Frozen Embryo Transfer (FET): Tips, Timeline & Process

The frozen embryo is a relatively new method of assisted reproduction that allows people to get pregnant at their preferred time in the future. In the frozen embryo transfer method, doctors fertilize an egg with sperm in the laboratory (IVF treatment). Then, the resulting embryo gets frozen and implanted in the mother's uterus at an appropriate time.

Why Do People Freeze Embryo?

For various reasons, couples may freeze and store their embryos to use them in the future. Some of these reasons include:

• Low level of anti-Mullerian hormone (AMH), which makes the ovaries produce fewer eggs;
• Having cancer. Some couples prefer to freeze their embryo before undergoing chemotherapy or radiotherapy; 
• Intending to have children in the distant future, even during the menopause period; 
• Having polycystic ovary syndrome (PCOS), which causes hormonal imbalance in women and reduces their ovaries reserve;
• Having menstrual disorders; and
• Intending to have more kids in the future by using the IVF method. 
• Also, in some rare cases, people freeze their fertilized eggs to sell them to infertile couples in the future. 

Preparing for Frozen Embryo Transfer

Frozen embryo transfer is not a complicated procedure, but before the operation, consider the following tips:

• Take your medications, especially the hormonal ones, as they were prescribed;
• Take an ultrasound scan to check the condition of the ovaries and uterus;
• If you have a history of miscarriage or premature birth, inform your doctor;
• Avoid having sexual intercourse for three days before the transfer;
• Reduce your screentime for a couple of days before frozen embryo transfer (FET);
• Have a nutrient diet and avoid dishes that irritate your digestive system;
• Avoid exposure to harmful chemicals and radiation;
• Stay hydrated;
• Eat a healthy breakfast on the day of embryo transfer. 

What to Do the Night Before Embryo Transfer?

Embryo transfer is one of the most important steps of the IVF cycle, so you should be well-prepared for it. In order to increase the chance of IVF success, consider the following tips the night before embryo transfer:

• Take a shower; 
• Avoid doing strenuous activities and get plenty of rest;
• Relax your body and mind by doing yoga and meditation;
• Ask your doctor if you should take any medication (including progesterone);
• Do not wear strong perfumes, as embryos are sensitive;
• Ask someone to be your caregiver; 
• Ask your doctor if your bladder should be full for transfer;
• Avoid having sex.

Read more: The Best Diet Before Embryo Transfer to Increase Fertility Chances.

Frozen Embryo Transfer Procedure Step by Step

Frozen embryo transfer is a rather simple procedure that does not require anesthesia. This operation is done in a fertility clinic or hospital and takes almost 15 minutes. On the day of the transfer, the doctor will perform an ultrasound scan on your uterus to check the condition of your endometrium. If everything is good, the process of embryo transfer begins.

After the initial preparation and rinsing of the discharges from the vagina, the IVF specialist transfers one or more embryos to the uterine cavity by a fine tube called a catheter. After the transfer, you have to lie down for 20 minutes, and then you can go back home.

You can take a blood or urine test almost two weeks after the frozen embryo transfer to confirm the pregnancy. Although taking a pregnancy test sooner might be tempting, specialists highly recommend waiting at least 15 days before taking the beta test.

What to Do after IVF with Frozen Embryo to Increase Success?

After IVF with a frozen embryo, take the following care:

• Take all the prescribed medications as before. Do not increase or taper off any medication at your discretion;
• Take a pregnancy test 15-18 days after frozen embryo transfer (FET). If the test is negative, repeat 48 hours later and if it is positive, continue taking the medication as usual and visit your doctor as soon as possible;
• Rest at home for up to three days and ask someone to be your caregiver;
• If you have a history of chronic cough or constipation, inform your doctor;
• Do pregnancy exercises;
• After transferring the embryo, you can take quick showers, but you shouldn't stay in a hot bathroom for too long;
• After the transfer, you can have all kinds of foods except canned and processed ones, herbal teas, and alcoholic beverages. For a proper diet after embryo transfer, add more fruits and vegetables to your diet to prevent constipation.
• You can sleep in any position you feel comfortable, and it is not necessary to put your legs up while sleeping; 
• Maintain vaginal hygiene;
• In case of spotting, bleeding, shortness of breath, or severe abdominal pain, contact your doctor immediately.

Things to Avoid After Frozen Embryo Transfer

• Avoid strenuous activities and sexual intercourse until your pregnancy is confirmed;
• Avoid straining during bowel movements;
• Avoid contact with people with colds, rubella, chicken pox, or the flu;
• Avoid stress and anxiety; and
• Do not take non-prescribed medicine without consulting your doctor.

Read more: How to Increase Chances of Successful IVF?

Frozen Embryo Transfer Timeline

Each cycle of frozen embryo transfer will take almost six to eight weeks. You must take birth control pills to restrain ovary activity for about three to four weeks. When the ovary is completely suppressed, it is time to check the hormone levels and endometrium. To that end, you must perform a transvaginal ultrasound scan and blood work for a few days. 

Based on the condition of your uterus, the doctor prescribes the estrogen injection. Usually, the patients have to inject estrogen for a week to thicken the uterus lining and prevent ovarian follicles from growing. After estrogen injections, another bloodwork and transvaginal ultrasound are needed to check the uterus lining. 

If your endometrium has the expected lining, i.e., 7mm, your doctor will ask you to take daily injections or vaginal suppositories of progesterone for four to five days.

Finally, you are ready for embryo transfer almost two weeks after taking birth control pills. Your doctor will determine the exact day of the transfer. On that day, you go to a fertility clinic with a full bladder and receive the fertilized egg through a simple procedure. As doctors suggest, the embryo will be implanted within 24-48 hours after the transfer, but you must wait 15 days before taking the pregnancy test. 

Side Effects of Frozen Embryo Transfer

In some cases, frozen embryo transfer may have temporary side effects such as: 

• Pain in ovaries;
• Cramping;
• Swelling of the ovaries;
• Mild lower abdominal pain;
• Bloating and diarrhea;
• Nausea and vomiting;
• Accumulation of fluid in the abdomen;
• Difficulty in breathing;
• Spotting or bleeding, which may last for three months;
• Pain in breasts;
• Frequent urination;
• Extreme fatigue; and
• Pelvic pain.

Success Rate of IVF with Frozen Embryo 

The frozen embryo transfer success depends on several factors, such as the cause and duration of infertility, health condition and BMI of the mother, uterine receptivity, quality of the embryo (embryo grade), and most importantly, the age of the mother. The higher the mother's age, the lower the success rate of IVF with the frozen embryo. In general, the frozen embryo transfer success is 60% for women under the age of 35 and %20 for women above the age of 40. 

Frozen Embryo Transfer Cost

The cost of IVF with frozen embryos depends on the procedure's price, embryo cryopreservation duration, hospital facilities, doctor's fees, medications, and the number of lab tests required. To know the exact cost of IVF with frozen embryos, you should ask your specialist or a fertility clinic.

Chance of Twins with Frozen Embryo Transfer

During the IVF procedure, some specialists transfer two or more frozen embryos into the mother's womb to increase the chance of pregnancy. In some cases, more than one embryo attaches to the uterine wall and forms multiple pregnancies. The chance of twins with a frozen embryo is not very high, but if you do not intend to have twins in IVF or even triplets, discuss it with your doctor before frozen embryo transfer (FET). 

Signs of Successful IVF with Frozen Embryo 

• No period after embryo transfer: Menstrual bleeding does not occur anymore when the embryo attaches to the uterine wall.
• Clear mucus discharge after embryo transfer: an increase in vaginal discharge can signify successful IVF with frozen embryos. Usually, women have clear mucus in the early weeks of pregnancy.
• Sore breasts after frozen embryo transfer: most women experience swelling, tenderness, and pain in their breasts at the beginning of their pregnancy. This happens due to hormonal changes in the body.
• Feeling sleepy and tired after IVF: during the first stages of pregnancy, the amount of progesterone in the body increases, which results in extreme fatigue and muscle cramps. 
• Headache and dizziness after FET (frozen embryo transfer): if the embryo transfer is successful, you may experience severe hypotension and hypoglycemia. As a result, you might feel down all day and experience headaches, dizziness, and even fainting.

Read more: How to Know if Embryo Transfer has Worked?

Conclusion

To summarize, frozen embryo transfer is the final step of the IVF process, through which the fertilized egg(s) is directly transferred into the mother's uterus using a catheter. IVF with frozen embryos is a complex procedure and should be done in a standard hospital and under the supervision of an experienced doctor. Luckily, in Iran, thousands of knowledgeable physicians and well-equipped fertility clinics offer the best healthcare services at a reasonable price.

IVF in Iran

If you intend to do IVF with frozen embryos in Iran, contact Raadina Co. to get more information about the top fertility clinics in the country and the price of this operation in Iran. Raadina Team offers you special embryo transfer packages, which include booking doctor's appointments, applying for a medical visa, arranging transportation in the country, and booking suitable and affordable accommodations.