![]() If the result is negative, we will try to help you understand why during a follow-up consultation and discuss the possible next steps. If the test is positive, we will arrange your seven-week early pregnancy scan. The pregnancy test is performed 10 days after embryo transfer. If the level is low, you will be asked to start additional medications as required. If the level is satisfactory, you will be asked to continue the luteal phase support medications you are on. Therefore as a part of all frozen embryo transfer cycles we will measure a your progesterone level around the time of embryo transfer. The high levels of progesterone during the luteal phase have been shown to be required for successful pregnancy. The hormone progesterone is significantly higher during the luteal phase than other phases of the cycle. The luteal phase is the latter phase of a woman͛s cycle during which pregnancy can occur. ![]() You will continue the Oestrogen medications but will stop any down regulation medications. At this stage you will be asked to start Progesterone supplementation (in the form of pessaries or injection) for luteal phase support. The embryo transfer will be arranged once the endometrium is thick enough. If the endometrium is not thick enough, you may also be asked to start Oesterogen patches. The development of the endometrium will be monitored using ultrasound scans (typically two). If the scan is good then you will start medications (Oestradiol valerate tablets – Climaval) to prepare the lining of your womb (the endometrium). You will be asked to call the clinic on the first day of your period and arrange for an ultrasound scan on day 5, 6 or 7 to check if the hormonal suppression has been effective. If you are having an FET as part of a hormone controlled cycle, you will start medications to suppress or down regulate your natural hormones typically from day 21 (of a regular 28 day cycle). Once ovulation has occurred, the frozen embryos will be thawed and transferred into your uterus on the appropriate day. You will be closely monitored using ultrasound scans and advised to use Luteinising Hormone (LH) urine test kits in order confirm a normal ovulatory cycle. It is important that frozen embryos are transferred at the correct time in a natural cycle. ![]() ![]() The embryo transfer will be performed under ultrasound guidance and there is no requirement for anesthesia. The actual embryo transfer Is identical to the one performed in a fresh IVF or ICSI cycle, except that the embryos will first be thawed in our laboratory at the appropriate time ahead of the procedure. Your consultant will advise you as to which option is suitable for you based on your medical history and age. Thawed embryos may be replaced during a natural cycle, without any medications, or in a hormone controlled cycle, in which medications are used to control the hormones. The frozen embryo transfer (FET or FER) is very simple compared to a fresh IVF or ICSI cycle because it does not involve any stimulation of the ovaries, an egg collection or fertilisation. (Maheshwari et al., review, Aberdeen University, 2012) In fact, there is an increasing belief that in certain conditions one should freeze all embryos in an IVF or ICSI cycle and transfer them at a later date (based on embryos frozen by the vitrification method and not slow freezing). In fact, studies have shown that there is less risk of bleeding during pregnancy, lower chance of a baby being born underweight, less risk of a baby being born premature and less risk of death when frozen embryos compared to using fresh embryos. ![]() There is no data to indicate any increased risk of abnormalities due to the freezing and thawing process. Frozen embryo transfer, or frozen embryo replacement, has now been performed for many years and has resulted in successful delivery of several thousand healthy babies. ![]()
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