Know Things Related to Frozen Embryo Transfer
Transfer of frozen embryos is one of the processes in a series of IVF procedures carried out by thawing embryos that were previously frozen. This procedure can be an alternative option to undergo if certain conditions that result in embryo transfer must be postponed first.
During the IVF process, most doctors will advise potential pregnant women to implant the embryo directly into the uterus. But in some cases, embryo implantation can be considered a delay. The delay is done by freezing the embryo with a special instrument, then stored and thawed again at the right time. Frozen embryos that have been frozen will follow the fertile cycle of pregnant women, so the success rate of IVF is also high.
Indications for frozen embryo transfer
There are several reasons why doctors recommend pregnant women to undergo frozen embryo transfer, as opposed to direct embryo transfer. This includes:
The choice to undergo direct or frozen embryo transfer in advance is the full right of future parents who will have a pregnancy. The doctor will only explain two types of procedures that must be considered by the patient.
Warning of frozen embryo transfer
Because this procedure may involve the administration of fertility drugs, the hormones estrogen and progesterone, patients with the following conditions are advised to be careful:
Prepare frozen embryo transfer
Prospective parents who will undergo frozen embryo transfer will undergo the steps of the test as performed by patients undergoing direct embryo transfer. Among others are:
After the prospective parents decide to choose the method of transferring frozen embryos rather than directly, based on the doctor's explanation and consideration, the fertilization procedure will be done first.
The fertilization process begins by stimulating ovulation or maturation of the egg of a pregnant woman. The goal is to get eggs in large numbers. Ovulation induction is done by administering a number of hormones, such as FSH, LH and HCG.
Giving hormones to stimulate ovulation is done in accordance with the menstrual cycle of pregnant women and is carried out for one to two weeks. If the eggs are ready to be taken, expectant mothers will undergo egg collection, which will be done consciously. The eggs that have been taken will be placed in the media and incubated in a special tool. If the egg is ready to be fertilized by sperm, the doctor takes the father's upcoming sperm, then mixes the egg in a medium or injects it directly into the egg. Eggs that have been fertilized and successfully developed will be frozen before being transferred to the mother's womb in the future.
Procedure for removing frozen embryos
The freezing process begins after the fertilized egg is converted into an embryo after incubation in a special laboratory. The embryo is then placed in a special fluid or CPA (cryoprotective agent) before being frozen. This liquid will protect cells from damage when the freezing and storage process is complete.
The cells that have been mixed with liquid CPA will then be cooled slowly and quickly (vitrification). Chill slowly, the embryo can take 1 to 2 hours. In general, the embryo rapid cooling method requires a stronger BPA. After the cooling process is complete, frozen embryos will be stored at -196oC in liquid nitrogen. Embryo freezing will take place 1 to 6 days after fertilization. Embryos that have been stored at very low temperatures can last a very long time, even for years after the fertilization process.
If a prospective mother is ready to undergo the embryo transfer which has been frozen, the embryo implantation process can be carried out. Embryos that have been frozen will be thawed first by soaking them in a special liquid. This liquid also functions to remove BPA that protects the embryo during storage and restores water content in embryonic cells.
As the previous explanation, embryo planting is liquid will be adjusted to the fertile future of the mother. Doctors can give hormones or wait for fertility to occur naturally.
Future mothers who receive hormones before embryo implantation will be monitored for hormone levels by taking blood samples immediately after menstruation. After menstruation ends, the doctor will start giving hormones. If the condition of the uterus is ready to accept the embryo, implantation will be carried out.
As long as embryo implantation is adjusted to the future fertility of the mother, monitoring of the state of natural hormones and the uterus of the body will be carried out more intensively compared to patients receiving hormone treatment. Hormone monitoring is carried out with blood samples, while uterine control is carried out ultrasonic. If fertility is confirmed, pregnant women will receive additional progesterone to prepare the lining of the uterus before embryo implants.
The embryo implantation process is carried out with a conscious state of pregnant women, but by giving them a sedative to help them calm down during the procedure. The doctor will insert a catheter into the cervix until it reaches the uterus. With this catheter, one or more thawed embryos will be inserted into the uterus using a special instrument. The embryo implanting process is usually painless, but pregnant women may experience mild discomfort and abdominal cramps during the procedure.
After transfer of frozen embryos
Prospective mothers who have undergone embryo transfer are encouraged to avoid tiring activities, but can still move as usual. If a prospective mother has a successful pregnancy, the obstetrician will monitor the patient's condition until birth.
If you are not pregnant, the patient will be asked to stop taking progesterone. The patient will menstruate about one week after stopping progesterone. However, if abnormal uterine bleeding occurs or the absence of menstruation after stopping progesterone, the patient should immediately contact the appropriate doctor. If the patient wishes to undergo embryo implantation again, the doctor will arrange the next implanting schedule. Frozen embryos that are still stored in reserves, the remaining results of fertilization, can be thawed for replanting purposes.
Risk of frozen embryo transfer
After embryo implantation is complete, patients can experiment with several things, such as:
If you experience severe pain after embryo implantation, the patient should immediately contact a competent doctor to check for complications.
The procedure for transferring frozen embryos is a safe procedure for future parents to follow. Nevertheless, the risk of complications remains. Among others are:
Indications for frozen embryo transfer
There are several reasons why doctors recommend pregnant women to undergo frozen embryo transfer, as opposed to direct embryo transfer. This includes:
- Planning an embryonic genetic screening. A pregnant woman in the future can undergo frozen embryo transfer if she plans to carry out genetic testing before an embryo is produced. Genetic testing usually requires a lot of time. To avoid damage during the process, the embryo will be frozen first. After genetic testing is complete, frozen embryos will be thawed again and then implanted in the womb of a pregnant woman.
- More than one embryo is produced. At the time of fertilization or in vitro fertilization, the resulting embryo can represent more than one. However, doctors will only allow pregnant women to transfer one embryo. The aim is to prevent triplets or quadruplets. Remaining embryos that are not used during transfer can be frozen and reused if the first embryo implantation process fails. Frozen embryos can also be reused even if the first embryo implantation is successful if both parents want a new pregnancy with IVF.
- Always under the influence of fertility drugs. In the IVF process, pregnant women can receive drugs to increase egg production. However, fertility drugs are thought to make the uterine lining not ideal for embryo fixation and have an impact on success rates. Therefore, doctors can recommend delaying implantation of the embryo into the uterus until the next fertile cycle. For the purpose of delay, the embryo will first be frozen and then thawed after implanting it in the uterus.
- Cannot undergo direct embryo transfer. Some pregnant women are at risk of developing ovarian hyperstimulation syndrome because fertility drugs cannot undergo direct embryo transfer, because they can cause infertility or even death in severe cases. Potential pregnant women with this condition will be encouraged to undergo frozen embryo transfer.
The choice to undergo direct or frozen embryo transfer in advance is the full right of future parents who will have a pregnancy. The doctor will only explain two types of procedures that must be considered by the patient.
Warning of frozen embryo transfer
Because this procedure may involve the administration of fertility drugs, the hormones estrogen and progesterone, patients with the following conditions are advised to be careful:
- Allergy to estrogen or progesterone
- Severe liver disease
- The cause of vaginal bleeding is unknown
- Have a history or suffer from arterial disease
- thrombophlebitis
- Breast cancer
- Deep vein thrombosis
Prepare frozen embryo transfer
Prospective parents who will undergo frozen embryo transfer will undergo the steps of the test as performed by patients undergoing direct embryo transfer. Among others are:
- Ovarian reserve test. This test is done to check the quality and number of eggs that can be produced by pregnant women. In this case, the doctor will examine the hormones FSH, estrogen and AMH from a blood sample. Prospective mothers can also do an ultrasound to visually determine the condition of the ovaries.
- Sperm analysis test. In this test, the quality of the semen sample of the prospective father will be examined.
- Uterine examination. The doctor will visually examine the condition of the uterus using sonohistography. This examination method allows to find out in detail the state of the uterine cavity.
- Examination of infectious diseases. This test is done to check whether both future parents have an infectious disease or not before undergoing IVF.
After the prospective parents decide to choose the method of transferring frozen embryos rather than directly, based on the doctor's explanation and consideration, the fertilization procedure will be done first.
The fertilization process begins by stimulating ovulation or maturation of the egg of a pregnant woman. The goal is to get eggs in large numbers. Ovulation induction is done by administering a number of hormones, such as FSH, LH and HCG.
Giving hormones to stimulate ovulation is done in accordance with the menstrual cycle of pregnant women and is carried out for one to two weeks. If the eggs are ready to be taken, expectant mothers will undergo egg collection, which will be done consciously. The eggs that have been taken will be placed in the media and incubated in a special tool. If the egg is ready to be fertilized by sperm, the doctor takes the father's upcoming sperm, then mixes the egg in a medium or injects it directly into the egg. Eggs that have been fertilized and successfully developed will be frozen before being transferred to the mother's womb in the future.
Procedure for removing frozen embryos
The freezing process begins after the fertilized egg is converted into an embryo after incubation in a special laboratory. The embryo is then placed in a special fluid or CPA (cryoprotective agent) before being frozen. This liquid will protect cells from damage when the freezing and storage process is complete.
The cells that have been mixed with liquid CPA will then be cooled slowly and quickly (vitrification). Chill slowly, the embryo can take 1 to 2 hours. In general, the embryo rapid cooling method requires a stronger BPA. After the cooling process is complete, frozen embryos will be stored at -196oC in liquid nitrogen. Embryo freezing will take place 1 to 6 days after fertilization. Embryos that have been stored at very low temperatures can last a very long time, even for years after the fertilization process.
If a prospective mother is ready to undergo the embryo transfer which has been frozen, the embryo implantation process can be carried out. Embryos that have been frozen will be thawed first by soaking them in a special liquid. This liquid also functions to remove BPA that protects the embryo during storage and restores water content in embryonic cells.
As the previous explanation, embryo planting is liquid will be adjusted to the fertile future of the mother. Doctors can give hormones or wait for fertility to occur naturally.
Future mothers who receive hormones before embryo implantation will be monitored for hormone levels by taking blood samples immediately after menstruation. After menstruation ends, the doctor will start giving hormones. If the condition of the uterus is ready to accept the embryo, implantation will be carried out.
As long as embryo implantation is adjusted to the future fertility of the mother, monitoring of the state of natural hormones and the uterus of the body will be carried out more intensively compared to patients receiving hormone treatment. Hormone monitoring is carried out with blood samples, while uterine control is carried out ultrasonic. If fertility is confirmed, pregnant women will receive additional progesterone to prepare the lining of the uterus before embryo implants.
The embryo implantation process is carried out with a conscious state of pregnant women, but by giving them a sedative to help them calm down during the procedure. The doctor will insert a catheter into the cervix until it reaches the uterus. With this catheter, one or more thawed embryos will be inserted into the uterus using a special instrument. The embryo implanting process is usually painless, but pregnant women may experience mild discomfort and abdominal cramps during the procedure.
After transfer of frozen embryos
Prospective mothers who have undergone embryo transfer are encouraged to avoid tiring activities, but can still move as usual. If a prospective mother has a successful pregnancy, the obstetrician will monitor the patient's condition until birth.
If you are not pregnant, the patient will be asked to stop taking progesterone. The patient will menstruate about one week after stopping progesterone. However, if abnormal uterine bleeding occurs or the absence of menstruation after stopping progesterone, the patient should immediately contact the appropriate doctor. If the patient wishes to undergo embryo implantation again, the doctor will arrange the next implanting schedule. Frozen embryos that are still stored in reserves, the remaining results of fertilization, can be thawed for replanting purposes.
Risk of frozen embryo transfer
After embryo implantation is complete, patients can experiment with several things, such as:
- bloated
- constipation
- Breasts harden
- Stomach cramps
- Vaginal discharge some time after planting
If you experience severe pain after embryo implantation, the patient should immediately contact a competent doctor to check for complications.
The procedure for transferring frozen embryos is a safe procedure for future parents to follow. Nevertheless, the risk of complications remains. Among others are:
- Ovarian Hyperstimulation Syndrome (OHS)
- Ectopic pregnancy
- Twin pregnancy
- Infection in the reproductive organs
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