Embryo transfer: 10 essential tips for success

22 Sep Embryo transfer: 10 essential tips for success

Embryo transfer day: a key hurdle for every IVF patient. It’s that moment when your fertility treatment and hopes converge. And the fact that it’s happening at all needs celebrating, since some fertility cycles don’t make it this far. The medication worked. You’ve got one or more viable embryos ready to transfer. Here we go.

So what should you do before, during and after your embryo transfer to maximise your chances? It’s the no. 1 question our patients ask us. A spectacular amount of myths abound, from drinking pineapple juice to doing handstands. We think it’s time to separate the wheat from the chaff. So we present our top 10 tips – based on facts, not fiction – for making your embryo transfer a success.

1. Request the most experienced doctor.

An embryo transfer is routine, your clinic will tell you. But you’re the patient and you’re paying. Insist the senior doctor or consultant in the team carries out your embryo transfer. With any luck they’ll be the person who’s managed your care so far.

Experience matters. A skilled practitioner has a steady hand, and you want the best. Someone who won’t touch the fundus and cause uterine contractions (okay, that really would be negligent). Someone who’ll follow the ultrasound-guided images like a hawk. And someone who’ll release your hard-won embryos at the MIP point like a pro.

2. Do a dummy run.

An embryo transfer should be quick and easy. Consider asking your doctor to do a mock transfer before the real thing. He may argue it’s not necessary. Ask why not. It can sometimes help to evaluate the uterine cavity, locate any potential barriers to entry (e.g. a cervical growth) and reveal if an alternative catheter should be used. A research fellow (not the consultant we’d requested) did our embryo transfer at a UK clinic. She didn’t read our notes properly, used the wrong catheter and delayed the transfer for over three minutes. The cycle failed, as did our request for a refund. Enough said.

3. Don’t have a hydrosalpinx.

High up on the embryo transfer no-no list are hydrosalpinges. No, we can’t pronounce them either, but they’re not nice. A hydrosalpinx is fluid in one or both fallopian tubes, often associated with a previous sexually-transmitted disease or endometriosis.

It can affect IVF treatment. The pesky fluid can leak into the uterus, meddle with your womb lining and cause havoc with the embryo you just transferred. It’s sensible to have ultrasound testing and/or a hysterosalpingogram (HSG) well in advance of your treatment. Your tubes should ideally be repaired before your embryo transfer can happen.

4. Test, test and test again.

This may seem obvious, but don’t trust clinics that skimp on essential pre-treatment tests. If they don’t request key results, they care more about their bank balance than your embryo transfer. For IVF patients using their own eggs, hormone profiling (FSH, AMH, etc.) is a must. As is a male-partner semen analysis, and a trans-vaginal scan of your reproductive organs, mid-cycle.

For donor-egg patients, hormone testing for TSH and Prolactin levels is a good idea. But, once again, a semen analysis, and a trans-vaginal scan on day 13 or 14 that includes a measurement of your lining thickness, is vital.

5. Take folic acid – ideally within a multivitamin.

Tried, tested and proven, a folic-acid supplement helps reduce the risks of birth defects. That holds true for couples trying naturally and through IVF. So start taking one a day from at least three months before your expected embryo transfer.

Speak to your doctor about how much to take and consider a vitamin/mineral supplement that includes folic acid, vitamin D and all your B vitamins. We took Pregnacare throughout our five years of IVF treatment.

6. If you’re over 40, consider transferring two embryos. Maybe.

Don’t get brainwashed into thinking a single embryo transfer is always best. It is, most of the time, but not necessarily always. If you’re over 40, a recent IVF study challenged the one-at-a-time rule.

A single embryo transfer is sensible in most circumstances though. Putting in two boosts the chance of a multiple pregnancy and linked complications. It’s generally better to put in one and freeze the rest.

Of course, the number you put it depends on the age, quality and quantity of your particular embryos, and your specific medical history. But we think single embryo transfers (especially in fresh cycles) are the better approach. Read our blog post on this. 

7. Don’t head for bed after your embryo transfer.

Duvet day after your embryo transfer, right? Wrong. It’s a myth that bed rest after embryo transfers helps. You’re better of relaxing and staying upright. Tell your partner to take you out for a nice lunch – minus the alcohol and postprandial coffee, of course. Then take a stroll round the park, but don’t do strenuous exercise. No heavy lifting or trampolining, either, and no hot baths. Those embryos want you active, calm and dry.

8. Try not to cough or sneeze.

If you have a cold on the day of your embryo transfer, tell your doctor. You shouldn’t really cough or sneeze during the procedure. It probably won’t affect your implantation chances once the embryos are in, but sneezing with the catheter inside your uterus isn’t wise. Ask for a cough remedy to keep the splutters at bay.

9. Book a clown – or give your partner a joke book.

Your embryo transfer should be stress-free, as should the next few minutes recovering from it. Bizarre as it sounds, a recent study found that IVF patients who were entertained by a medical clown for 15 minutes post-embryo transfer were twice as likely to get pregnant than joke-free patients. We’re guessing a medical clown has a red nose, white coat and a good brief. The point is, this admittedly small Israeli study suggests low stress levels can help implantation. If your clinic doesn’t have a salaried clown to hand, tell your partner to start rehearsing his Ricky Gervais routines.

10. Own your IVF health – no one else will.

Preparing for your embryo transfer isn’t just about following your treatment protocol and chilling out. IVF clinics never tell you anything about looking after yourself. But it’s crucial you and your partner do. Ditch the caffeine (both of you), don’t touch alcohol, take moderate exercise and (female patients only) consider acupuncture on your embryo transfer day: it may just make a difference. And take it really easy the first few days after your ET. This is when implantation happens. Don’t go back to work for a while if your office pulses with adrenaline. Do what makes you relax.

Hope your enjoyed our top 10 tips to help make your embryo transfer a success. Now read our guide to improving your pregnancy chances during the two-week wait.

Stop press! Two extra tips. First, a frozen transfer may give you a healthier singleton (another good case for freezing embryos and not going for broke in a fresh cycle). And research suggests embryo glue may benefit certain patients – ask your clinic about this.

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