Embryo Transfer

Embryo transfer is carried out on D3 or D5. The grading of the embryo is important as the selection of the embryo is based on grading. The number of embryos to be transferred depends on the age of the patient. Single embryo transfers(SET) is preferred as the complications for the mother and baby due to multiple pregnancies The patient should report to the clinic(with 6 hours starvation. No anesthesia is necessary usually. The physician identifies the cervix using a vaginal speculum. One or more embryos suspended in a drop of culture medium are drawn into a transfer catheter, a long, thin sterile tube with a syringe on one end. The physician gently guides the tip of the transfer catheter through the cervix and places the fluid containing the embryos into the uterine cavity (Figure 7). The procedure is usually painless, although some women experience mild cramping. A half an hour bed rest may be needed.

Post Transfer :

No hospitalization is required and the patient can return home half an hour by any means of transport. She can lead a normal life with no restriction of activity. Bed rest is not needed and lack of movement may, in fact, promote venous thrombosis( blood clots in the leg veins). Diet can be normal and plenty of fluid intakes is necessary. Nausea, vomiting, any discomfort should be reported to the clinic.


Progesterone :

Progesterone is a hormone produced by the ovary. It is first detected in the middle of the menstrual cycle when an egg is released (ovulation). Progesterone prepares the lining of the uterus (endometrium) to allow a fertilized egg (embryo) to stick or implant. If a pregnancy does not take place, progesterone levels will fall. If an embryo implants into the lining of the uterus, the ovary will produce progesterone until eight weeks into the pregnancy. After that time, progesterone will be produced by the placenta throughout the rest of the pregnancy.

During an in vitro fertilization (IVF) cycle, medications are usually used to prevent you from releasing an egg early (premature ovulation). These medicines affect progesterone levels. Progesterone is supplemented to make up for this decrease. It helps in the embryo implantation.

Progesterone supplementation is started on the day the eggs are harvested. If a pregnancy is confirmed, progesterone has to be taken throughout the first trimester. Progesterone can be taken as an intramuscular injection or vaginally (suppositories, gel or vaginal tablets). There appears to be no difference in the chances of becoming pregnant or continuing a pregnancy if progesterone is given by injection or intravaginally.

Pregnancy Confirmation :

The blood test for pregnancy is done 2weeks after egg recovery. The serum beta HCG level is checked and should be above 50 miu/ml to confirm a pregnancy. A scan done at 6 weeks of the pregnancy confirms the presence of a sac and a clinical pregnancy is confirmed when the fetal heartbeat is seen at 7-8 weeks.

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