FET Frozen Embryo Transfer

• Introduction

  Unlike a fresh stimulated IVF cycle, an FET cycle requires very little testing in advance. If you are returning after a delivery or certain types of gynecological surgery, your doctor may require an updated mock embryo transfer (MET) and transvaginal scan, if indicated. You and your partner may also need to update your informed consents for FET cycles.

• Step one: Booking an FET cycle

  When you decide to begin a frozen cycle, please contact our office and let us know. We will then review your records to ensure your pre-screening is up to date. If necessary, we will order any repeat screening tests. If appreciable time has passed since you last consulted with your doctor, we will schedule a follow-up visit with your doctor.

• Step two: Preparing the lining of your uterus

  A FET cycle will take approximately 6 to 8 weeks. A cycle typically begins with an injection Prostap on approximately day 21 of your cycle to suppress the normal ovarian cycle. After the course of Prostap you will have a bleed and you will need a baseline assessment involving bloodwork and ultrasound. Depending on the test results, your doctor may instruct you to begin daily tablets of estrogen to build the uterine lining. After a designated period of time on the estrogen tablets, you will return for a transvaginal ultrasound lining check. If the lining check demonstrates that your hormone levels are appropriate and your endometrial lining has thickened, your doctor will likely instruct you to add vaginal pessaries of progesterone to your medication regimen. Your nurse will then confirm an FET date and you will come in for your transfer several days later. Estrogen and progesterone continue after the transfer, and through to the blood pregnancy test about 2 weeks later.

• Step three: Embryo transfer

  The embryo transfer is a simple procedure that only takes about 5 minutes to complete. There is no anaesthesia or recovery time needed. When your nurse arranges your transfer, she will notify you and provide instructions on when to arrive and how to prepare. You need to have a full bladder for the procedure as a full bladder ensures good visualization of the lining of the uterus and proper placement of the embryos. It's important to drink the specific amount of liquid recommended 30 to 40 minutes ahead of time. You will review your cycle with the doctor and the number of embryos recommended for transfer. Upon entering your procedure room, the embryologist will again confirm your last name and the number of embryos for transfer. The embryologist will load the transfer catheter in the embryology lab with the embryo(s) and then the doctor will insert the catheter into the uterus and push the embryo through with a small amount of fluid. An external abdominal ultrasound provides visual guidance via a monitor to the doctor throughout the procedure. Once the doctor transfers the embryo, he or she will slowly remove the catheter. Since the embryo is invisible to the naked eye, the embryologist will then examine the catheter under a microscope in the lab to ensure that the catheter did indeed release the embryo. The nurse will give you instructions for the following 2 weeks until it's time for the pregnancy test.

• Step four: The pregnancy test

  Two weeks after the embryo transfer, you will perform a pregnancy test. This test is frequently called a "beta" because it measures the beta chain portion of the hCG hormone emitted by the developing embryo. We let you do this test in the privacy of your own home using a urinary pregnancy test and you then let us know the outcome so we can plan the next steps.

1. What are the benefits of an FET cycle over a fresh stimulated cycle?

   FET is often a good choice over a fresh stimulated cycle if you have frozen embryos to use. Benefits include
   
   Lower cost
   Less complex treatment
   Fewer monitoring appointments
   No risk of ovarian hyperstimulation syndrome (OHSS)
   No anaesthesia or egg retrieval
   Significantly reduced medication cost
   Nearly identical success rates

2. What kind of medication will I take when doing an FET cycle?

   For some women with a completely regular cycle we can do a FET without any medications. For many women though it is beneficial to construct a cycle for them using HRT tablets and progesterone pessaries.

3. How do frozen embryos allow doctors to perform genetic testing?

   If you have a risk of passing certain genetic conditions on to your children, we can test the embryos for certain genetic mutations. This is called preimplantation genetic diagnosis (PGD). After the doctor retrieves the eggs and they are fertilized, the embryologist will biopsy each suitable embryo. The embryologist will then freeze the embryos while awaiting results from the biopsied cells. The doctor can then transfer only embryo(s) for which testing indicates the genetic mutation (and corresponding medical condition) in question is absent. In addition to testing for genetic mutations (PGD), embryo freezing has allowed for preimplantation genetic screening (PGS). This screening looks for abnormalities in chromosome number, such as trisomy 21, which causes Down syndrome, and many others that are likely to result in implantation failure or miscarriage. Likely candidates for this testing include patients with failed implantation and older women, who are at higher risk for chromosomal abnormalities.

Fees

We are delighted to be able to offer your frozen embryo transfer as a treatment package with a single cost from the moment you decide to pursue treatment. Our full price list can be found here for download, but below is a summary of what the FET package includes. At any time, if you have any questions about the fees, please contact us as soon as possible on 0141 956 0509 to speak to a member of staff.