Embryo Transfer Stage in IVF Treatment
Embryos that reached the transfer stage are transferred to the uterus with the help of a thin catheter between the 2nd and 6th day following the egg collection procedure. Transfer in routine applications is done on the 2nd, 3rd and 5th day. However, the transfer is done on the 4th or 5th day in those with pre-implantation genetic diagnosis, and on the 5th to 6th day in those who will undergo blastocyst transfer. The selection of embryos to be transferred is very important. The best quality embryos that did division according to the developmental stage are selected.
The number of embryos to be transferred varies between 1 and 2. The age of the woman, the quality of the embryos and previous IVF attempts are taken into consideration during the determination of the number of embryos. According to the relevant guide in Turkey, 1 embryo can be transferred during the first two IVF treatments under the age of 35, and a maximum of 2 embryos can be transferred afterward. If the patient is 35 years or older, a maximum of 2 embryos can be transferred regardless of previous IVF attempts.
ET procedure should be performed with minimal trauma. In order to determine how the actual transfer will be made, a trial transfer must be made before, and the cervical canal of the patient and the position of the uterus, as well as the length of the uterus must be noted. In the light of this previously obtained information, the real transfer can be made comfortably.
In our center, ET is performed under ultrasound control. The advantage of performing ET under ultrasound control is the ease of the catheter placement and the exact observation of where the embryos are placed in the uterus.
The patient is prepared on the gynecological table as if for a gynecological examination. The cervix is exposed by inserting a speculum into the vagina. The vagina and uterine canal are cleaned with sterile serum or special fluids. The uterine cavity is reached by passing through the cervix and cervical canal using the external catheter used for ET, the procedure is watched on the ultrasound screen. The external catheter tip is not advanced any further after passing 1.5 to 2 cm through the uterine canal.
The embryologist places the embryos to be transferred into the inner catheter, after being sure that the outer catheter is in the right place. Embryos which are in a very small amount of fluid are located at the tip of the inner catheter. Later, the inner catheter carrying the embryos is advanced through the outer catheter and delivered to the uterine cavity. After the embryos are deposited into the most suitable area of the endometrium with the help of an injector, the catheters are slowly withdrawn. During the transfer procedure, manipulations that might cause contractions, bleeding or trauma in the uterus should be avoided, and the catheter should not be touched to the fundus part of the uterine cavity.
After the transfer procedure is completed, the catheter is checked by the embryologist. In this way, it is ensured that the embryos are given.
After the transfer procedure, the patient is discharged after resting for about 1 to 2 hours. Extending the resting period does not increase the chance of pregnancy. Embryo Transfer is the last step in resulting pregnancy in IVF treatments. In the next stage, the patient waits for 12-14 days until the pregnancy test. During this period, the patient is explained that she can continue her normal daily life. Sexual intercourse is prohibited, excessive fatigue and sports activities should be avoided.