Embryo transfer in the eco program. Artificial insemination (IVF): how to behave after embryo transfer

The problem of infertility, according to statistics, is faced by about 5% of couples around the world. Of course, the problem is not large-scale, but it is tragic for each individual family. An effective method of treating pathology is IVF. Many patients, after completing the protocol, are interested in how it feels after IVF, how embryos develop and how to increase the chances of success. Therefore, before performing the procedure, it is recommended to collect all the necessary information in order to exclude psychological overstrain and stress.

One of the important stages of the procedure is the replanting of embryos during IVF. The process of embryo implantation cannot be influenced by external factors, so it is important to undergo a preliminary medical examination, receive medical support after IVF, as well as psychological support after IVF, and follow the doctor's recommendations in order to increase the chances of success.

General information about IVF replanting

The egg after ovulation and fertilization is covered with a protective shiny shell that retains its properties until the formation of the embryo. But after replanting during IVF, the shell should break, and the embryo should successfully gain a foothold in the endometrium.

The villi of the trophoblast of the embryo are immersed in the endometrium to a certain depth and provide reliable fixation. When optimal conditions are formed, the embryo continues further development and pregnancy occurs, otherwise the embryo is rejected and menstruation begins.

On average, with IVF after embryo transfer, they need 1-2 days for implantation, in rare cases up to 10 days. But sometimes early implantation of the embryo is diagnosed.

If during IVF after replanting optimal conditions were formed, then you can count on a positive result:

• The thickness of the endometrium is approximately 1.3 cm;
• The walls of the uterine cavity produce a sufficient amount of nutrients;
• The concentration of progesterone is above normal values.

Embryo implantation in IVF after replanting

The process of engraftment of embryos during IVF after transfer and the replanting procedure itself is an important stage in infertility therapy. Before embryo transfer, patients undergo ultrasound to determine the parameters of the cervical canal, uterus, measure the thickness of the endometrium and assess the condition of the ovaries. These examinations can be performed at the clinic "IVF Center" Volgograd.

After that, the vagina, cervix and cervical canal are treated and the specialist injects a special drug that increases the chances of successful implantation. The embryo is placed in a special syringe with a nutrient medium, it is injected into the uterine cavity under ultrasound control, then it is released.

With IVF, after embryo transfer, a woman may experience a feeling of fullness in the lower abdomen, this is a variant of the norm. Then the transfer procedure is repeated and hormonal support is prescribed after IVF.

The first days after replanting with IVF

The development of the embryo by day after replanting during IVF depends on the time of their transfer to the uterine cavity. For many women, the transfer of 2-3 day old embryos is recommended, since it is easier to culture the embryos to this stage in the laboratory and the viability of the embryos is higher in the natural environment, so they are transferred.

But sometimes it is recommended to replant 5-6 day old embryos, since the chance of fixing such embryos after transfer during IVF increases significantly. After all, at this stage they are ready to leave the shiny shell and gain a foothold in the endometrium.

How long after IVF does it take before implantation and pregnancy? It depends on many factors, but most often The process proceeds according to the following scenario:

• Full-fledged embryos without genetic abnormalities develop well and implant in the uterus;
• After the transfer of the blastocyst during IVF, it begins implantation into the endometrium, after the transfer during IVF, 2-3 day old embryos are in the cavity for 2 days to continue development;
• The embryo penetrates deeper into the endometrium and begins to form the placenta;
• Chorionic villi start secreting hCG;
• 2 weeks after IVF (14 days), the concentration of hCG is sufficient to confirm the fact of pregnancy, ultrasound is performed at 3 weeks after IVF.

Experts recommend performing a pregnancy test 2 weeks after IVF - not earlier. Otherwise, the patient may receive false negative or false positive results. It is impossible to change the time of embryo implantation after replanting during IVF by external factors and it remains only to wait.

What can be done after IVF to increase the chances of embryo attachment

Many women are interested in how much time passes after IVF before pregnancy and how to determine it? About a week after IVF, the embryo is fixed in the uterine cavity, but for pregnancy to occur, it must begin to form a placenta that produces hCG. It is the increase in hCG 2 weeks after IVF that allows you to confirm the fact of pregnancy. Ultrasound of the uterus is recommended to be performed at 3 weeks after IVF.

But it is worth noting that a woman can increase the chances of success after transferring with IVF:

• After embryo transfer during IVF, it is necessary to lie down for 30 minutes and rest;
• In the first weeks after IVF, it is necessary to limit physical activity;
• Psychological support after IVF is very important so that the patient feels calm and does not experience stress;
• Within a week after IVF, it is necessary to exclude sexual intercourse, although at other times after IVF, sexual relations can be resumed, there are no strict prohibitions, but experts recommend starting them only after diagnosing pregnancy;
• It is important to adhere to the right lifestyle and follow the recommendations of the doctor.

Feelings after IVF

In most cases, women do not experience any sensations after IVF. Sometimes, after replanting during IVF, patients may feel discomfort in the lower abdomen, but it quickly passes. But after IVF, a woman does not experience other sensations until the onset of pregnancy. Are there any sensations after the transfer of embryos into the uterine cavity? The answer is unequivocal. Implantation cannot be felt.

But no matter how much time has passed after IVF, all women are trying to determine possible changes in the body:

• Swelling of the mammary glands;
• Drowsiness;
• Weakness;
• mood swings;
• Nausea;
• Enhanced sense of smell.

But these feelings after IVF in most cases do not indicate the onset of pregnancy, but the consequences of using hormonal drugs. Signs of pregnancy can form in the early period or late, the main thing is not to concentrate on the sensations after IVF and keep calm. After all, a negative result is not a reason to abandon the goal, moreover, the chances of success increase with each attempt. And when you get a positive result, you should also not worry and be nervous, as this can adversely affect pregnancy.

Monday, May 2, 2016

The statement that it was not difficult for our ancestors to conceive and give birth, unlike us - the generation of the era of progress, is only partly true. And earlier there were problems of fertilization and gestation, but they were not able to solve them the way they do now.

The ecology on which we depend today really needs to be protected, and this is manifested in the increasing frequency of not always explainable cases of infertility. But the possibilities of modern doctors have increased incredibly, thanks to which the chance to give birth to a healthy baby has appeared even for women with the most disappointing diagnoses.

An effective complex treatment method called IVF (in vitro fertilization) is becoming more and more popular every day. Embryo implantation is recommended for complete female infertility (when both fallopian tubes are recognized as impassable), for male infertility; when, as mentioned above, the reasons for the non-occurrence of pregnancy cannot be determined or errors were made in the treatment of patients with various other forms of infertility. Treatment is permissible by doctors for no more than 1.5–2 years: if they are not effective, one should proceed to IVF.

Embryo development prior to IVF replanting

In vitro fertilization consists of several stages, the most important of which is the replanting of embryos. This is such a crucial moment that it requires especially careful preliminary preparation. A woman needs to follow all the doctor's recommendations for examining the pelvic organs and the microflora around the uterine cavity, which largely determines the conditions for successful conception; treatment of possible sexual infections, restoration of hormonal balance, stimulation of the ovaries. When the endometrium of a woman becomes favorable for IVF, they begin to transfer embryos, which must first undergo their development.

After the follicles with eggs mature, the doctor punctures the ovary, extracts the eggs, then they are fertilized with the husband's sperm (in some cases, the donor). This happens separately from the mother's body. In the event that the husband has a low sperm quality, one sperm is injected using an ICSI microneedle. From English Intra Cytoplasmic Sperm Injection (ICSI) is translated as "the introduction of a spermatozoon into the cytoplasm of the oocyte."

The cytoplasm is the most important cellular part responsible for the ability to develop the cell as a whole.

Oocytes are future eggs.

In general, in medicine there are 2 methods for preparing embryos:

auxiliary hatching;
vitrification.

Embryo hatching is a mechanical or chemical effect on the shell of the fetal egg with the embryo inside to weaken. What helps the fetal egg easier to get out of the shell and then attach to the uterus.

Vitrification of embryos is a "fantastic" phenomenon of the 20th century - freezing of viable embryos in liquid nitrogen.

Transfer of frozen embryos

Once upon a time, we perceived the ideas of scientists that a person is able to achieve immortality by freezing his body as something out of the ordinary. The thought, however, excited mankind, and therefore novels and films that play on this possibility were popular.

And although the ideas remained ideas, the freezing of the “future man” has been a wonderful reality for several years now, allowing scientists, relying on experimentally proven methods (and with God's help, of course), to create a new human life.

So, embryos at a temperature of -196° are treated with liquid nitrogen. In the process, 30% of them die, unable to bear the stress, the rest retain the ability to develop and can endure the "ice age" for several years. This storage process is known in medicine as "cryopreservation".

The most famous in Russia was the case of the use of embryos after vitrification by show business stars Alla Pugacheva and Maxim Galkin. According to the artists themselves, they were able to give birth to Lisa and Harry - twins - thanks to freezing. Alla is 64 years old, and Maxim is 37, but they were able to become parents, since Pugacheva "just in case" froze her eggs back in the early 2000s. True, a surrogate mother helped the spouses carry the babies. But this is a topic for a separate discussion. Most importantly, the impossible became possible and made two loving people happy. And how many such wonderful cases are happening all over the world!.. Needless to say, praise to medicine!

Frozen embryos are used for transplantation only those that have the greatest strength. And in general, only viable embryos at a certain stage of development can be frozen (weak ones are dangerous due to their tendency to destruction). They can be stored frozen for an unlimited number of years, but the defrosting process is stressful for them. So good embryos may die, but those that survived give hope for a positive result.

Embryo transfer procedure in detail

Embryo transfer during IVF is divided into 2 stages: either on days 2 and 5, or on days 3 and 5, depending on individual indications. Such terms are connected with the fact that specifically on the 5th day the fetal egg is implanted during natural fertilization.

With IVF, the replanting of 2 embryos is officially acceptable. Why is the official version limited to the number 2? The fact is that sometimes embryos take root as much as they planted. And then the risk of losing a pregnancy increases significantly, because IVF gets women who, for various reasons, could not get pregnant on their own. Therefore, doctors for safety net produce a reduction of embryos (removal of embryos - one or more).

Contrary to the fears of future parents, the transfer of embryos using IVF is not considered difficult (it takes 10-15 minutes) and is completely painless. The gynecologist with the help of ultrasound and, accordingly, with constant monitoring of what is happening on the computer monitor, conducts a catheter into the uterine cavity through the cervical canal. This is where the embryos are transferred.

Any recommendations during this period must be agreed with the treating doctor, even those that are informally discussed by women who have experience in participating in the IVF procedure. It is noted that it is useful to apply the following measures:

eat protein foods and pineapples, drink plenty of fluids, but only one that does not cause flatulence in the stomach; only freshly squeezed juices are allowed;
a few hours before replanting, intimacy with a partner is desirable for better blood circulation in the uterus, which will help the embryos implant more easily (however, after replanting, it is dangerous to have sex until hCG analysis or the first ultrasound);
2 hours before the start of the embryo transfer procedure, one tablet of piroxicam (PIROXICAM) is taken, which has a beneficial effect on successful implantation.
Traditionally, in IVF clinics, on the day of the puncture, blood is taken from women for estradiol (a female hormone that shows the functional state of the ovaries). You should save the result in order to make comparisons later.

Rules of conduct after replanting

So, the most crucial moment is over, but the next most important stage in the development of events is coming - the adaptation of the body to the implanted embryo. How should a woman behave, how to eat?

The diet after replanting is determined by the individual condition of the patient. If there is no threat of OHSS (ovarian hyperstimulation syndrome), then it is better to eat as usual. It is very dangerous to throw fanaticism into a new diet that is contrary to the usual diet. The body should not experience stress. The state of physical and mental peace - rule number 1! In the first three days after the procedure, you should generally lie flat, getting up only when necessary to go to the toilet and bathroom.

After these days of rest, on the contrary, it is better to start moving, but slowly, walking slowly in the fresh air. As before replanting, you need to eat protein foods, avoiding chicken meat, into which drugs harmful to the body are injected for rapid growth. For a woman, this is not scary - for the fetus it can matter. Pure water in large quantities, if there are no health restrictions, is also very useful.

Diagnosis of pregnancy after replanting

After embryo transfer, as a rule, there is an increase in temperature. If the woman has not been warned about this, she may panic. There will be a desire to bring down the temperature just in case. In no case should this be done if the mark on the thermometer is not higher than 37.5. These indicators indicate the predicted reaction of the body to the invasion of a foreign body. This is such a "protest", which should be given a little time and not protest in response.

The appearance of temperature may mean:

a sharp release of progesterone;
the reaction of the body to the embryo after taking large amounts of hormonal drugs;
that the desired pregnancy has already occurred.

In the process of adapting the body to a new situation, the immune system struggles for internal balance, hormones that support gestation begin to be produced, and everything gradually returns to normal. But, of course, the doctor must be aware of the temperature increase in his patient and monitor the changes all the time. The norm or deviation from it can only be ascertained by a specialist. Moreover, sometimes a fever can indicate an infection or an ectopic pregnancy.

After embryo transfer, monitoring the basal temperature scale cannot be considered indicative and reliable, because hormonal drugs affect the woman's condition. But still, these data are also taken into account.

Support in the form of 2 injections of utrogestan at night and 1 injection of progesterone during the day is prescribed immediately. Also, after the puncture, all patients are given five-day injections of fragmin, which improves blood circulation in the uterus.

Next, they look at the coagulogram (the results of the analysis of the blood coagulation system). If it is normal, then no more fragmins are prescribed. Only in case of deviations, for example, with increased clotting, etc., the patient is prescribed any individual treatment - depending on the situation.

Symptoms and sensations after replanting

And according to doctors, and according to the reviews of women on forums on the Internet, it turns out that the symptoms after transplantation resemble the state at the beginning of menstruation: the stomach pulls strongly above the pubis and weakness appears. This is usually. But sometimes there are small spotting. If they occur on days 6-12, this may indicate implantation bleeding, it will be pink. It does not last long - a few hours - and indicate that the fertilized egg has penetrated the wall of the uterus, which, in fact, was achieved by doctors when conducting IVF.

But, of course, bleeding can also be an alarming symptom of a hormonal disorder in a woman's body. And here the responsibility lies largely with the attending doctor: it is he who must monitor the balance between the content of estradiol and progesterone in the body of his patient. To do this, he prescribes special drugs. Spotting may indicate an imbalance, and then an urgent need to change the dose of drugs.

Bright and strong spotting after the embryo transfer procedure indicates the rejection of the fetal egg. In this case, you should not "wait for the weather by the sea", but urgently contact a gynecologist for advice. With the threat of a miscarriage, hospitalization can be the measure that will help maintain the pregnancy.

In a word, IVF is a delicate process, and if you follow all the recommendations of doctors, and most importantly, with the personal strength of intention, you can really fulfill your dream of bearing and giving birth to a healthy baby.

Currently, the in vitro fertilization procedure has become part of the life of patients diagnosed with infertility as a routine manipulation, which is available to almost every woman who is not able to conceive offspring on her own. A couple of decades ago, such methods of assisted reproductive medicine were inaccessible to almost anyone. This technique has given life to thousands of children who would not have had a chance to exist without the use of the latest technologies in the field of reproductive medicine. How to check the queue for eco?

How can a woman who has undergone embryo transfer feel and can she feel pregnant?

After such manipulation, the patient may complain about:

• Drawing, aching pain in the lower abdomen;
• Feeling of general weakness;
• Vomiting and nausea.

These are subjective sensations that do not carry any truthful information about the state of pregnancy. These signs and complaints may be caused by the use of medications used in the protocol. The woman has no choice but to limit psycho-emotional and physical stress and humbly wait.

The first reliable signs of implantation, which indicate that the replanting was successful, occur after two weeks, but some of them to one degree or another may disturb earlier.

Some women may experience dysuria, which manifests itself in frequent urination, due to the pressure of the enlarged uterus on the bladder. Breast engorgement and soreness can also be a sign of pregnancy due to the effect on them of a high dose of progesterone during pregnancy. And some women complain about the appearance of a drop of blood on their underwear already in a depressed state, confident that these are signs of unsuccessful IVF, run to their doctors in tears.

But not always the appearance of these symptoms indicates negative consequences. Often, the implantation process is accompanied by injury to the small vessels of the endometrium, and it is this sign, quite the opposite, that can indicate the successful implantation of the embryo into the endometrium and signal the onset of pregnancy. More about that. when after IVF when to do a pregnancy test you need to check with your doctor

And even such a sign as a delay in menstrual bleeding will not say anything good or bad in the early days. It can both be a sure sign of the onset of pregnancy, and in its absence, be the cause of hormonal failure associated with taking drugs in the in vitro fertilization protocol.

And only a blood test for the level of hCG or an ultrasound scan can give a guarantee of an answer to the question of whether a woman has become pregnant or not. Or a positive pregnancy test. In contrast to the positive, it can be negative in the first days of the delay due to a low level of hCG and a successfully developing uterine pregnancy.

If, during laboratory diagnostics, doctors receive an indicator equal to 50-100 IU / ml, then these values ​​\u200b\u200bare accepted as doubtful, but the support of the luteal phase with progesterone preparations continues. If the results are above 200-100 Med / ml, then we can judge the successful course of pregnancy, and with indicators above 300, we can assume that there is a multiple pregnancy in the uterus.

The survival of embryos during IVF depends on many factors and in many cases it is impossible to say exactly what caused the unsuccessful protocol. Including from the correct support of pregnancy with progesterone and control of what symptoms after IVF embryo transfer by day.

If implantation has occurred, it is very important to support the woman's body in the first period of embryo development by prescribing exogenous progesterone. Such therapy reduces the risk of complications such as the threat of abortion, spontaneous abortion. Women who have passed the in vitro fertilization protocol begin taking progesterone preparations from the day of ovarian puncture. The duration of therapy is purely individual.

However, experts in the field of reproduction argue that you should not stop taking gestagens until at least 12 weeks of gestation, and if there are indications, leave it, adjusting the dosage depending on the clinical situation.

In order to support the luteal phase, such drugs are used. Like utrozhestan - micronized progesterone, duphaston, lutein.

A very controversial issue is the route of administration of progesterone, which can be oral and vaginal. Some experts tend to introduce capsules into the vagina, others are categorically against it. However, it is known for sure that when taken orally, the effects of utrogestan are systemic, which cannot be said about vaginal use. And for a pregnant woman, the action of progesterone on all receptors present in all organs and tissues is very important.

Large doses of drugs can cause side effects inherent in them in the form of dizziness, nausea, and vomiting. But in order to keep the desired pregnancy, women are willing to endure this and even more.

Rules of conduct for women after embryo transfer.

To ensure that the embryo implantation process runs as smoothly and efficiently as possible. A woman must adhere to certain norms, with which her attending physician is obliged to acquaint her:

• In the first two weeks after embryo transfer, a woman needs to exclude any mental and physical stress, only peace, only positive emotions;
• The question of sexual life: in the first two weeks, the question is not even considered - it is strictly forbidden to have sex. Further, the attending physician, depending on the clinical situation, prolongs the period of sexual rest or does not limit the couple in this. Any physical activity can increase the risk of spontaneous abortion;
• Sports also need to be excluded;
• Limit sitting position. Rest more and get positive emotions;
• Strictly prohibited smoking, drinking alcoholic beverages;
• Limit contact with patients with infectious diseases;
• Baths and saunas are also prohibited.

Nutrition after IVF

Nutrition is no different from the nutrition of a woman with spontaneous pregnancy. The diet should be balanced in terms of the composition of proteins, fats, carbohydrates, too fatty, spicy dishes should be excluded from the diet. Food products should be natural, of high quality and with a good shelf life.

A woman's menu must necessarily include a large percentage of protein products, namely meat. So protein is the main building block of any cell. Therefore, its reserves must be constantly maintained. The level of a woman's hemoglobin also depends on the amount of incoming protein, and not only on the iron consumed, as everyone used to think. Indeed, if we consider the name "hemoglobin", it is easy to understand that "heme" is iron, and "globin" is a protein, the same essential element involved in the transfer of oxygen. From meat, it is preferable to choose lean beef, veal, tongue, liver, turkey and rabbit meat. Mandatory is the inclusion in the diet of fish, especially red, eggs, dairy products, including cottage cheese. Also important components in the menu are fruits and vegetables, herbs.

It is better for a woman to receive vitamins and microelements from food than to use additional synthesized vitamins.

Water balance is also an important part of a woman's diet. A pregnant woman should not limit herself in drinking. Of course, carbonated drinks, water with the use of dyes are best excluded.

Do not include in the diet: smoked products, sausages, sausages, salted, dried fish, flour in large quantities, any kind of canned food, mushrooms in any form, cabbage in large quantities, as well as foods rich in fiber, which can increase intestinal motility , promote gas formation and provoke uterine tone.

If a woman has any somatic diseases, then she should be consulted by a therapist and informed about a special diet table according to Pevzner, which corresponds to her nosological unit.

Signs of unsuccessful eco after replanting

There are cases when the transfer of embryos did not give a result and implantation did not occur. This situation is characterized by the appearance of signs:

• The onset of menstrual bleeding, starting from the first day after embryo transfer;
• Negative pregnancy test;
• The level of hCG obtained in laboratory diagnostics is below 50 IU / ml;
• The absence of subjective signs of pregnancy is not a guideline for confirming such an assumption.

As a result, it must be said that the stage of embryo transfer into the uterine cavity is one of the main stages of the in vitro fertilization protocol. If you have a diagnosis and a doctor’s conclusion that you really need an in vitro fertilization procedure, you can carry out this, as well as the rest of the basic IVF program, free of charge at the expense of compulsory medical insurance by submitting an application on the site.

The birth of children conceived "in vitro" in our time is not something out of the ordinary - this is a common practice in the case of family infertility. On the planet today there are about 5 million people who were conceived through IVF. This procedure consists of several consecutive steps. Embryo transfer is the final stage of the IVF protocol and, perhaps, the most responsible one. About how it goes and what a woman can feel after replanting, we will consider in this material.

What it is?

Fertilization itself during IVF does not take place in a test tube, despite the well-established definition, but in a Petri dish - a special container in which the sex cells of a man and a woman are placed. Sometimes the meeting of the spermatozoa and the egg has to be "organized" manually - using the ICSI method. If fertilization has taken place, after 14 hours, initial metamorphoses are observed in the structure of the egg. Next, the cultivation of the embryos begins.

Growing embryos under the vigilant supervision of embryologists takes several days. The transfer of "grown up" embryos to the uterus is carried out when, according to the reproductologist and embryologist, the most favorable time for this comes.

The transfer itself can be standard, double and combined. With a standard transfer, the procedure is carried out once on the appointed day. With double replanting, it is carried out twice - first, the embryo is implanted, which was cultivated 2-3 days after fertilization, and then the embryo is implanted, which has reached the blastocyst stage (5-6 days after fertilization). A double transfer increases the couple's chances of a long-awaited pregnancy. But there is also a reverse side of the coin - a previously transferred embryo can “fall out”, it will be washed away with a solution. It also increases the likelihood of multiple pregnancy.

Combined transfer increases the chances of conception with a second protocol after an unsuccessful one. With it, two types of embryos are introduced - fresh, obtained in the current protocol, and cryopreserved, which were frozen in the previous protocol or even earlier. Such replanting is most often done in a natural cycle, without prior hormonal stimulation of the ovaries.

With a successful protocol, implantation of the transferred embryos into the uterus occurs after a few days. The embryo takes root and a full-fledged, quite normal pregnancy begins.

Optimal time

Cultivation of embryos is an interesting and painstaking process. An embryologist has practically no right to make a mistake - for transfer, you need to select the strongest and most viable embryos. This largely determines whether IVF will be successful.

The transfer date is determined individually. The age of the embryos in this case, according to general practice, should be within 2-6 days from the day of fertilization. However, there are exceptions. What can they be associated with:

Number of embryos obtained

If there are a lot of embryos (more than 2-3), then it is quite difficult to choose the best ones on the second day of cultivation, it takes more time to assess the rate of egg cell division. In this case, the transfer may be slightly delayed. This is called prolonged cultivation, its purpose is to track the development of each of the embryos, because some may stop developing or slow down.

If few embryos are received, then the terms can be shifted down, that is, the transfer can be carried out already on the second day after the start of cultivation. This is due to the fact that in the uterus, if implantation takes place, the embryo will be better than in a nutrient medium, and, in fact, he has no choice - the number is limited. Either he or nothing.

The state of the endometrium of the uterus

The functional layer of the main female reproductive organ must be sufficient in thickness and structure. The looser the endometrium, the better for the embryos - it will be much easier to attach to the membranes.

Therefore, after the collection of eggs, a woman is prescribed progesterone preparations - this hormone helps prepare the endometrium for the upcoming implantation of the embryos.

If the reproductologist, based on the results of ultrasound, concludes that the endometrium is not ready, the cultivation of embryos will be extended.

Woman's age and number of IVF protocols in history

The younger the woman, the higher the chance of a successful implant. Therefore, at the first IVF at the age of up to 35 years, doctors try to transfer embryos into the uterus - “two-day” or “three-day”.

If a woman is over 35 years old, and she has already had several IVF attempts behind her, the date of embryo replanting is postponed to a later date. It is believed that "five-day" or "six-day" embryos attach more often.

The condition and well-being of a woman

If the patient suddenly catches a cold, she has symptoms of ovarian hyperstimulation after oocyte retrieval, if any chronic diseases have aggravated under the influence of previously taken hormones, the transfer will be postponed indefinitely. Quite often, in this case, the protocol is interrupted. Two-day and six-day embryos are frozen and stored in a cryobank until the next attempt.

After recovery, a woman can undergo a combined natural cycle transfer or cryotransfer.

Quite often, reproductologists use a standard formula to determine the transfer date (provided that the woman's body is completely ready for the procedure and there are no contraindications):

• if by the third day of cultivation more than 5 embryos of good and excellent quality were obtained, the transfer is carried out on the fifth day;
• if by the third day of cultivation less than 5 embryos are obtained that meet the standards of "good" or "excellent", the transfer is carried out immediately on the third day.

In any case, the date of the procedure is set individually, taking into account all the above factors and special circumstances that may arise.

Number of embryos

This question is not so much medical as ethical, and it is considered by bioethics. It is recommended to transfer as many embryos as the mother can bear and give birth if they take root. The method in which a large number of embryos are implanted, and then, after the onset of pregnancy, a resection (removal) of the “extra” is carried out, from a moral point of view, is unpleasant.

From the point of view of most religions, resection is no different from abortion. And the woman herself, who fought for the right to become a mother for so long, will find it morally difficult to choose which of her children to kill and who to give life. Keeping all the embryos in the uterus can be dangerous for a woman, because carrying four or five babies is an extremely difficult task. Therefore, there are recommendations from the Ministry of Health, which state that women who are under 40 years old can transfer no more than three embryos with her consent, and women older than this age - no more than four. Quite often, only two embryos are planted. According to established practice, in 40% of cases, when 3-4 embryos are implanted, only 1-2 take root. In the vast majority, 1 baby takes root.

There are categories of women who are immediately recommended to transfer only one embryo, no more. The chances of conception, of course, are reduced, but the likelihood of a successful pregnancy, if everything goes well, increases immeasurably. In addition, there are no pangs of conscience and moral and ethical problems. These women include:

• patients with scars on the uterus (after surgery, a history of caesarean section);
• surrogate mothers, if the biological parents do not want two babies;
• donor programs of in vitro fertilization.

In most cases, only 1 egg can be obtained in the natural IVF protocol, so without options, a woman also falls into the list of those who receive only one embryo, and then, provided that the quality of the embryo is good or excellent.

Training

Most often, women who have an IVF embryo transfer procedure are concerned about how to properly prepare for this. Is it possible to drink and eat, is it necessary to do an enema and empty the bladder. Since the procedure itself is quite simple, it does not require any specific preparation. But there are several important rules that it is advisable to follow before this important stage of IVF:

• in the morning before the procedure, you need to take a warm shower, without using aggressive cosmetics;
• it is better to fill the bladder so that the uterus is better visualized on ultrasound, and therefore, a couple of hours before the manipulation, you need to drink several glasses of clean drinking water;
• on the day of the procedure, do not wear jewelry and bijouterie, contact lenses, and do not use cosmetics and perfumes;
• breakfast on the day of the procedure should be light, not burdensome for the digestive system.

Before manipulation, a woman should do a blood test for progesterone. The next time, the level of progesterone will be determined in the woman's blood plasma already on the 7th day after replanting.

In the days preceding replanting, it is important for a woman to pay special attention to the prevention of acute respiratory viral infections and influenza, not to be in crowded places in order to exclude infection with viral diseases. Sexual relations are contraindicated, as well as stress and excessive physical activity. On the eve of manipulation, you need to go to bed early in order to sleep better and feel cheerful. There are no special recommendations regarding diets and regimen before this procedure.

As already mentioned, the readiness of the endometrium of the woman's uterus before transfer is an important component of a successful protocol. It is in order for the functional layer of the reproductive organ to reach the necessary requirements that progesterone preparations are prescribed - Utrozhestan, Dufaston, Proginova, Crinon and others in individual dosages. Often, the anti-inflammatory drug Metipred is prescribed before the transfer.

The mucous membrane of the uterus under the influence of these drugs begins to become looser. This facilitates the stage of adhesion - sticking of the fetal egg. Progesterone preparations improve the filling of the endometrium with blood, this facilitates the second implantation phase - invasion, in which the membranes of the embryo go deep into the endometrium and grow into it, connecting with the mother's blood vessels.

The optimal value for transfer is considered to be the thickness of the endometrium of the uterus at the level of 9-12 mm.

Technique

The embryo transfer procedure itself should not frighten a woman - it is not painful, not scary and does not take long. The manipulation is carried out under sterile conditions, in the same small operating room where the woman's eggs were taken. Before the procedure, patients are usually offered to take a sedative to calm down and cope with anxiety. You can refuse it, because there will be no pain.

Before starting with the couple or the woman herself, they agree on the number of transferred embryos and decide what to do with the rest if there are “extra” ones. A woman, by law, can dispose of them at her discretion.

There are several options:

• give consent to cryopreservation and long-term storage in a cryobank (may be useful if the protocol is unsuccessful and pregnancy does not occur, and also several years after a successful protocol, if you want another child);
• donate embryos as donors to the cryobank of the clinic for use in programs of other infertile couples who need donor material;
• donate embryos to the needs of science for study and experiments;
• dispose of the embryos by leaving them unattended until the natural cessation of development.

Any decision of the patient is documented and signed by her personally. After that, the woman is escorted to the operating room, placed on a gynecological chair and the primary treatment of the external genital organs is carried out.

The embryos will be introduced into the uterine cavity through a thin polymer catheter, which will be inserted through the cervical canal inside the cervix. The process is not very pleasant, but not painful. The catheter material is non-toxic and will not harm the embryos in any way.

After the introduction of the catheters, the embryologist gives the reproductologist a 1 ml syringe with a certain number of embryos in a nutrient solution. The syringe is carefully connected to the outer end of the catheter and its contents are slowly injected into the uterine cavity. It is important that there is a slow and careful introduction.

The whole process is controlled by an abdominal ultrasonic sensor. This allows you to see the location of the catheter inside the uterine cavity. It is important that the catheter reaches the bottom of the uterus (its upper part), but in no case touches the endometrium, so as not to injure the mucous membranes.

After insertion, the catheter is carefully removed and immediately visited under a microscope to exclude a situation in which embryos could remain in it.

In severe cases, double-lumen catheters can be used, while antispasmodic drugs are injected into the vein, which will prevent spontaneous uterine contractions.

The procedure takes about five minutes. After that, the woman is advised to remain in a horizontal position for about 40 minutes, then she is allowed to get up and go home.

What can you feel after replanting?

During the first day after the manipulation, a woman may feel that she slightly weakly "pulls her stomach" or there is a slight pain "as before menstruation." This is a normal reaction to the introduction of a catheter into the cervical canal. Small mucous or spotting discharge should also not be embarrassing and frightening. You should not expect that the sensations by day will differ significantly from those that the woman had before the transfer - most patients have absolutely no special symptoms.

Slight pulling pains may be the body's reaction to hormonal drugs that were used in the first phase of the cycle and are now prescribed to increase the likelihood of implantation. It is impossible to feel the implantation itself, but some women experience the so-called implantation bleeding approximately 7-9 days after the transfer. It is manifested by the appearance of a brownish "daub" on the gasket. This is a good sign that may indicate that the implantation has taken place successfully. Previously, there was no point, just as there was no point in conducting pharmacy tests, because a woman was injected with hCG for the maturation of oocytes, and traces of the hormone are present in the blood plasma. Premature analysis, done too hastily, can give a false positive result and, accordingly, a false hope of pregnancy.

On the 21st day after the transfer, you should visit a doctor and do an ultrasound to make sure that the pregnancy has come and is developing. Signs of pregnancy may appear no earlier than 14 days after the embryo transfer - they usually manifest as engorgement and increased sensitivity of the mammary glands, a change in taste preferences, drowsiness or insomnia.

Basal temperature is not a very good method for diagnosing pregnancy after in vitro fertilization, because a woman takes progesterone preparations, and this hormone causes basal temperature to remain at elevated values ​​even in the absence of pregnancy.

Possible Complications

Embryo transfer rarely causes any complications. If the manipulation is carried out by experienced doctors, everything should go without negative consequences for the woman's body. Very rarely, medical errors are recorded associated with too rapid introduction of embryos, as well as wounding the end of the catheter to the mucous membranes of the uterus.

It is impossible not to take into account such possible complications as ectopic pregnancy - tubal or cervical. After the introduction of the embryos, they are “in free flight” for several days, floating freely in the uterus, and therefore they may enter the fallopian tube or cervix. If implantation takes place outside the uterine cavity, the pregnancy is doomed to termination - the embryos have no chance of surviving, and for the mother, the ectopic location of the embryos can be deadly. Ectopic pregnancy after IVF occurs in 1-2% of cases. At the same time, in about half of these cases, a heterotypic ectopic pregnancy is recorded, in which one embryo is attached correctly - in the uterus, and the other - in the tube or isthmus.

Whether an embryo is implanted in the uterus or not, no one knows - neither the doctor, nor the scientists, nor the woman herself. Therefore, it is quite difficult to increase the chances of implantation. General recommendations for women after embryo transfer are as follows:

• Take your medications as scheduled. If the doctor prescribes progesterone, do not forget about the dosage and frequency. A missed dose can lead to a decrease in the level of the hormone relative to the norm. This will make implantation impossible. Low progesterone can also lead to rejection of the ovum after successful implantation.
• To support pregnancy at the very initial stage, Decapeptyl, Diferelin, Divigel are often additionally prescribed. If D-dimer is elevated in the blood, it is recommended to take Clexane. Schemes are purely individual, do not self-medicate and follow the scheme assigned to you.
• Avoid physical activity, heavy lifting, jumping, running, sharp squats.
• Avoid sex and masturbation.
• Do not take a hot bath, swim or sunbathe.
• Give up smoking and alcohol.
• Be positive as stress hormones interfere with progesterone production and by themselves can be a significant barrier to implantation and successful fetal development.
• The diet should be complete, the time is not right for diets. Try to eat more animal proteins.
• Take walks in the fresh air every day.

It is important not to "wind up" yourself and not to look for signs of pregnancy ahead of time. It is also desirable to clearly understand that IVF success is estimated at only 35-40%, and the probability of failure is higher than the probability of a successful protocol. This must be treated adequately in order to avoid depression and disappointment if menstruation does begin.

It is difficult to overstate the importance of this moment. On the one hand, the technical execution of this procedure does not cause difficulties, on the other hand, the result depends on the accuracy of compliance with the rules. It is not surprising that both physicians and patients attach so much importance to embryo transfer. I would like to take into account all possible difficulties, take all existing measures to ensure that everything goes well. Let's break it down step by step.

At all stages of the IVF program, it is very important to follow the doctor's recommendations. If you have any doubts, do not look for answers from your friends or on the Internet, ask your doctor.

How can I best prepare for embryo transfer?

Naturally, questions arise - is it possible to eat and drink before the transfer, is it necessary to inject a morning dose of progesterone into the vagina, is a full bladder needed, etc. The answer is simple - preparation is not required. You can eat and drink as usual, continue to take medications, as recommended by the doctor. The main task is to be in the clinic on time. With some anatomical features, the doctor may ask you to fill the bladder shortly before the transfer, in which case it makes sense to assess whether you can survive without going to the toilet for at least half an hour after the transfer of the embryo into the uterine cavity. If you feel that there are already strong urges, it is better to check with your doctor if you should urinate.

How is everything going?

Some features are possible. I'll tell you how everything happens in our clinic.

A woman comes to the clinic, she is escorted to the ward. By this time, photos of the embryos prepared for transfer are already ready. The embryologist reports all the information about the embryo, gives photographs. The patient changes and goes to the operating room, where we check the patient's identity again. An ultrasound of the uterus is performed on a conventional gynecological chair, the length of the cervix is ​​measured, and the anatomy of its canal is assessed. Then a speculum is placed, as in a normal examination, the vagina is treated with a warm solution, and a TEST transfer is performed with an empty catheter. If all is well, then the embryologist draws an embryo into the catheter and once again announces the patient's last name and first name, the number of embryos. The doctor gently inserts the catheter and the embryo through it into the uterine cavity, removes the catheter and passes it to the embryologist for examination. The task is to perform the introduction of the catheter as carefully as possible, the use of any additional instruments (forceps, probes, etc.) dramatically reduces the likelihood of implantation. If the catheter is clear, the procedure is complete. The doctor once again conducts an ultrasound, in which the small drop of liquid in which the embryo is located is usually clearly visible in the uterine cavity. We give ten minutes to lie down in the operating room and then we transport her to the ward, where the woman can stay for some more time.

What will I feel? Will it hurt?

It's not worth worrying. The embryo is introduced into the uterine cavity through a thin soft plastic tube - a catheter. The most unpleasant moment of embryo transfer is the process of inserting an ordinary speculum into the vagina, a procedure familiar to any woman, nothing new. The embryo transfer process itself is painless. Sometimes there is discomfort when the catheter is inserted into the uterus (with the anatomical features of the cervix), but these sensations are extremely rare.

How to behave during the transfer and after it?

All you can do to help your doctor is to relax and think about something pleasant and distracting. You can talk to a nurse or a doctor, remember the pleasant moments of life or make plans for the future, but it is advisable not to listen to your physical sensations. The calmer the woman is during the procedure, the easier everything goes. Try to relax your muscles and breathe into your belly, not too often. Usually women are afraid to even move, which is understandable, given the whole difficult path to this moment. However, there is no data on the need for rest after embryo transfer.

Waiting for the result

In addition to practical issues, patients, as a rule, are also concerned about tactical issues. On which day of development and how many embryos to transfer, fresh or cryo protocol, whether the quality of the endometrium will affect, etc.

And so, when?

On the 3rd or 5th day? Part of the embryos stops developing on the 3rd-4th day, postponing the choice of a promising embryo until the 5th day, we weed out those who are already obviously doomed to stop. That is why the effectiveness of the transfer to the 5th day is higher. A separate conversation about clinics where the conditions in the embryological laboratory are not optimal, where even a promising embryo runs the risk of stopping in development. It is quite clear that it is reasonable in such a situation to transfer the embryo to the uterus as soon as possible, without waiting for the fifth day. Another argument that should not be forgotten, especially if there is no problem of choice, is the forecast. Cultivation up to the 5th day allows us to talk about the prognosis. Often couples come for help with many failures, stories are like two peas in a pod: several programs, all with excellent quality embryo transfers on the 3rd day and not a single pregnancy. As a rule, this is the result of stopping the development of the embryo on the 3-4th day. How can you find out if you don't check? We practice embryo transfers on the 5-6th day of development, even when we have only one embryo. However, if patients insist on an early transfer, we go forward.

Today, they have learned how to grow human embryos in the laboratory for up to two weeks, to say nothing about one.

How many - one or two?

This is a security issue. All the main claims of society towards IVF are associated with multiple pregnancy. Children from multiple pregnancies are more likely to be born small, premature, they have a higher risk of various damage to the nervous system during childbirth, etc. More. Yes, in most cases, the last word is up to the patient, but our active position is to transfer one by one.

Endometrium - thin or not?

The thickness of the endometrium is a simple sign that allows you to talk about the chances of implantation. There is a lot of evidence that in a fresh cycle, an endometrial thickness of less than 7 mm leads to a lower chance, however, in a cryocycle, hormonal therapy improves the chances even with a thin endometrium. The solution is simple - IVF, cryopreservation of all promising embryos and planned preparation of the endometrium for transfer.

Fresh transfer or cryo?

Today, the quality of cryopreservation of embryos is so high that we do not fear for the state of the embryo during its freezing. The question is only about the optimal state of the endometrium. Against the background of stimulation, the state of the endometrium, as a rule, is not ideal for embryo implantation, the chances increase significantly if this important moment is postponed until the next cycle. The only exception is, perhaps, IVF in the natural cycle and with minimal stimulation, as well as with donor eggs. Moreover, it must be borne in mind that some drugs used for stimulation can themselves worsen the condition of the endometrium. A separate topic is the control of progesterone levels in the blood. I’ll make a reservation right away that this indicator may be of interest to us only on the day the trigger is introduced (the last injection before the puncture, which triggers the final maturation of the eggs). Increasing it on that day above 1.5 ng / ml or 4.8 nM / l reduces the chances of implantation by 1.5-2 times (in a fresh cycle). So, in most cases, cryopreservation is the best choice.

In vitro fertilization is a method of conceiving a child artificially.

If a married couple has decided to use this method, then it is necessary to understand how to prepare for embryo transfer during IVF.

The embryo transfer process is a key step and requires special preparation.

How to behave before embryo transfer

Preparation for embryo transfer during IVF begins two months before the start of the procedure itself. The day of artificial insemination is appointed by a specialist after passing all the necessary tests and at the end of the preparatory stage.

If any kind of pathology is detected, a woman is prescribed an appropriate complex of treatment. Preparation before IVF embryo transfer can be delayed if a hormonal imbalance is detected.

To increase the chances of pregnancy, a woman also needs to follow some rules:

1. to exclude the use of alcoholic products;
2. stop smoking;
3. adhere to a good sleep;
4. exclude foods containing caffeine;
5. give up spicy and fatty foods;
6. do not overwork;
7. avoid stressful situations;
8. avoid taking hot baths and visiting baths;
9. It is forbidden to take any drugs without consulting a doctor.

And also a woman should tell the doctor about all the drugs she takes: both at the moment and in the last six months.

Note! Only with a favorable hormonal background, the IVF embryo transfer procedure will occur with the desired result - pregnancy.

Preparing for the transfer

Before being prepared for embryo transfer, the embryo must go through a preparatory stage.

There are two preparation methods.

Freezing

The method is based on the treatment of embryos with liquid nitrogen. The processing temperature in this case reaches almost -200 °C. But not all embryos adapt and survive the treatment.

Approximately 1/3 of them do not withstand high temperatures, and the survivors can be frozen for several years. At the same time, embryos do not lose the ability to actively reproduce and develop.

Assisted hatching

The method is based on the artificial incision of the zona pellucida of the embryo. The method involves the impact of a mechanical or chemical type.

In the process of these manipulations, the shell becomes weakened, which provides an easy exit for the fetal egg. As a result, the fertilized egg is attached to the uterus.

The choice of method for preparing the embryo is prescribed by the doctor, based on the results of the analysis and the general condition of the woman.

Rules for the male half

The man plays an equally important role in the transfer process as the woman. The correct approach from the male side is also important and necessary.

To do this, you must adhere to the following recommendations:

• refuse to donate sperm during viral diseases, as this directly affects the active functions of spermatozoa;
• exclude alcoholic beverages;
• refrain from smoking;
• exclude products of artificial origin from the diet;
• eat foods that affect the activity of spermatozoa;
• do not use drugs without a doctor's prescription;
• eliminate overwork of the body.

A man must also understand the extent of his responsibility and take the procedure seriously.

Since it is necessary to prepare for embryo transfer during IVF in compliance with all established standards and recommendations of qualified specialists in this field, the process itself must also be approached carefully.

A very important point is the moral attitude of a woman. It is necessary to treat in vitro fertilization as positively as possible, try to exclude possible experiences. Sometimes doctors insist that the training course should also include a visit to a psychologist.

It is important to know that a nervous breakdown can form from an unsuccessful result. This entails consequences and various kinds of diseases.

A few hours before the procedure, you must visit the bathroom to shower and shave.

Just before the process itself, you need to drink enough water so that the bladder is full.

Possible sensations

Since a woman wishes (in most cases) carefully to prepare for embryo transfer during IVF, the subsequent actions and sensations are no exception.

With the existing features of the female body, each female representative may experience different sensations.

The most common include:

1. dizziness;
2. gagging;
3. feeling of nausea;
4. pain in the breasts (enlargement);
5. a state of constant fatigue;
6. sharp and (or) dull pain in the lower abdomen;
7. allocation of a different nature;
8. the presence of a feeling of constant discomfort;
9. frequent mood swings;
10. insomnia;
11. prostration.

After the procedure, you should not relax, as the next stage is no less important. It is necessary to follow certain rules, as well as adhere to certain prohibitions for a period of at least two hours after the end of the process:

• be in a prone position;
• muscles should be relaxed;
• it is forbidden to raise (in any direction) arms and legs;
• emotional state should be at rest.

There are also tips for the following days:

1. limit body movements for a 2-week period;
2. cancel any trips;
3. rest mode to observe for 10 days;
4. exclude any sports (even the most insignificant ones);
5. Postpone household chores to a later date.
6. it is forbidden to supercool the body;
7. the use of tampons is prohibited (in case of bleeding);
8. bathing is prohibited (only shower procedures);
9. it is forbidden to lift any kind of weight (maximum 1 kg);
10. without a doctor's prescription, do not use drugs, and the recommended drugs must be taken without fail;
11. prevent the body from possible overheating;
12. daily in the morning to measure the temperature of the basal type and record it on paper;
13. complete rejection of spicy, fried and salty foods;
14. stick to milk-protein products (meat and fish products);
15. normalize the consumption of vegetables and fruits.

Conclusion

There are also restrictions on sexual activity. So, before the embryo transfer process, experts allow the introduction of sexual activity, but after the procedure and until the gestation period reaches 13 weeks, it is strictly prohibited. In most cases, a hectic intimate life in the first triad of pregnancy is a factor influencing miscarriage.

Until the expiration of 5 days, sleep should be in a supine state strictly on the back, the next days - any position is allowed.

During an acute influenza epidemic, do not visit public places to avoid possible infection.

Careful preparation for embryo transfer during IVF, recommendations and advice from specialists - all this will directly affect the result.

If necessary, a woman is prescribed hormonal preparations before the procedure in order to prepare the uterus for the adoption of the embryo. On the day of embryo transfer, tests for estradiol and progesterone are taken, ultrasound is done and the thickness of the endometrium is determined. This is necessary in order to plan further pregnancy support tactics. Just before the embryo transfer, the woman is advised to drink plenty of water to fill her bladder. The manipulation itself is carried out in a gynecological chair, under sterile operating conditions. Feelings during the transfer of embryos are quite tolerable. The whole procedure lasts 5-7 minutes, it is almost painless. After embryo transfer, the woman is in a supine position for some time, then she can return home and lead a normal life, limiting only significant physical activity.

Embryo transfer and its hormonal support

Embryo transfer, whichever day is chosen for the procedure, requires hormonal support. Progesterone preparations are prescribed to increase the chance of pregnancy. This hormone changes the secretory function of the endometrium, making the inner layer of the uterus the most receptive for further implantation of the embryo. It also reduces the contractility of the walls, contributes to the tight closure of the cervical canal, which significantly reduces the likelihood of miscarriage. Progesterone is prescribed regardless of whether the transfer of 3 embryos or one was carried out.

Normally, progesterone is synthesized by the corpus luteum of the ovaries, which is formed under the influence of the luteinizing hormone of the pituitary gland. Also, the function of stimulating its production is performed by hCG (chorionic gonadotropin), and from the second trimester the hormone is produced in the placenta. When pregnancy has caused the embryo transfer, progesterone preparations should be taken until approximately 14-15 weeks. In some situations, the reception is extended until the twentieth week, until the function of its synthesis is completely taken over by the placenta. Cancellation should be carried out gradually, under the strict supervision of a doctor.

Now hormonal preparations, when IVF is transplanted, are prescribed, most often, in the form of tablets, vaginal suppositories or creams. Injections are used less often, as they can cause more complications, require outside assistance during administration. The most convenient form of progesterone is oral, but with its appointment there is more stress on the liver. Vaginal suppositories and creams are not so convenient to administer, but progesterone acts faster with this application and has less toxic effect on the liver.

One of the most common oral medications used both before and after embryo transfer is duphaston, a synthetic analogue of progesterone. It is prescribed in a dose of 30-60 mg, it does not adversely affect the fetus and in therapeutic doses is not dangerous to the health of the mother. Vaginal capsules utrozhestan are also prescribed quite often. They contain progesterone, derived from natural plant materials. Apply them three times a day, the daily dose is 600 mg. If necessary, it can be increased to 800 mg by adding to the course of therapy an injection of a 2.5% oil solution of progesterone, twice a day, at a dose of 100 mg per dose. Candles should be inserted deep into the vagina to prevent leakage. An increase in dose may be needed if, after the embryo transfer is done, the stomach pulls, there is a discharge, or the level of progesterone in the blood is too low.

The drug krynon is available in the form of a gel, injected into the vagina using a special applicator. It contains 90 mg of progesterone in one dose, it is prescribed for about a month after the embryo transfer caused the pregnancy. Lutein, another progesterone drug that is prescribed to make IVF transplants successful. Available in the form of sublingual or vaginal tablets. Vaginal tablets are administered twice a day, sublingual - 3-4 times.

Many women ask how to behave so that the embryo transfer causes pregnancy. Immediately after the procedure, it is recommended to stay in the same position for ten minutes in which it was carried out. Then the woman can rest on the couch for another hour. Some researchers argue that bed rest is needed on the first day, but according to recent data, this does not particularly affect the implantation of the embryos and does not increase the chance of maintaining a pregnancy. Too much physical activity should be limited, even if the sensations during the embryo transfer are quite normal. You should not go to the gym, do general cleaning at home or drive a car out of town. It is also worth eating well, excluding foods that cause increased peristalsis, do not recommend drinking a lot of black tea and coffee. About two liters of fluid should be consumed per day. Of course, you can not drink alcohol and smoke.

Feelings on the day of the embryo transfer may be related to the procedure itself or to the excitement that it caused. After all, a woman has been waiting for a child for so long and really wants the attempt to succeed. By and large, in the first two weeks there are no reliable signs of pregnancy, all changes in the body that the patients feel are associated with the consequences of ovarian stimulation and taking hormonal drugs. They may experience drowsiness, dizziness, chest tension, nausea. All these symptoms do not indicate either the onset of pregnancy, or the fact that it is in danger of failure or the replanting of embryos did not end with their implantation.

In the early days, doctors recommend measuring basal temperature. It may be more likely to indicate a threatened miscarriage, or the successful completion of an IVF procedure, as well as hormonal deficiency. When the embryo transfer is carried out, the basal temperature remains at 37 degrees or rises by a few tenths. If the temperature drops within three days, you should consult with a reproductive specialist. This condition may require correction of hormonal maintenance therapy.

What should alert a woman in the first two weeks? Sometimes, after the embryo transfer is carried out, discharge appears. If they are not too intense, you should not be afraid, but you need to inform your doctor about them. This phenomenon often occurs with hormonal deficiency and requires correction of progesterone doses. Allocations on the day of embryo transfer may indicate poor cleaning of the cervical canal from mucus before the procedure, its damage or injury to the uterine mucosa. But again, all this is not yet evidence of an unsuccessful attempt, although it requires observation.

If, after the embryo transfer is done, the stomach pulls, bloating appears, pain in the ovaries or uterus, headache, darkening in the eyes, incomprehensible visual impairment, you should immediately go to the doctor. There are sensations on the day of embryo transfer or a little later. These symptoms may indicate ovarian hyperstimulation syndrome. The complication is observed quite rarely and responds well to therapy, especially in the initial stages. It may be necessary to slightly change the doses of drugs and the pregnancy support program. But it can end quite happily.

Embryo Transfer and Pregnancy Diagnosis

When an embryo transfer is done, what is the best day to diagnose pregnancy? Some women want to know as soon as possible if their IVF attempt was successful, and they start doing tests from the very first days. In fact, they are not very informative. If the test is clearly positive, pregnancy has occurred, if there is no second strip, this does not yet indicate that the embryo transfer did not end with their implantation in the uterus. Doctors recommend donating blood for hCG on the 14th day after the procedure. also after the embryo transfer has been done, on day 5, an analysis is made for the amount of progesterone in the blood. It helps to properly adjust hormone doses to support pregnancy.

The level of human chorionic gonadotropin on the 14th day of embryo transfer should be 29-170 IU. Then every 2-3 days it doubles up to approximately 6-7 weeks. Further, the growth of hCG slows down, doubling the amount of hCG occurs every 4 days. From about 9-10 weeks, the level of hCG decreases slightly. One analysis for hCG is not enough to reliably diagnose pregnancy. Approximately 21-22 days after the embryo transfer was done, an ultrasound is done. Previously, it is not advisable to conduct a study, since it will not be possible to see the fetal egg. But in the third week it is already possible to clearly say whether the embryo develops in the uterus or not, to detect a tubal and multiple pregnancy.