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Tuesday, November 30, 2021

21 Things to Consider after Embryo Transplant

We know that you've been trying hard to conceive and have waited long enough. But these two weeks between embryo transplant and the first pregnancy test is going to be the hardest. Between checking for bleeding and domineeringly ruling exhaustion as fatigue, your motherhood develops every passing day.
Due to the uncertain nature of hormones like Estrogen, Progesterone, and fertility medications, some symptoms may indicate a successful pregnancy, but don't get your hopes high too soon as there are no particular signs that confirm pregnancy before the test.
No matter what happens in the next weeks, it's always better for you to be informed about what to expect. Reasonably often, you will find yourself getting overwhelmed with all the emotions and inputs, which might make you take ignorant decisions.

1. What is IVF Embryo Transplant
In Vitro(meaning outside of a living organism) Fertilization - IVF is a series of process that assists in conceiving a child. IVF is the most effective assistive technology for reproduction.
In the initial stage, mature eggs are retrieved from the ovary, and healthy sperm is collected to initiate fertilization in the lab. Following successful fertilization, the embryo is carefully transferred to the uterus, which is termed an embryo transplant.
One healthy IVF cycle takes nearly three weeks if the egg and sperm involved in the process are your own, but if anonymous donors are involved, the process can take longer.
The prospects of conceiving a healthy baby using IVF depend on several factors like age, condition of donated egg and sperm, cause of infertility, and many more.
The most crucial step is embryo transplant itself; oftentimes, the embryo detaches itself from the uterus resulting in a miscarriage, which can be prevented by taking the service from experienced doctors and health donors during the procedure.

2. What is Frozen Embryo Transfer:
Embryos from previous IVF rounds can be kept and frozen indefinitely. When this happens, many intending parents with remaining embryos from earlier egg retrievals choose to thaw and then transfer their extra embryos.
The most popular kind of transfer is frozen embryo transfers, which allow for genetic testing of embryos prior to implantation, resulting in greater success rates and a lower risk of genetic flaw or miscarriage.
Previous IVF embryos can be stored and frozen forever. Many intended parents with leftover embryos from prior egg retrievals prefer to thaw and then transfer their excess embryos when this happens.

3. Why In Vitro Fertilization (IVF) is done
IVF is an invasive process - requires operative measures to ensure the completion - which is used as an assistive treatment for infertility and is statistically quite successful than other medical measures taken by the couple in order to conceive.
Typically, IVF shouldn't be the first choice of you and your partner, less invasive techniques that are recommended by your doctor should be considered initially. But for women, over the age of 40, IVF is considered the primary treatment for infertility.
Despite being a complicated and time taking process, IVF is often the safest alternative for older women.

IVF is employed in case your partner has:
•    Fallopian tube damage:
The fallopian tube is the pathway for the egg to be transported to the uterus. If blockage or damage in the Fallopian tube occurs, the healthy egg won't be able to be transported to the uterus and concludes in infertility.
•    Ovulation disorders:
Ovulation disorders are major causes of infertility in women and are defined as hormonal complications that cause disturbance to produce a healthy egg.
•    Fibroids:
Fibroids are small tumors in the uterus - very common in women between 30s and 40s - which can disturb the normal procedure of pregnancy.
•    Impaired sperm functions:
In men, it's common to have low sperm concentration, less mobility of sperm, and abnormality in sperm shape and size, which results in infertility, but often is correctable by treating for underlying health conditions.
•    Genetic Disorder:
IVF can be helpful if you and your partner have genetic disorders that can be passed upon your children. Before embryo transplant, several eggs are cultured and discarded with identifiable problems to reduce the chances of inheritance.

4. What to Expect After Embryo Transplant
After successful embryo transplantation, you must wait for more than 2 weeks before the clinical pregnancy test. Before that, if conceived, the mother gradually starts showing symptoms that may or may not be related to pregnancy. But often telltale signs like missed period gives away the news before the clinic does.
Your fertility expert may only transfer one embryo into the uterus in many circumstances. For women 35 and older, transferring two embryos might sometimes improve the odds of successful implantation. The age of the embryo recipient and her reproductive history are two factors that influence how many embryos are transferred.

5. Are Bleeding and Spotting Sign of Pregnancy
No. Just you bleeding soon after embryo transplant is not a sign of pregnancy.
However, if you find yourself bleeding brown and light from the vagina after several days of embryo transplantation, it could be a hint of pregnancy - which should never be termed as such before paying a visit to your doctor. Often, the use of vaginal progesterone causes brown light bleeding.
The usual bright red blood is often a sign of blood contamination in the uterus, which may affect the chances of your pregnancy. Soft catheter and correct techniques should be addressed to execute the IVF process for a successful pregnancy. External bleeding can also occur, which doesn't harm the embryo.
Only after the pregnancy test, you can be sure about your bleedings, but before that, always consult your doctor before rejoicing.

6. What about Cramps
Crampings can be a sign of a successful embryo transplant.
But often, you get crampings in several stages of IVF and it's a completely normal response to the hormonal drugs you were given for the healthy pregnancy you are seeking. elevated progesterone levels contribute to crampings more than anything and often subsides once the levels are normalized.
Anxiety associated with the IVF process and pregnancy can also lead to crampings and other side effects. After embryo transplant, it's only natural that you may be anxious about the results and start cramping as a side effect or you might have misjudged the severity of the crampings due to the same.

7. Sore Breasts
Breasts becoming heavy and sore is one of the first signs during natural pregnancy that some may experience. Breasts become sore due to the elevated progesterone levels in the body. Sore breasts are not "the best" sign to tell if you are pregnant, because it's only associated with hormones, and you have been getting medicines for that.
But, sore breasts can indicate that the hormonal drugs are working pretty well and you have a better chance of conceiving than not having sore breasts.

8. Could Fatigue and Tiredness Signs of Pregnancy
You are on your way to prolonged fatigue and tiredness even after you give birth to the beautiful child. The raised progesterone is also associated with tiredness and fatigue. Most women feel fatigued when the body prepares itself for pregnancy, but can also be a side effect of anxiety.
IVF treatments begin with stimulating the ovaries with drugs to promote the release of matured eggs. When your body starts producing eggs, it's only natural for you to be fatigued.
Before transplanting embryos, you were given fertility drugs to increase progesterone levels for the uterine linings to be thickened, which helps in the embryo transplantation process.
Following plantation of the embryo, you can experience increased fatigue due to successful pregnancy. after all, your body exerts energy to help your baby grow.
Get plenty of sleep, stay hydrated, and don't be afraid to ask for help. You will be fine.

9. Nausea
Nausea could be the first indication of pregnancy.
Morning sickness typically starts with the fertility drugs like Clomiphene Citrate and HCG Injection but is often administrated at the start of the IVF process. Nausea after embryo transplantation could be the residual effect of the drugs but often announces a successful pregnancy.
You might be happy to know that theoretically nausea is caused by the Human Chorionic Gonadotropin(HCG) hormone, which our body naturally produces just after the embryo connects itself to the uterine lining in a natural pregnancy. Higher HCG level - severe nausea - often indicates twins, but don't neglect if goes beyond your limits, consult your doctor.

10. Bloating and Pregnancy
Again, increased progesterone levels are responsible for the bloat. When the hormones take over your body during the egg retrieval and embryo plantation process, your digestive system slows down to save energy for the embryo to grow. Which can make you feel bloated.
Women with OHSS - A large number of growing follicles in the ovaries - may feel bloated if fluid leaks into the stomach during IVF. One-third of women, who go through the IVF process have reported bloating after and before embryo plantation.
There are, however, limitations for those considering new moves. A fresh embryo transfer would be unlikely to succeed if a woman's progesterone level is high due to the factors surrounding embryo implantation. Fresh transfers should also be avoided by individuals at risk for OHSS, as the drugs used to stimulate egg maturation might be hazardous.

11. Changes in Discharge
Cervical mucus could be an early sign of pregnancy.  Embryo transplantation, which is also called implantation, can cause a change in discharge concentration. You might experience a muddy blood discharge due to ovulation.
Just after implementation, the mucus tends to be clear in color and gummy. Which occurs after 6 to 12 days of embryo transplantation.
During the first week after successful embryo transplantation, stickier, white mucus, known as leucorrhea could be discharged depending on the individuals.
While increased vaginal discharge indicates pregnancy, it can also be caused by the prescribed medications you were taking for progesterone in vaginal preparations like gel and vaginal tablets. Which is obviously not a sign of pregnancy.

12. Missed Periods and Pregnancy
IVF or not, a missed period is generally a major sign of pregnancy. During the lifetime of yours, as a woman, it's totally normal to miss periods when it starts and when menopause starts.
But, when you are expecting a pregnancy, and if your periods work like charm, it might be the time to schedule the test.

13. Increased Pee
Your more frequent visits to the bathroom could be the bearer of the news. An increased level of progesterone and HCG causes more frequent urination in pregnant women. Your kidney processing the excess bodily fluids during pregnancy could be another reason for more pee - sometimes several times in a night.
During pregnancy, Urinary Tract Infection can be experienced more often. The symptoms include:
•    Cloudy Urine
•    Pink or red urine
•    Strong smell
•    Burning sensation while urinating
•    Pain

14. How Not Having Symptoms Help
Symptoms are part of the picture, not the whole.
At least 10-15% of women don't have any symptoms even after a successful embryo transplant. You might misjudge the situation, but nothing can't be said for certain before the pregnancy test.
Pregnancy is a personal thing, like your wallpaper, everyone is expected to experience it in a whole different light. You, not having any symptoms this early should be a part of your experience.
Keep waiting for the first symptom to appear, be patient.

15. Taking Pregnancy Test
The embryo should attach within 72 hours after the transplant, but don't jump the gun just now. If you can't wait for 15 days and are impatient, do it after 10 days at least.
You can take your first pregnancy test following the embryo transfer after two weeks have elapsed. Your fertility clinic will schedule a blood test two weeks after the transfer to determine the pregnancy outcome in order to receive a more precise readout.
Following the attachment of the embryo, the body releases HCG to sustain the increased metabolic activity, which needs at least 10 days to be detectable. HCG is what pregnancy tests use to determine the results.

16. Risk of IVF Embryo Transplant
There are several risks involved, such as:
•    More than one Embryos and births:
While having twins may be a wonderful fantasy, it is not always the fact. If more than one embryo is transplanted to your uterus through IVF, the chances of multiple births increase. Multiple births are linked to low birth weight and early labour risks.
•    Premature birth with a low birth weight:
IVF increases your baby's chances of being delivered prematurely or with a low birth weight.
•    Ovarian hyper stimulation:
Use of medicines for ovulation, such as HCG, can induce ovarian hyperstimulation syndrome, which causes enlarged ovaries and discomfort. Symptoms such as vomiting, nausea, and bloating persist around a week on average. Rapid weight gain and dyspnea may occur in extreme situations.
•    Miscarriage:
Miscarriage has the same risk in IVF as in normal pregnancy - approximately 15-20%, which rises with age.
•    Egg-retrieval complications:
Using an suctioning needle to harvest eggs might lead to contamination or injury to the bladder or vein. Sedation and general anaesthesia are both dangerous.
•    Ectopic pregnancy:
An ectopic pregnancy occurs when a fertilised egg implants outside the uterus, generally in a fallopian tube, in around 2% to 5% of women who have had embryo transplants. The fertilised egg will not survive outside the uterus, and the pregnancy will be terminated.
•    Abnormalities: Maternal age is associated with birth defects in toddlers. Whether IVF is responsible for birth defects or not is still in research.

17. Things to Do and Avoid:
Here are some things that you might want to do and some things which are to be avoided.
1. Pamper Yourself:
When you've undergone a life-changing procedure, give yourself some time to relax after the initial enjoyment of embryo transplant. Between 48 and 72 hours is the most crucial for the embryo to transplant itself. Some experts suggest that you keep taking rest frequently until the results come in and skip vigorous workouts throughout the process.
While you are in the process of entertaining yourself, don't feel guilty about it. Give yourself a professional massage, take a bubble bath, groom yourself, buy something, sleep in, or even have a picnic with your partner, whatever you do, don't indulge yourself in physically exhausting activities.
More than physical health, keep your sanity alive, read a light book, watch Netflix.
2. Keep Taking Medicines:
Your fertility medications are your best friends right now. Without taking them, you risk the whole process. If your doctor suggests you take progesterone medications even after several weeks, you need to do that for a healthy pregnancy. Progesterone is an important hormone that is typically used in IVF to help embryo transplantation.
Vaginal tablets and gels might be a little annoying, but don't discard them before your doctor says so.
3. Eat Healthily:
What you will be eating now, is going to affect the next 9 months. Alcohol ingestion and smoking are not recommended by experts.
Eat a variety of vegetables and fruits which are rich in Vitamin B, calcium, protein, and iron. Throw occasional vitamin medications into the diet.
4. Start taking folic acid:
Maternal supplementation with folic acid is associated with a lower risk of heart defects in babies. Additionally, folic acid may reduce the chances of your baby having a cleft lip.
5. Don't Have Sex:
Don't indulge in penetrative sex for the first 2 weeks after embryo transplantation. Sexual intercourse can contract the uterus, which may disturb the embryo trying to plant itself on the linen.
6. Don't Ignore the Symptoms:
Often, couples find themselves in a complicated situation when they misinterpret the symptoms of underlying conditions as pregnancy. Several of the pregnancy-related symptoms like bleeding and more urination mentioned before can also be experienced due to underlying complications. Consult your doctor whenever something doesn't feel right.


18. How it's Done:
Before your clinic can start the IVF process, you and your partner are expected to go through some screening process.
•    The embryos transplanted is typically based on the patient's age and the quantity of eggs retrieved. Because older women have a lower likelihood of implantation, more embryos are usually implanted unless the eggs are given or the embryos are genetically screened. Most doctors follow stringent guidelines to avoid higher-order multiple pregnancies, such as triplets or more.
•    Extra embryos can be stored and saved for future use for several years. While the majority of embryos will survive the freezing and thawing process, some will not. IVF can result in multiple pregnancies if multiple embryos are transplanted, posing health hazards to both you and your infants. How you handle the situation is up to discuss.
After the screening process, the first thing IVF needs is eggs. Which is procured by stimulating the ovaries to produce multiple ones. Several different medications are used for the purpose, such as:
•    To stimulate your ovaries, you may be given an injectable drug that contains follicle-stimulating hormone (FSH), luteinizing hormone (LH), or a combination of the two. Such medications stimulate the development of more than one egg at a time.
•    Considering the follicles are mature enough for egg retrieval, you will be given human chorionic gonadotropin (HCG) or other medications to help the eggs grow.
•    Your doctor may advise you to start taking progesterone supplements on the day of egg retrieval or at the time of embryo transplantation to make the lining of your uterus more amenable to implantation.
Some tests are also necessary, like vaginal ultrasound and several blood tests to ensure a healthy pregnancy.

The next step is egg retrieval, which can be done in the doctor's office several hours following the final injection.
•    You will be sedated and given pain medication throughout the egg retrieval procedure.
•    Standard procedure of retrieval is transvaginal aspiration. To locate follicles, an ultrasound probe is put into your vagina. The eggs are then extracted by inserting a small needle into a guide and passing it through the vagina to follicles.
•    If your ovaries cannot be reached through transvaginal ultrasound, an abdominal ultrasound may be employed to supervise the needle.
•    The eggs are extracted from the follicles using a needle connected to a vacuum apparatus. In around twenty minutes, several eggs can be extracted.
•    Mature eggs are incubated in a nutritive liquid (culture media). Eggs that seem to be healthy and developed will be mixed with sperm in an endeavour to develop embryos. However, not all eggs will be fertilized successfully.
The next process is sperm retrieval. If you're utilizing your partner's sperm, you must deliver a sperm sample at your doctor's office or clinic before egg collection. Masturbation is commonly used to gather sperm samples. Aspiration, a process to extract sperm straight from testicleswith a needle or operative technique, is occasionally necessary. Sperm from donors can also be utilized. In the lab, sperm and semen fluid are separated.

Fertilization is attempted using two generic methods.
1.    Healthy sperm and mature eggs are combined and incubated for 24 hours during traditional insemination.
2.    ICSI involves injecting a healthy sperm straight into each maturing egg. ICSI is frequently performed, when the quality or quantity of sperm is a concern and the efforts during prior IVF processes have failed.
Following egg retrieval and fertilization, embryo transfer is done at the clinic or doctor's office.
•    A modest sedative may be administered to you. Although you may suffer slight cramping, the treatment is normally painless.
•    Catheter is a thin, long, flexible tube that is entered into your vagina, via your cervix - into your uterus by your doctor.
•    The catheter's end is linked to a syringe clutching one or more embryos in a liquid of very small volume.
•    The doctor will insert the embryo or embryos into your uterus with a syringe.
•    An embryo will implant in the lining of your uterus around six to ten days following egg extraction if it is successful.

19. Defining Factors of Successful IVF:
The chances of you giving birth to a beautiful baby don't only depend on the skills and experience of the doctor and supporting staff, but also on several factors relating to you, such as:
1. Maternity Age:
If you're younger, you're more likely to get pregnant and deliver a healthy child using your own eggs through IVF. Women over the age of 41 are commonly recommended to consider using donated eggs during IVF to increase their chances of success.
2. Embryo Status:
Embryos with more development have a higher pregnancy rate than embryos with less development. However, not every embryo survives the development cycle. Contact your doctor or another health care expert about your specific situation.
3. Fertility History:
If you have given birth previously have a higher chance of conceiving via IVF than women who have no history of giving birth. Women who have tried IVF several times yet failed to conceive have lower success rates.
4. Infertility Causes:
Having regular mature eggs improves your probability of becoming pregnant with IVF. Those with acute endometriosis had a lower chance of becoming pregnant with IVF than women with unexplained infertility.
5. Lifestyle:
Smoking women had fewer eggs recovered during egg retrieval process and are more likely to miscarry. Smoking reduces a woman's chances of success with IVF by half. Being Obese might make it more difficult to become pregnant and have a child. Alcohol, too much coffee, recreational drugs and some medicines canvbe dangerous.

20. Results:
Your doctor will analyze a sample of your blood 12 to two weeks following the egg retrieval to see if you're pregnant.
If You are Pregnant:
For prenatal care, your doctor will send you to an obstetrician or another pregnancy expert.
If You are Not:
After you stop taking progesterone, you'll most likely start getting your period within a week. Contact your doctor if you don't receive your period or if you have unusual bleeding. If you want to try another round of in vitro fertilization (IVF), your doctor may advise certain actions you may take to increase your chances of becoming pregnant.
21. Failed IVF, What's Next:
1.    Get an honest evaluation of your chances of success with a second attempt from your IVF specialist.
2.    Consider making changes to the medication protocol if you had problems with ovarian stimulation or had a low quantity of eggs.
3.    If ordinary or excellent embryos were available for transfer but none were implanted, consider IVF again at the same or a different IVF facility.
4.    It's most likely due to an egg problem or an IVF lab quality control problem if there were substantial egg and/or embryo quality difficulties. Consider switching the IVF clinic to one that has a better in vitro fertilization success rate to evaluate if the problems were caused by egg quality, ovarian stimulation, or a problem with the IVF lab.
5.    The uterus can be the source of the problem, but this is uncommon. The transplanted embryos were almost invariably too weak to implant and continue normal development, resulting in implant failure. Embryo implantation is almost usually successful in the uterus.
Overall, second-time IVF success rates are only slightly lower than first-time IVF efforts. Couples with the greatest egg quality are more likely to conceive on their first try, but this is partially offset by the possibility of learning from the first failed cycle and making modifications to improve success for the second in vitro fertilization effort.

The Bottom Line:
After an embryo transfer, the two-week wait is frequently fraught with emotional, stressful, and taxing ups and downs.
Although certain early indicators of pregnancy, including mild bleeding, spotting, and cramps, may indicate that the operation was successful, the only way to know for sure is to take a pregnancy test.
Before we conclude, it's important for you to know that whatever happens, there is always a second chance. Talk with your partner and doctors to determine the next steps following a long vacation.

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