Transferring an embryo is the process of placing an embryo into a woman's uterus with the intention of establishing a pregnancy.
The uterus must be ready to receive an embryo which is why uterine preparation meds are used- usually estrogen to start with and then progesterone 3 to 5 days before the transfer. Other meds such as Orgalutran can also be used, to make sure your body doesn’t ovulate.
The uterine preparation can be tough on your body, mimicking early pregnancy. In the past I’ve felt bloated, exhausted and sore. But I actually felt quite good on this cycle, possibly because we are in sunny Portugal, having a really relaxing holiday. Your fertility clinic usually require the lining to be at least 6mm or more to go ahead with the transfer. Mine was 15mm which the doctors at Ferticentro were really happy with.After the egg collection and fertilisation, the embryos develop for either 3 days or 5 days. They are watched closely either using a traditional microscope or in our case using the Embryoscope. Some clinics transfer 3 day embryos, and some do 5 day ‘blastocysts’. It was very cool to watch the progress of our little embryos. We started with 10 mature eggs from Audrey, of which 7 fertilised. By day 5 they decided to exclude 2 of them due to abnormalities which meant we were left with 5 beautiful embryos.
Transferring 1 or 2 Embryos:
Gone are the days of transferring 5 or 6 embryos at a time. The more embryos you transfer, the greater the chance of a multiples pregnancy. And these always carry significantly higher risks.
Many clinics nowadays have a one embryo policy, but most clinics are willing to transfer two as long as you are in good health and are aware of the risks.
Each embryo transfer we’ve done in the past has been with two embryos at a time. The 2nd which resulted in Ava, was with two. We’ve always known there is a risk of twins when transferring two but have felt the risk is one we are willing to take (if it means that we are more likely to get pregnant then transferring just one.)
This time, we had to make that decision again, weighing up the pros and cons. You need to think of it physically, emotionally, financially, practically and medically. In the end we decided to stick with our decision to transfer two.
I think it’s such a personal decision and at the end of the day, you and your partner are the ones who have to live with the result of that decision. So yes, listen to professional advice and from those you trust. But make your own mind up.
Day of Embryo Transfer:
Our embryo transfer was on Monday, five days after the egg collection. This is considered a ‘fresh embryo transfer’ because it was done right after egg fertilisation. In other cases, embryos can be frozen and transferred at a later date and this is a ‘frozen embryo transfer’.
You don’t need to be fasting or anything for this procedure. It’s very simple. Feels quite like a smear test. A speculum is used to visualise the cervix and then a soft catheter is loaded up with the embryos and handed to the doctor performing the transfer. Within seconds it’s all over. They just need to check the catheter under the microscope to make sure there are no embryos left in it! After that they let you rest on your back for a half hour or so.
Our transfer wasn’t until 6.30pm in the evening, and because it was Ava’s bedtime, I went by myself. This was fine, we’ve done this before, but I’d recommend bringing a phone in with you so you can listen to some relaxing music for that half hour if you are alone. My phone battery was dying, so I improvised and ended up singing show tunes to myself while I waited.
They recommend not to do any heavy lifting or strenuous exercise for 5 days after the transfer. They also advise to steer clear of public swimming pools and baths for the first 3 months of an IVF pregnancy. I asked Dr Torgal to clarify this for me... could I do any swimming at all, and she said that the sea or lakes are fine. They just advise against swimming pools because of the risk of infection. I’ll see if I’m brave enough for the Irish Sea when I get back home. I love to swim and also love my baths- so this is a big thing for me to give up for 3 months. But it’s all worth it in the end, to ensure a healthy pregnancy.
The Two Week Wait:
So now it’s a waiting game. After embryo transfer you are supposed to wait between 10-14 days to do a pregnancy test. Most people end up doing a HPT (home pregnancy test) and then if it’s positive, they go to their GP for a blood test. The only definite way to know for sure is by a blood test. The pregnancy hormone is called HCG and most HPT’s can pick up this hormone at very small amounts. When I was pregnant with Ava, I ended up testing early (7 days after a 3 day transfer) and I nearly fainted when the Clear Blue Digital test said PREGNANT right away. I ran into Audrey in the kitchen who knew immediately by the look on my face. I hadn’t told her I was testing because if it was negative I knew it could still possibly be too early.
Experts advise you to avoid testing early because it can be extremely upsetting to get a false negative, and then later to find out that you are pregnant. The thing with testing early is that you have to be prepared for a negative. If it’s negative, you need to test again at the right time to be sure. But if you’re anything like me you would test twice a day until your blood test. Just to be sure!
I’ve been following lots of other peoples fertility journeys on social media and some people say they would prefer to know as early as possible, especially if it is negative. Rather than get their hopes up for two weeks. Others say it’s easier to just wait for a blood test and be told definitively one way or the other.
I guess, you and your partner need to decide what you feel is best.
Either way it can be a long two weeks. Plan some fun, but not too strenuous activities for this time. If, like us, you already have children, you will no doubt be kept busy. But if you are first timers, make sure you have some nice things to do. Don’t go too far away from home, cramping and light bleeding are common during this time and you might feel a bit tired, so don’t push yourself. If you can take some time off from work, I highly recommend it. Being in work, where a lot of people don’t know what you are going through, can be difficult. Or if you are the sort of person who wants to stay active and not think about it, keep on working. As long as it's not too physically demanding of course.
We’ve been so fortunate that we can stay in Portugal for the rest of our TWW so we should have an answer either way before we go home. Pregnant or not?