The embryo transfer procedure  is an exciting and stressful milestone for every couple undergoing an IVF treatment.  It is the final step of the IVF cycle and there all hopes are concentrated at. Couple had passed the weeks of medications and monitoring, the egg retrieval procedure and anxiously waited to see how the embryos develop. Once the embryo is placed in the uterus, there is one last thing that must happen before getting officially pregnant: an implantation.

What embryo implantation is?

Implantation occurs when an embryo attaches to the wall of the uterus in the endometrial lining. It occurs six to ten days after the egg retrieval proces in IVF, which is one to five days after the embryo transfer.

What affects implantation rates?

It depends mostly on two factors: the quality of the embryo and the receptiveness of the uterus. 

Most implantation failures are due to chromosomal abnormalities in the embryo, which explains why implantation rates go down as a woman ages. If a patient suffers from poor egg quality, the resulting embryos may not be healthy enough to implant. Donor eggs can help overcome this problem in many cases.

Uterine receptivity can be affected by many things: hormone, thyroid, and autoimmune disorders, an anatomical problem with the shape or positioning of the uterus, or trouble with the endometrial lining. A thorough diagnostic process early in treatment should be able to identify these issues, and there are ways of treating most of these problems before couple get to the embryo transfer stage.

Many couples ask what they can do to help implantation, or if there are any tips to maximize the chances of embryo implantation after transfer. It’s difficult to accept that implantation is largely out of your control - being too concerned with affecting implantation causes unnecessary stress at a time when you should be doing your best to relax. But there are some steps you can take as you prepare for your transfer and after the procedure to give yourself the best possibility of success.

BEFORE EMBRYO TRANSFER

Blastocyst transfer

Embryo is transfered three to seven days of culturing in the laboratory. Blastocysts are embryos after at least five days of development. Modern techniques in fertility technology have made it possible to bring embryos to the blastocyst stage before the transfer procedure.

Transferring blastocysts instead of early-stage embryos allows more time to monitor the embryo’s quality. This allows embryologist to choose the most viable embryos for transfer, improving the chances of implantation success. Blastocyst transfer also more closely mimics the process of a “natural” pregnancy: by day five of a naturally fertilized embryo’s development it would just be leaving the fallopian tubes for the uterus, and the uterine lining should be at its most receptive to implantation at this point.

Consider embryo screening

The genetic testing of embryos prior to transfer is a good way to make sure that the most viable embryos or blastocysts are chosen, which can improve your chances of implantation. Preimplantation genetic screening (PGS) is a technique used to check that embryos have the right number of chromosomes. This allows the embryologist screen for a wide range of genetic mutations known as aneuploidy (missing or extra chromosomes) that could cause implantation failure.

Preimplantation genetic diagnosis (PGD) is used to screen for single-gene disorders, or for chromosomal translocations, where parts of chromosomes are rearranged. It is number of screening procedures  allowing the exclusion of embryos with genetic disorders, including chromosomal abnormalities such as chromosomal translocation, aneuploidy or other structural defects, or monogenic disorders. A cell (blastomere) of the embryo is extracted and subjected to comprehensive genetic analysis.

Embryo Monitoring

A special incubator called the EmbryoScope takes photos of the embryos every five minutes and puts them together into time lapse films. This means that the embryologist can watch how the cells divide and develop. Recognizing patterns at certain key points during the culturing process help embryologist to decide which embryos have the best chance of implanting after transfer.

Assited hatching

Early stage embryos are enclosed by a very thin membrane known as the zona pellicuda. Before an embryo can implant, it must “hatch” from this covering. A technique known as assisted hatching make it easier for an IVF embryo to implant. The procedure takes place in the lab under a high-powered microscope. The embryologist creates a tiny hole in the zona pellicuda, which may improve the implantation rate of the embryo, especially for patients who have a challenging prognosis.

Acupuncture

Acupuncture helps the body to become balanced and healthy. There are many studies that show great success when using acupuncture in combination with medical fertility treatments and on it’s own.

Acupuncture is gaining acceptance as a complementary therapy to other fertility treatments, where it has proven to be especially beneficial. Studies have shown that acupuncture definitely increases the rate of pregnancy in women undergoing IVF. It has been noted that acupuncture increases production of endorphins, the body’s natural “feel good” brain chemical that also plays a role in regulating the menstrual cycle, egg production and possibly ovulation.

It has also been found that acupuncture treatment for infertility increases blood supply and flow to the reproductive organs - increased egg follicles and elevated hormone levels around the ovaries.

It is also possible that acupuncture could help when the lining of the uterus is too weak to maintain a pregnancy – a problem associated with miscarriage. Increased blood flow may lead to a stronger lining in the uterus better able to sustain an implanted embryo.

AFTER EMBRYO TRANSFER

Take it easy

While there’s no evidence that bed rest is beneficial after transfer, finding ways to relax during the dreaded “two week wait” between transfer and your official pregnancy test is good common sense. You have been through so much in the weeks leading up to the transfer, and this is an important time to nurture yourself. Get plenty of sleep and listen to your body: if you want to take a day off to cuddle up on the couch, go for it. If you feel anxious and want to move around, go for a quiet walk somewhere soothing.

Abstain from vigorous exercise

Again, you don’t need to restrict all your normal activities, but high-impact exercise is a bad idea at this point. Your ovaries are likely to still be enlarged and tender at this point and need to be protected, and a hard workout can also stimulate uterine contractions, which you want to avoid for obvious reasons.

Eat as if you’re already pregnant

There are a lot of “implantation diets” and “miracle foods” discussed on the internet, but no real evidence to back up their claims. If you over-focus on one food or group of foods you may be missing out on the balanced nutrition you need to build a healthy baby. The best diet to aid implantation is the same diet you should be eating throughout your treatment and pregnancy: nutritionally balanced with lots of protein, fiber, and vegetables. Avoid foods like high-mercury fish and soft cheeses, and check with your doctor about any vitamins or supplements you should be taking. Of course, avoid all harmful substances such as alcohol, nicotine, and caffeine.

Avoid extremes of temperature

Hot tubs, saunas, hot yoga, or any activity that raises your internal temperature is something to avoid at this point. In general it’s best not to be submerged in water such as pools or baths during this time, as it leaves you vulnerable to infection. Stick to a soothing hot shower until your doctor tells you otherwise.

Lean on your support system

This is the time when your partner, friends, family, therapist, or even an online community can be invaluable. Anxiety is a terrible thing to live through, and isolation makes it even worse. Don’t try to shoulder your stress alone. Let other people cheer you on as you wait to find out if embryo implantation was successful.

  

 

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