s instructions, eat well, avoid stress, stay hydrated, get enough sleep, and leave the rest in the hands of Allah SWT.
- What are the symptoms of pregnancy after an embryo transfer?
Breast tenderness, fatigue, frequent urination, cramping, and spotting occur because of hormonal medication, not pregnancy.
- Can I walk immediately after an embryo transfer?
Yes, unless your doctor says otherwise. It’s good to start walking soon after embryo transfer.
- What is the best sleeping position after an embryo transfer?
Sleeping on the back or left side is considered an optimal position after embryo transfer.
- How successful is pregnancy after an embryo transfer?
It varies from patient to patient. The factors affecting your chance of conception after an embryo transfer include your age, health, existing medical conditions, cause of infertility, and the doctor’s expertise.
- How much does an embryo transfer cost?
The cost varies depending on your package and the clinic you choose.
- Why does IVF fail with good embryos?
It’s possible for pregnancy to fail despite good embryo quality. It’s common in women with a too-thin or too-thick uterine lining and undetected genetic issues.
