Preparing for Embryo Transfer

What to Expect: Cycling for Embryo Transfer 

After you make it through all of your screenings and match with intended parents you will begin preparing to cycle for your embryo transfer procedure. You will receive your medication calendar and instructions from the IVF clinic. If you have never been through the IVF process before, the information can feel overwhelming. We hope this guide helps you feel more comfortable with this exciting milestone. 

List of medications your fertility clinic may prescribe to you for your upcoming IVF cycle

Birth Control

Fertility clinics often begin the medication protocol by prescribing their patients birth control. Birth control is used to regulate the timing of your menses to predict the start time of your cycle more easily.

Leuprolide (Lupron) 

Some fertility clinics prescribe their patients Lupron in preparation for their embryo transfer. Lupron is an injectable fertility drug. It shuts off your body’s normal process of hormone and egg development.

Estrogen

 Estrogen is prescribed to prepare the uterus lining for embryo transfer and sustain a pregnancy after embryo implantation. It comes in many different forms: Patches, Injections, Oral Tabs, and Vaginal Inserts. You typically begin taking estrogen after your baseline ultrasound.

Progesterone

Progesterone is a synthetic natural hormone that supports the lining of the endometrium and to possibly aid in the implantation of the embryo. It is typically administered as an intramuscular injection or as a vaginal suppository. Progesterone begins on Day 15 of your cycle, depending on the results of your transvaginal ultrasound, and continues until 8-12 weeks of pregnancy.

Antibiotic

Antibiotics are prescribed to help with the implantation of embryos and to reduce the risk of infection post embryo transfer. Doxycycline and Cipro are the most common antibiotics prescribed. You typically begin taking the antibiotic 5 days prior to the embryo transfer.

Medrol

Steroids are often prescribed to mildly suppress the immune system to prevent rejection of the embryo after transfer. You typically begin taking the steroid 5 days prior to the embryo transfer.

Immunosuppressants

Immunosuppressants such as Tacrolimus are prescribed to mildly suppress the immune system to prevent rejection of the embryo after transfer.

Baby Aspirin

Some fertility clinics prescribe their patients a low-dose aspirin. Research has found it may increase the chances of a clinical pregnancy.

Prenatal Vitamins

To prepare your body to support a healthy pregnancy, fertility clinics will prescribe a prenatal vitamin up to three months prior to beginning the cycle for embryo transfer.

Organizing Your Medications

The number of medications you receive can be overwhelming. Between pills, suppositories, vials, needles, alcohol wipes, and a sharps container, there is a lot to keep organized. Having a designated area for your medications and supplies will help keep everything more manageable.

IVF Cycle Monitoring

You will be closely monitored prior to beginning your medication protocol and during the protocol. Monitoring appointments include transvaginal ultrasounds and lab work. On day 2-4 of your period you will attend your first monitoring appointment, also called your baseline appointment. You can expect a transvaginal ultrasound that will look at your ovaries, uterus and endometrial lining and lab work to check your hormones. Your doctor will want to confirm you are not pregnant, you have no ovarian cysts, your uterus lining is thin, and your estrogen level is low. The purpose of the baseline check is to confirm your body is ready to begin the IVF medication protocol. About one week prior to your embryo transfer you will attend a final monitoring appointment. The lining of your uterus will be checked in addition to lab work to check your hormone levels. This final lining check is done to ensure your uterus lining is optimal and receptive for your embryo transfer.  

It is important to remember that each fertility clinic has their own medication protocol and timeline. You may know other women cycling for an embryo transfer whose protocol may look different from yours. That is ok! Always follow your specific instructions and timeline from your reproductive endocrinologist. If you have any questions about your monitoring appointments or your medication calendar, please let us know!

Appointment

Day

Notes

Monitoring #1

1

Considered the baseline appointment. Transvaginal
Ultrasound and hormone levels checked.

Monitoring #2

7-9

*Not performed by all clinics* Transvaginal Ultrasound
and hormone levels checked

Monitoring #3

15

Transvaginal Ultrasound and hormone levels checked.
This final lining check is done to ensure your uterus
lining is of optimal thickness and displays a
trilameter pattern which means it is receptive for an
embryo transfer.

Progesterone injections typically begin the following
day.

Embryo Transfer

20

Lab Work and Embryo Transfer

hCG #1

29

Lab work (typically looking for a result of 50 or
higher)

hCG #2

31

Lab work (Looking to see that the results from the last
28 hours have doubled. It is important that you go to
the same facility where the first hCG was drawn and
that you have the test performed 48 hours after the
first result

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