welcome back this week we are talking about the final step in the ivf process the embryo transfer
yeah and just in case it's your first time meeting us i'm kurt i'm a board certified
pediatrician and supportive partner i'm sarah i'm a board-certified ob gyn a fertility
specialist and now an ivf patient myself and we are the doctors bjorkman
this week we are talking all about the embryo transfer what it is how it's performed and what to
expect now embryo transfer day is a really special day it's this culmination of weeks of injections
ultrasounds you've got a minor surgical procedure possibly you did genetic testing and all this has
happened after a long battle with infertility yeah so it really is an exciting and nerve-wracking day
and the preparation for it depends on whether you're doing a fresh versus a frozen embryo
transfer yeah a fresh transfer means you're doing this transfer about five days after
your retrieval yep um and a frozen transfer means that after your retrieval the embryos were created
and then frozen to be transferred at some point in the future this is done for a variety of
reasons you know you may have a big response to a stimulation you may have planned genetic testing
or it may just be the way your clinic does it yeah and fresh or frozen the lead-up to transfer
may be a bit different but the day of is very much the same for either indeed whichever you're doing
fresh or frozen it is very important that you are taking your medications and following kind
of your calendar or protocol as prescribed yeah and the meds here are very important for getting
your uterine lining ready for this transfer yes so things to think about ahead of time are to
make sure that you know what time your procedure is and what time you need to arrive at the clinic
you're going to want to know what the clinic policy is on visitors or having a partner with you
and then you want to find out if you need any labs or anything else done the day of that procedure
so what to expect on the day of your transfer so the day of the team is going to ask you
to come with a full bladder yeah and why is that so the first reason is that a full bladder
really helps us be able to see um when we are using the trans abdominal ultrasound we want
to be able to look through your abdominal wall and be able to see the uterus clearly
and that fluid helps with visualization the second reason is that a full bladder often helps kind of
straighten out your uterus um so that there's a nice nice straight path for the catheter
now there are a lot of people involved with the transfer day usually there's a nurse
the physician the embryologist and a sonographer so when you arrive at the clinic usually a nurse
is going to have you get undressed from the waist down they review any labs you have had done
you also might not need any and then you're going to meet the rest of the team your physician will
usually sign a consent form for the procedure they will do multiple checks to confirm your identity
um and do this confirmation checks with the lab and then the embryologist or doc will kind of go
over your embryo report with you if it's a fresh transfer they may give you a rundown of what's
happened over the past five days so how many eggs were retrieved how many fertilized normally
and then show you that blastocysts or embryos that have made it to day five and which one
you're going to transfer if it's a frozen transfer they'll have a picture of your embryo
and share how it survived the thought process and then it's time to get ready for the procedure
so let's talk about the embryo transfer so the procedure the embryo transfer itself is a very
safe and simple procedure to start out a speculum is placed in the vagina just like when you get
a pap smear but what if someone's had difficult speculum exams in the past so that's something you
definitely want to let your team know um because often we can give you some valium ahead of time to
help you relax help your uterus and pelvic floor muscles relax and to help you be more comfortable
this is in addition to knowing ahead of time we can often use a different more smaller speculum
and things like that to help make it better for you so after the speculum is placed we're going
to clean the cervix off with a cotton ball and some saline we then do a quick practice with the
catheter to make sure we have a nice smooth path to the uterus and this is the transfer catheter
yes yes it is so as you can see it is a small flexible catheter um that we gently thread through
the cervix okay so it kind of it has an outer sheath here and then this inner soft catheter
yeah and all this is being done with ultrasound guidance correct so once we know we have a nice
smooth path we let the embryologist know we remove this inner catheter and we have the embryologist
load that embryo up in this soft inner catheter that outer catheter usually stays there to hold
the path and so we then thread that inner catheter back through the outer catheter until we get
to a specific spot up in your uterus kind of at the thickest portion of the lining and then we do
the transfer so we have this small syringe that is filled with some fluid that we gently inject and
often as that is happening your doc will let you know hey you were doing the transfer and you often
see a flash of bright flash on the ultrasound so the embryo is microscopic so we can't see that
but when the embryologist is loading up the embryo they put one air bubble in front of the embryo and
one behind it so that when you inject you see the flashes and those are those air bubbles that were
loaded with your embryo well it's transfer day here we go sun baby dust wishes luck
after that the physician then slowly removes the catheter and then the embryologist is able
to check the catheter to make sure that the embryo didn't get stuck in the catheter itself correct so
every once in a while um the embryo does stick in the catheter and so if that happens the
embryologist loads the embryo back up and we do the transfer again until we know it is in
the right place in your uterus yeah and then once the embryologist gives you the all clear
it is okay to either rest for a little bit or get up and go pee yes there is no data
that suggests that a prolonged period of rest or laying supine putting your hips up things
like that increases your chances of pregnancy so i think our patients usually hang out for about five
minutes and then they're on their way yeah after the transfer it is really important to keep taking
your medications as prescribed yes um and then usually um ten days after the transfer it is time
to take your pregnancy test now that pregnancy test that's a blood test yes your clinic will
want to get a blood test or a quantitative hcg so that is a number they usually repeat that after 48
hours to make sure it's rising appropriately well how early can you take that tester can you use
home tests so generally your clinic is going to recommend waiting until 10 days after and getting
the blood test so this is for a couple reasons one getting a negative home pregnancy test can
be just emotionally tough and two it might just be wrong that you're just testing too early that
being said i know many patients myself included um start testing earlier so we have a video all about
how early you can take a pregnancy test and signs of implantation in early pregnancy coming your way
next week so hopefully that is everything you need to know about the embryo transfer if you have any
questions tips anything please leave them below if you are getting ready for your embryo transfer
sending you all the luck and baby dust we will see you next week bye guys there is this sort of
voodoo or myth or whatever there's absolutely no evidence for that if you eat french fries
after your embryo treatment you're more likely to get pregnant um and so again while there's no
evidence for it i like french fries i'm so i'm really trying to embrace all this so here we go
we're doctors but not your doctors anything we've said in this video
is for education or entertainment purposes only it is not medical
advice any specific medical questions you have should be directed to your provider