In this post, you will learn all the steps of a frozen embryo transfer.
I answer frequently asked questions like:
- What are the steps for a frozen embryo transfer?
- How many days after menstruation does transfer occur?
- Are frozen embryo cycles better than fresh cycles?
Let's start.
Disclaimer:
Although I am a doctor by profession, I am not YOUR doctor. All content and information on this website is for informational and educational purposes only. It does not constitute medical advice and you do not create a physician-client relationship through your use of this site. The information presented here is not intended to prevent or treat infertility and is not a substitute for medical or professional advice. You should not just rely on leaving this information. Always consult your local physician for your specific needs and circumstances before making any decisions. Persons who fail to seek advice from the competent health authority assume responsibility for any damage, loss or injury that may occur.
When is the transfer of frozen embryos performed in IVF?
A frozen embryo transfer can be performed at any time in the future if you have already gone through an in vitro fertilization (IVF) cycle that produced usable embryos.
In other words, it can happen as early as the next cycle after egg retrieval or several months (or years) later.
How long does a frozen transfer cycle last?
A frozen embryo transfer cycle takes approximately 3-4 weeks. In the first two weeks, your uterine lining is prepared for implantation. Once your feed is ready, you're ready to goprogesteroneSupplement sometime in the third week.
Embryo transfer occurs after 3 or 5 days of progesterone support.
What is the timeline for transferring a frozen embryo? (Daily)
Now let's detail the steps of a day by day frozen embryo transfer (FET) cycle.
Step 0: Prepare the work
If you use your own eggs/embryos, you must first go through an IVF cycle.
The IVF process and freezing all usable embryos usually takes 2-3 weeks. You can continue reading my postThe IVF cycle timelinelearn more.
If you've had frozen embryos, speak with your doctor to determine if you're eligible to start FET right away.
Many fertility specialists will have you return for an appointment to determine whether you should be on a drug FET cycle or a natural FET cycle.
You may also need an examination of the uterine cavity (saline sonography orhysteroscopy) or onefake transferbefore proceeding.
Once everything is resolved, your fertility clinic will direct you to call or email to report the first day of your cycle.
Label 1:
Day 1 refers to the first day of your menstrual period. After informing your clinic, you will be scheduled for day 2, 3 or 4 of your cycle to possibly start the FET cycle.
Day 2, 3 or 4:
On days 2-4 of your menstrual cycle, you'll have a morning monitor, a transvaginal ultrasound, and blood work.
Se oThe ultrasound looks normal and your hormone levels are "baseline"You start your FET cycle on this day.
If you are doing a medical FET cycle:
You will begin estrogen supplementation that day.
Estrogen pills do two things: they thicken the lining of the uterus and prevent the growth of an ovarian follicle.
They'll be back in about a week or so to check on your liner's progress.
If you are in a natural cycle:
You will not take any medication. They will come back in about a week or so to check on your plating progress.
Tome ~ 10-14:
On your second morning surveillance visit, your lining should increase in thickness.
The aim is to reduce the chuck size to ~7mm.
If you are running a medical cycle:
If your feed grows as expected, you will be given a start date for progesterone supplementation.
This usually involves an intramuscular injection of progesterone with or without a vaginal progesterone suppository.
If you are in a natural cycle:
Your lining should be thicker and you should develop a dominant ovarian follicle.
Your reproductive endocrinologist may be waiting for your body to start ovulating (aka your blood tests show that your LH hormone is rising).
In this case, your doctor may or may not prescribe youtrigger shotto initiate ovulation.
Label ~15-18:
Sometime after the two-week mark, you'll start progesterone.
If you are doing a medical FET cycle:
You will begin intramuscular progesterone injections as soon as your doctor determines that your mucosa is suitable.
You will administer the progesterone injection twice on the first day and once a day thereafter.
Embryo transfer is then planned:
- on the sixth day of progesterone injections (if you have a blastocyst stage embryo transfer)
- on day 4 of progesterone injections (if you have a day 3 cleavage stage embryo transfer)
If you do a natural FET cycle:
You start taking progesterone suppositories the day after your injection (or the day after you ovulate).
Embryo transfer is then planned:
- on the sixth day, progesterone suppositories (for blastocyst transfer)
- on day 4 of progesterone suppositories (if you have a day 3 cleavage stage embryo transfer)
Label ~19-24:
This is the day of the embryo transfer. It's a simple procedure that shouldn't take more than 20 minutes.
You are expected to come with a full bladder, which will help visualize and guide the catheter with the embryo into the uterus.
To learn more about what to expect on the day of your embryo transfer, read:Embryo transfer precautions: what not to do.
Label ~ 28-32:
You will take your first pregnancy test on September 11th at the earliest. after the transfer!
How many days after the FET is the implantation?
We believe that an embryo will implant within the first 24-48 hours after the FET. You probably won't feel anything anyway except very mild cramping.
Can I take a pregnancy test 8 days after the embryo transfer?
We recommend waiting at least 9-11 days after the transfer to avoid a false negative result.
Before that point, levels of human chorionic gonadotropin, also known as hCG, are not high enough to result in a positive home pregnancy test.
It is much better to have a quantitative hCG blood test at your doctor's office after 9 to 11 days.
How many weeks pregnant after IVF frozen transfer?
You are approximately 2 weeks and 5 days pregnanton the day of a blastocyst embryo transfer (assuming it works).
If you have a positive pregnancy test after about 9 days, you are approximately 4 weeks pregnant.
What are the typical 5-day success rates for frozen embryo transfer?
However, the transfer success rate of untested frozen embryos can drop to 20-30% and decrease as the mother ages.
Here are some recent studies: [1] [2] [3]
check my postembryobiopsyto see if you are a good candidate for genetic screening.
Why do frozen embryo transfers fail?
Unfortunately, we don't always know why some embryo transfers fail.
In general, there could be an embryo quality issue, implantation failure, or other endometrial issues that we still don't fully understand.
Pre-implantation genetic testingit can help check for numerical chromosomal abnormalities, but it cannot test for all types of genetic conditions that may exist.
What can you do after embryo transfer to increase success rates?
Unfortunately, there isn't much you can do to ensure a successful pregnancy.
You've already done everything in your power. The rest stays with the embryo.
If you are taking a progesterone supplement, do not stop taking it until your doctor tells you to.
You do not needBed rest.Also, it's a good idea to avoid high temperatures for the first 1-2 weeks after transferring.
Also, you should try to eat a healthy diet and stay well hydrated.
Are FETs better than fresh embryo transfers?
However, many studies have shown that pregnancy rates and live birth rates are similar in many patients.
Despite this, many patients are not good candidates for afresh embryo transfer.
check my postFreeze – All IVF cyclesknowing when to freeze your embryos and my other post on the subjectDisadvantages of frozen embryo transfer cyclesto help you make an informed decision.
Conclusion
Now you understand the FET cycle timeline in relation to an IVF treatment cycle.
FETs are a great way to provide flexibility in the timing of your pregnancy, as any embryo created can be stored indefinitely for future use.
If you have questions about the next step, you might be interested in reading:
- When Should You Stop Estrogen and Progesterone After IVF (And Why)
- The time after an unsuccessful treatment cycle: (what to expect)
Book an appointment today with Dr. Robles to discuss your fertility options!
Alex Robles, MD
Dr Alex Robles is a Spanish-speaking Latin American reproductive endocrinology and infertility specialist based in New York City and a board-certified OBGYN. He has a special interest in health, lifestyle and nutrition.Book an appointment today with Dr. Robles to discuss your fertility options!
References:
- Bdolah Y, Zeimet R, Aizenman E, Lossos F, Abram TB, Shufaro Y. The success rate of frozen-thawed embryo transfer is influenced by age and the ovarian response to oocyte aspiration, independently of the blastomere survival rate. JABRA Assist Play. November 1, 2015;19(4):210-5. DOI: 10.5935/1518-0557.20150041. PMID: 27203194.
- Veleva Z, Orava M, Nuojua-Huttunen S, Tapanainen JS, Martikainen H. Factors affecting the outcome of frozen and thawed embryo transfer. sum playback. September 2013; 28(9):2425-31. DOI: 10.1093/humrep/det251. Epub June 11, 2013. PMID: 23756705.
- Roque M, Haahr T, Geber S, Esteves SC, Humaidan P. Fresh versus frozen elective embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes. Buzz playback update. January 1, 2019;25(1):2-14. DOI: 10.1093/humupd/dmy033. PMID: 30388233.