The embryo transfer

Possible complications: ovarian hyperstimulation syndrome Number of embryos replaced Supernumerary embryos   Back to IVF|ICSI - Step by Step

An embryo on day five...

... is placed in the catheter and...

... replaced into the uterus.

The replacement into the uterus of embryos produced by the process of IVF, takes place on either day three or five after the pick-up.

• The choice of day is determined by the gynaecologist and embryologist. Sometimes the decision is only made on day three itself. You will be contacted on the day in question when the most optimal moment of transfer is established.
• On the day of transfer, you will be informed on the phone (normally after 11 p.m.) at which time you will need to be on the ward. It could be that you will be required to wait a while in your room on the ward, before your turn comes for embryo transfer.
• At the time specified, you may come to the ward VPE 03.
• The embryo transfer takes place in the operating theatre. It takes very little time to perform and is painless and risk-free. In order to access the cervix, a speculum is placed in the vagina. Then the gynaecologist will place the embryos into the uterus, using a fine plastic catheter which he or she passes through the cervical opening.
• The procedure requires no anaesthetic and unlike during the pick-up, your partner will be permitted to attend in theatre.
• After the transfer, you will be returned to the ward, where you will rest in bed for two hours, then you may go home.
• You may continue life as normal, there is no need to do anything differently than otherwise, as this will not alter your chances of a successful outcome to the transfer.

   
Ovarian hyperstimulation syndrome
Some women can have an episode of Hyperstimulation syndrome during IVF treatment shortly after the embryo transfer. The symptoms usually consist of a swollen abdomen accompanied by pain, but can occasionally be more serious: nausea, vomiting, heavy pain, increase in weight and breathing difficulties.
The condition occurs as a result of the hormones which are administered during the stimulation phase. After the stimulation of the ovaries with hMG or rec-FSH, a hCG injection is given, which triggers ovulation, but at the same time, stimulates the ovaries further. If the woman then becomes pregnant, her own body will also start to produce hCG (see natural conception).
As of this point, it is then but a small step from stimulation to hyperstimulation. Basically, the hyperstimulation causes the remains of the follicles which were punctured during the pick-up, to form into cysts in which fluid collects. This siphers through into other bodily cavities, such as the abdominal cavity, where the fluid balance of the body is brought out of regulation.

Number of embryos replaced

The number of embryos to be replaced will be discussed and decided between you, the gynaecologist and the embryologist.

• The choice will be determined for the large part by your age (the older you are, the less fertile you become), the quality of the embryos and the number available. To a lesser degree, your personal choice will be considered.
• The results of previous IVF treatments also influence the number of embryos which may legally be replaced. If you have not been pregnant after several attempts using one embryo, this can be reason for using two or more embryos during the next attempt. However, the risk of multiple pregnancy does increase with the number of embryos replaced.

 
Surplus embryos
If the treatment results in more embryos than may legally be replaced at transfer, the remaining embryos may be frozen for possible later use in future treatments. Only good quality embryos will be frozen: they often do not survive the thawing process and only about 50% of frozen embryos will be of a good enough quality to be considered suitable for embryo transfer.

Embryo's are prepared for freezing