Following your consultation with our doctor, we will ask you to consider when you can visit us for a two-three day period at the clinic to have your embryo transfer. Your plan for treatment will be developed around this visit date. When you visit the clinic, your thoroughly matched, excellent morphology embryo, normal for 23 chromosomes, will be thawed ready to be used in your embryo transfer.
The embryo recipient’s treatment
Before preparing you for your embryo transfer we identify and treat any medical conditions which may lower your chances of success.
It is hugely important to identify underlying issues that could potentially lower your chances to succeed. Our main goal is to support you to resolve these issues comfortably so you can move on to a successful and timely embryo transfer.
Hormonal medication scheme makes sure you arrive to St. Petersburg for your embryo transfer logically ready for successful implantation (within implantation window)
The effect of the hormonal treatment on your endometrium is controlled by 2 ultrasound examinations at your home country
Embryo recipients (meaning women who require donor embryos to become pregnant) might or might not have a menstruation cycle. Either way, we will normally request that you take hormone tablets for several weeks. When you stop taking them, a ‘withdrawal bleed’ (period) will usually follow this. At times, another ‘probe cycle’ will be necessary to confirm that your uterus lining is growing sufficiently as an outcome of the tablets. Our doctor will make sure this is written into a personal treatment plan for you. A ‘down-regulating’ medicine is usually needed to be administered by injection, to reduce any risk of premature ovulation, shifting of ‘implantation window’ and reduction in implantation rates.
After you have got your menstruation you will require a scan to ensure there is a thin uterine lining and no cysts are present. You will then begin to take oestrogen tablets, cream and/or patches to grow the uterine lining ready for your embryo transfer. You will begin taking progesterone 5 days prior to the intended day of Embryo Transfer. Generally, this will be taken as cream or as progesterone pessaries inserted into the vagina.
Please ask for a telephone consultation to allow one of our doctors to talk to you about your medical history and personally advise you about the ideal plan, resulting in you having a live birth via either embryo adoption or alternatives.
Here the short summary of the purpose and action of the main medication groups that we use to make you ready for your embryo transfer.
Our medication scheme ensures that the embryo transfer is done within the ‘Implantation Window’
Treatment feels much milder than hormonal stimulation for IVF with own eggs.
The main goal for hormonal medication for embryo recipient is to make sure that the embryo transfer is done in the timing when the implantation is most likely to occur — ‘Implantation Window’
We usually ask our patients to tell us which week or certain dates are convenient for them to come to St Petersburg for embryo transfer and then adjust the readiness of the uterus to these dates with the help of very little hormonal medication. Luckily medication for embryo recipients feels much milder than hormonal stimulation for IVF with own eggs.
Here we describe the purpose of main medication groups that we use to make the recipient perfectly ready for embryo transfer.
Combined Oral Contraceptives (Birth Control Pills)
Pill time menstruation and prevent cyst formation
Help to time menstruation logically for the timing of the transfer (usually 3 weeks before transfer)
Helps to avoid follicular functioning cysts in the embryo transfer cycle.
This should be started from day 2 of menstruation – 2 to 3 months before your visit to St Petersburg
We prefer the monophasic combined pills without placebo tablets in the pack, which means that every pill in the packet is the same as any other pill. These contain both synthetic oestrogens and progesterone. Here are just some brand names for these types of pills – Neovletta, Microgynon 30, Marvalon, Valette, Femodene
Down regulation helps to avoid premature ovulation and shifting of implantation window
- Switches off own ovarian activity in the embryo transfer cycle.
- Helps to avoid premature ovulation which would shift implantation window forward and would result in reduction in success rates.
- Examples of this type of medication are Procrene Depot – 3,75mg – 1 single injection, alternatively Diphereline Depot, Buserelin Depot, Zoladex, Decapeptyl Depot, or other agonist GnRH
Oestrogens Grow the lining in the uterus and sustain it after transfer
- Grow the endometrium lining in the Uterus making it ready for implantation
- Support the endometrial lining in the uterus so that it doesn’t bleed out before the embryonic placenta takes over the function of hormonal support
- We use both oral and transdermal forms to sustain a stable concentration in the patient
- Examples of Oestrogens tablets are Progynova, Progynon, Estrodial
- Examples of Oestrogen patches are Clemara, Estrodot, Evorel and Vivelle
Progesterone make uterus lining receptive to the embryo and supports pregnancy.
- Times the readiness of endometrium for implantation
- Supports the endometrial lining in the uterus so that it doesn’t bleed out before the embryonic placenta takes over the function of hormonal support
- Receptors on the surface of the endometrium which are capable to recognise the receptors on the surface of the embryos will appear on day 5 of progesterone supplementation and will usually be gone after 48hrs.
Improved delivery of hormones to the target organ and reduce maternal hostility towards the embryo
- We also use Vitamins and medication to improve the blood flow in the uterus as well as medication to reduce the immunity of potential mother to the embryo, all of these will be listed in the individual treatment plan of the patient.
Embryo transfer is a simple painless procedure.
The embryo transfer procedure is a painless and simple one that is performed on day 5 of embryonic development (in Blastocyst stage). We use only best morphology embryos normal for 23 chromosomes from young healthy egg and sperm donors
We recommend Single Elective Embryo Transfer (SET) based on both: morphologic and genetic criteria.
SET based on morphology and genetics of embryos results in 60% clinical pregnancy rates.
SET is efficient and safe.
Our standard is to use single elective embryo transfer and this results in over 60% rates of clinical pregnancy.
Should two donor embryos be transferred, the opportunity to become pregnant will grow from over 60% to 70%, however risk of multiple pregnancy will much increase leading to a twinning rate of more than 50% (over half of women who become pregnant will be having twins).
It’s known that the chances of complications for mother and child in pregnancies with twins are 5-6 times higher than with single baby pregnancies, for example, a very low birth weight and underdeveloped internal organs and nervous system, which can lead to serious consequences in later life.
Twin pregnancy has 6 times higher risk of complications than singleton pregnancy.
At our clinic, we can increase rates of success not by the volume of embryos that are transferred, but by a detailed selection of possible egg and sperm donors, as well as the highest standards in our laboratory to make sure that the blastocysts used are of only the very best quality.
A thin, soft plastic catheter is used to transfer the embryo and this is inserted into the womb vaginally and through the canal of the cervix. It is not necessary to take medicine or be sedated.
Treatment after embryo transfer
Progesterone and oestrogen must be taken up to week 12 of the pregnancy.
Once the embryo has been transferred, you will continue to take oestrogen tablets and progesterone tablets for 10 days before taking a pregnancy test (which will be a blood/urine test). Should the test result be positive, you will have a scan 10 days to 2 weeks later to confirm your pregnancy. The appearance of a ‘foetal pole’ on your scan (which appears similar to a rice grain in the foetal sac) gives clinical proof you are pregnant. Progesterone and oestrogen must be taken up to week 12 of the pregnancy. After that, you will take the progesterone on its own up to week 30.
The miscarriage risk is in our patients is very low because we help you not only to get pregnant but also to stay pregnant and have a healthy baby.
Once you know the result of the pregnancy test, please tell us as soon as you can as we will be eagerly anticipating your news! Should you be pregnant, please keep us updated with how things are progressing for you. We very much hope that things progress smoothly. However, if there are any issues in your first trimester, we inform our patients beforehand of the actions required by them, so they know what they need to do.
Unfortunately, should the pregnancy test show a negative result, you are unlikely to be pregnant. Of course, patients sometimes want to carry on with their treatment and try a new test in a few days time. If this shows a negative result as well, hormone treatment will be stopped.
If things haven’t turned out like you wanted, we’ll do our utmost to provide you with any support and information you may need.
In common with any pregnancy, those that are assisted carry a low miscarriage risk, as well as risks of being ectopic, defects in the development of the foetus, and difficulties during the pregnancy and the delivery. The miscarriage risk is not higher at our clinic following embryo adoption, than it is for a young woman in her 20s using her own eggs. The reasons for this are our use of the best quality eggs and sperm from fit, youthful egg donors; embryos of the best morphology and tested for 23 chromosomes; the advice we give you on the most appropriate hormone support for you; and the way we keep in touch with you regularly to prevent any possible complications at the earliest stage.
Please ask for a telephone consultation to allow one of our doctors to talk to you about your medical history and personally advise you about the ideal plan resulting in you having a live birth either via embryo adoption or one of the alternatives.