Know What's Related to Frozen Embryo Transfer

Frozen embryo transfer is one of the processes of a series of IVF procedures This is done by thawing an embryo that has been frozen previously. This procedure could be an alternative choice to live, if any condition certain cause embryo transfer must be postponedlfirst.

In the IVF process, Most doctors will advise expectant mothers to immediately undergo implantation of the embryo in the uterus. However, in some cases, the implantation of the embryo can be considered to be postponed. Delay is done by freezing the embryo using a special tool, then stored, and thawed again at the right time. The thawing of frozen embryos will follow the cycle of the fertile period of prospective pregnant women so that the success rate of IVF is also high.

Indications for Frozen Embryo Transfer

There are several conditions that cause doctors to recommend pregnant women to undergo frozen embryo transfer, rather than direct embryo transfer. Such as:

Planning to conduct genetic screening of embryos. A pregnant mother-to-be can undergo frozen embryo transfer, if she plans to carry out genetic tests on the resulting embryos first. Genetic testing will usually take some time, so to prevent damage during the process, the embryos will be frozen first. After the genetic test is complete, the frozen embryo will be thawed again, then implanted in the womb of the expectant mother.
Embryo that dgenerate more than one. During the fertilization process in vitro, The number of embryos produced can be more than one. However, doctors will only allow expectant mothers to transfer one embryo. The goal is to prevent triple or quadruple pregnancies. The remaining embryos that are unused at the time of 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 was successful, if both parents wish to have another pregnancy via IVF..
Still in effect fertility drugs. In the IVF process, Pregnant women can be given drugs to increase egg production. However, fertility drugs are thought to make the uterine wall not ideal for implantation of the embryo and have an effect on the success rate. Therefore, doctors may recommend delaying implantation of the embryo into the uterus, until the next fertile cycle. For the purpose of the delay, the embryo will be frozen first, then thawed when implanted in the uterus.
Cannot undergo direct embryo transfer. Some expectant mothers who are at risk for ovarian hyperstimulation syndrome (ovarian hyperstimulation syndrome) due to fertility drugs, can not immediately undergo embryo transfer, because it can cause infertility or even death, in severe cases. Expectant mothers who have this condition will be advised to undergo frozen embryo transfer.

The choice to undergo direct or frozen embryo transfer is the full right of prospective parents who will undergo pregnancy. The doctor will only explain about the two types of procedures for the patient to consider.

Frozen Embryo Transfer Alert

Since this procedure may involve the administration of fertility drugs, namely the hormones estrogen and progesterone, patients with the following conditions are advised to exercise caution:

Allergy to estrogen or progesterone
Severe liver disease
Vaginal bleeding of unknown cause
Have a history of or suffer from arterial blood vessel disease
Thrombophlebitis
Breast cancer
Deep vein thrombosis

Frozen Embryo Transfer Preparation

Prospective parents who will undergo frozen embryo transfer, will go through the stages of testing as carried out by patients who undergo 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 the mother-to-be. In this case, the doctor will check the hormones FSH, estrogen, and AMH from a blood sample. Prospective mothers can also undergo ultrasound so that the condition of the ovaries can be seen visually.
Analysis test sperm. In this test, the sperm sample from the father-to-be will be checked for quality.
Uterine examination. The doctor will examine the condition of the uterus visually using sonohysterography. Through this examination method, the condition of the uterine cavity can be known in detail.
Infectious disease screening. This examination is carried out to check whether both prospective parents are suffering from infectious diseases or not, before undergoing IVF.

After the prospective parents decide to choose the frozen embryo transfer method instead of direct, based on the explanation and consideration from the doctor, the fertilization procedure will be carried out first.

The fertilization process begins by stimulating ovulation or the maturation of the mother's egg. The goal is to get eggs in large numbers. Ovulation induction is done through the administration of a number of hormones, such as FSH, LH, and HCG.

Giving hormones to stimulate ovulation is carried out in accordance with the menstrual cycle of the prospective mother, and is carried out for 1-2 weeks. If the egg is ready to be collected, the mother-to-be will undergo egg retrieval, which is done in a conscious state. The eggs that have been taken will be put into the medium, and incubated in a special tool. If the egg is ready to be fertilized by the sperm, the doctor will take the sperm from the father-to-be, then mix it with the egg in the medium, or inject it directly into the egg. The fertilized egg that has successfully developed into an embryo will be frozen before being transferred to the mother-to-be's womb at a later date.

Frozen Embryo Transfer Procedure

The freezing process begins after the fertilized egg develops into an embryo, after being incubated in a special laboratory. The embryo is then placed in a special fluid or CPA (cryoprotective agent) before freezing. This liquid will protect cells from damage, during the freezing and storage process.

Cells that have been mixed with CPA liquid will then be cooled, either slowly or rapidly (vitrification). Slow cooling of the embryo can take 1-2 hours. Generally, rapid embryo cooling methods require stronger CPAs. After the cooling process is complete, the frozen embryos will be stored at -196 oC in liquid nitrogen. The embryo freezing process will be carried out 1-6 days after fertilization. Embryos that have been stored at very low temperatures can last a very long time, even years after fertilization.

If the mother-to-be is ready to undergo frozen embryo transfer, then the embryo implantation process can be carried out. Embryos that have been frozen will be thawed first, by immersing them in a special liquid. This liquid also functions to remove CPA which protects the embryo during storage, and restores water content in the embryonic cells.

As previously explained, the implantation of the liquid embryo will be adjusted to the fertile period of the mother-to-be. Doctors can give hormones or wait for the fertile period to occur naturally.

Prospective mothers who are given hormones before implanting the embryos will have their hormone levels monitored through blood sampling since menstruation occurs. After menstruation is complete, the doctor will start giving hormones. If the condition of the uterus is ready to receive the embryo, implantation will be carried out.

In implanting embryos that are adjusted to the fertile period of the mother-to-be, monitoring the condition of the body's natural hormones and uterus will be carried out more intensively, compared to patients receiving hormone therapy. Hormone monitoring is done through blood samples, while monitoring the condition of the uterus is done through ultrasound. If the fertile period has been confirmed, the mother-to-be will receive additional progesterone hormone to prepare the uterine wall before implanting the embryo.

The embryo implantation process is carried out in the condition that the expectant mother is conscious, but given sedatives to help calm her during the procedure. The doctor will insert a catheter into the cervix until it reaches the uterus. Through this catheter, one or more embryos that have been thawed will be inserted into the uterus using a special tool. The implantation process is generally painless, but expectant mothers may experience some discomfort and mild abdominal cramps during the procedure.

After Frozen Embryo Transfer

Mothers-to-be who have undergone embryo transfer are advised to avoid strenuous activities, but can still carry on with their normal activities. If the mother-to-be has a successful pregnancy, the obstetrician will monitor the patient's condition until delivery.

If you are not pregnant, the patient will be instructed to stop taking progesterone. Patients will experience menstruation about a week after stopping progesterone. However, if there is abnormal bleeding from the uterus or no menstruation after stopping progesterone, the patient should contact the doctor immediately. If the patient wants to undergo embryo implantation again, the doctor will arrange the next implantation schedule. Frozen embryos that are still stored in the storage room, left over from fertilization, can be disbursed for replanting purposes.

Risk of Frozen Embryo Transfer

After the embryo implantation is complete, the patient may experience several things, such as:

Bloated
Constipation
Hard breasts
stomach cramps
Vaginal discharge some time after implantation

If you experience severe pain after undergoing embryo implantation, the patient should immediately contact the relevant doctor to be checked for complications.

The frozen embryo transfer procedure is a safe procedure for both parents-to-be to undergo. However, the risk of complications remains. Among others are: