Embryo Transfer Day 101: Everything You Need to Know

It's finally the big day, the one you've been anxiously waiting for...your embryo transfer! Everything you've done during your IVF cycle has been working towards this one potentially life-changing procedure. Let's explore what you can expect before, during and after.

In this article:

• What is an embryo transfer?
• Before Your Embryo Transfer
• During Your Embryo Transfer
• After Your Embryo Transfer
• How to Increase Blood Flow to Uterus After Embryo Transfer
• Embryo Transfer Day FAQs
• Is embryo transfer painful?
• Should I eat fries after embryo transfer?
• How many embryos should I transfer?
• Fresh vs Frozen Embryo Transfer

What is an embryo transfer?

An embryo transfer is a short procedure in the in vitro fertilization (IVF) treatment process during which an embryo is carefully transferred into the uterus with the goal of achieving a successful pregnancy. 

What to Expect at Your Embryo Transfer 

It's only natural that you probably have (quite) a few questions about what happens before, during and after your embryo transfer!

As a medical assistant who helps perform multiple embryo transfers each day, I'm here to get all those questions answered and help you feel a bit more prepared for this exciting milestone. 

Part 1: Before Your Embryo Transfer

Your Care Team will check the procedure schedule the day before transfer day to confirm if you are doing a fresh or frozen embryo transfer and will prepare any consent forms.

While your partner or support person may want to accompany you to your transfer, you can drive yourself to and from the appointment alone if needed, since you won't be receiving anesthesia. 

On embryo transfer day:

• DON'T wear any perfume or hairspray (little embryos are super sensitive to scents)
• DO come to your transfer with a full bladder (learn why below or in this video)

We want you to feel as relaxed as possible on this exciting day, and will do everything we can to ensure you have a smooth, stress-free experience. One of the best ways to add a little extra relaxation to the mix is by scheduling a pre- and post-transfer acupuncture session with one of our amazing fertility acupuncturists! 

After you arrive at our Norwalk location, we will bring you back to the surgical suite and get you set up. We will verify your name, date of birth, and other important details. We will then walk with you to one of our two embryo transfer rooms and do a quick ultrasound to assess how full your bladder is.

Once all of this is complete, you will be ready for your transfer!

Thinking about growing your family with IVF?

Download our free guide to IVF to learn more about how much it costs, how long it typically takes, and how this fertility treatment can help you.

Part 2: During Your Embryo Transfer

The doctor performing your embryo transfer will go over paperwork with you before starting the procedure, including reviewing the plan you put together with your primary Illume Fertility doctor, a photo of your embryo from that morning, and any preimplantation genetic testing performed on the embryo (if you chose to have your embryo tested).

You will then see your ID on the screen and verify which embryo has been selected for your transfer. Once this is confirmed, you will see your embryo in real time under the microscope in the embryology laboratory (which is right on the other side of the transfer room wall). 

From there, we will begin the transfer process, which is when you’ll see the embryo placed in your uterus on the ultrasound monitor. The doctor performing your transfer will talk you through what they are doing throughout the procedure.

The entire embryo transfer process should take between 10-15 minutes total, but keep in mind that reviewing paperwork, verifying your identity, and preparing for transfer will take up most of that time - the actual transfer only takes a couple minutes!

The most important thing to do after your transfer is follow the IVF protocol given to you by your Care Team. Assume you are pregnant until proven otherwise (a term commonly known in the fertility community as #PUPO).

With that in mind, only take Tylenol or Tylenol Extra Strength if you experience any discomfort following your transfer, and continue with your prescribed medication regimen.

You don't need to be on bed rest, but we do recommend light activity the day of transfer and day after transfer. No going in a hot tub, jacuzzi, or hot bath. We also recommend no sexual intercourse until your pregnancy test. 

Your official pregnancy test will take place approximately nine days after embryo transfer. Depending on the results, your Care Team will instruct you on next steps.

How to Increase Blood Flow to Uterus After Embryo Transfer

After embryo transfer, increasing blood flow to the uterus helps improve the chances of a successful pregnancy. Here are some ways to increase blood flow:

1. Light exercise like walking, yoga, swimming, and other gentle movement can increase blood flow to the uterus. It's important to avoid high-impact activities or anything that causes strain or stress to the body.

2. Acupuncture has been shown to increase blood flow to the uterus and improve pregnancy outcomes. Learn more from fertility acupuncturist Dr. Amy Matton here.

3. A healthy diet rich in nutrients such as protein, vitamin C, and iron can improve blood flow to the uterus. You can consult with one of our nutritionists for recommendations.

4. Stay hydrated! Drinking plenty of water can help to improve blood flow to the uterus.

5. Relaxation techniques such as meditation, deep breathing, or massage can help, since stress can decrease blood flow to the uterus.

Always consult your doctor or nurse for specific recommendations!

Embryo Transfer Day FAQs

Your fertility Care Team has heard it all - trust us! Aside from ensuring you have the best chance at IVF success, our number one goal is to help you feel as confident and comfortable as possible during this exciting experience. 

Here are some of the most common questions patients ask about embryo transfer day:

How full do I need to be for embryo transfer?

Transfers require a full bladder, which helps get your uterus in optimal position to receive the embryo. Your team will advise you to drink 20-30oz of fluid, starting an hour before your scheduled embryo transfer.

How full is too full? Nurse Monica explains in this video.

Have a different question? Submit it for a video response in our Ask Monica series!

Can you see the embryo transfer happening?

Amazingly enough, yes! In the transfer room, there will be a screen where you can watch your itty bitty embryo being transferred into your uterus in real time. Incredible, right?

While you won't see the embryo itself since it's so small, you will see a flash of white light as it is transferred into your uterus, which is the result of a tiny bit of air being pushed out of the tube with the embryo. 

Is embryo transfer painful?

Not at all! If you've had an intrauterine insemination (IUI) procedure or a pap smear before, your embryo transfer will likely feel similar. You should not experience any pain during the transfer - the only mild discomfort some patients report is due to having a full bladder or from the thin catheter inserted through the cervix. 

How is the embryo transfer day decided?

The embryology team at your fertility clinic will work with your reproductive endocrinologist to decide which day your embryo transfer should be performed.

Together, they will evaluate the number of embryos that are ready and available to transfer, the quality of those embryos and your medical history. These and other important factors will be taken into consideration when making the decision about when to schedule your transfer.

What is the best day for embryo transfer?

In the past, most fertility clinics would transfer embryos on Day 3 of development. As improvements have been made to the IVF process, it has now become standard practice to transfer embryos on Day 5, Day 6 or even Day 7 of development, after the embryo has reached the blastocyst stage (200-300+ cells).

The reason? Letting an embryo to develop to the blastocyst stage allows the embryologists to further evaluate the embryo's quality and also results in higher live birth rates. Our nurse Monica explains more here.

Can my embryo fall out after transfer?

Yes, we hear this question a lot - along with "Can I pee my embryo out by accident?" so if you've ever wondered about this, you're not alone! Thankfully, the answer to both questions is a resounding no! Your little embryo is safe and secure, nestled in your uterus, so sneezing, coughing, peeing, or jumping won't dislodge it.

Should I eat fries or salty foods after my embryo transfer?

The superstition that eating McDonald’s fries will improve pregnancy rates after an embryo transfer is a myth. There is nothing wrong with carrying on the tradition, but it won’t necessarily increase your chances of success. 

What are the stages of IVF?

Get a step-by-step walkthrough of the entire IVF process from start to finish, learn about the cost of IVF, how to get started, and more.

Can I take a pregnancy test after my embryo transfer?

We know it's tempting to test at home, but we strongly recommend waiting for your official pregnancy test via blood work nine days after your transfer, instead of using urine pregnancy tests at home.

The reason? It can be too early to test positive at home (which can cause unnecessary anxiety, so a blood test is the best and earliest way to detect a pregnancy. 

How many embryos should I transfer?

While it's tempting to want to transfer multiple embryos to try and up your chances of success, it isn't always the best option. Here at Illume Fertility, we strongly advocate for "one healthy baby at a time," so we only transfer one embryo at a time (in most cases). 

According to a 2019 CDC report, half of the IVF procedures in the United States at that time involved transferring two embryos, 23% involved three, and 10% involved four or five.

The results? Transferring multiple embryos can result in more live births, but it also increases the chance of medical complications for both mom and babies. Multiple embryo transfers are done less frequently as technology continues to improve.

Fresh vs Frozen Embryo Transfer

The timing of your embryo transfer can vary, depending on if you are proceeding with a fresh or frozen embryo transfer. Here's what you can expect in terms of timelines:

Fresh Embryo Transfer (ET)

Your embryo transfer procedure will usually take place five days after egg retrieval if you are doing a "fresh" transfer. During that waiting period, the eggs are mixed with sperm so fertilization can take place.

The embryology team will then carefully monitor your tiny embryos to ensure they have the best chance of survival, and your nurse will instruct you on what to do to prepare for your embryo transfer.

Frozen Embryo Transfer (FET)

Those having a frozen embryo transfer (FET) typically have embryos frozen from a previous IVF cycle or are choosing to have their embryos biopsied for preimplantation genetic testing (PGT). In this case, your embryos were most likely frozen five, six, or in some cases, seven days after egg retrieval. If you are proceeding with an FET, the process takes quite a bit longer, usually 3-4 weeks from the time you get your menses.

Unfortunately, it’s not as simple as just thawing the embryos and ‘popping’ them back into the uterus! It takes a bit more effort. Here's how the process works:

Once you're cleared to start a cycle, you will take an oral medication called Estrace for approximately 2-3 weeks. This helps to thicken the lining of your uterus and give your embryo the best chance at successful implantation. You will be seen for a mid-cycle ultrasound to assess your lining and your doctor will give you the “green light” to proceed.

You will then be instructed to begin intramuscular progesterone injections (often referred to as PIO shots) along with vaginal progesterone inserts. Not the most glamorous part of the process, but an essential step that ensures your body will be ready to welcome an embryo - and hopefully, progress to a health pregnancy.

Your FET will take place six days after starting progesterone. This timing is critical to the success of your transfer. 

You've got this, warrior!

Whether this is your first embryo transfer or your fifth, we know that you're probably feeling an intense mix of emotions right now. Embryo transfer day is a big milestone on your fertility journey, and one that you've worked so hard to get to.

Remember that you've already done everything you can to make this IVF treatment cycle a success, and now it's time to step back and let your fertility doctor and Care Team guide you through this next stage of the process.

We're all rooting for you and wishing you the best on your journey to parenthood.