Once that thickness is achieved, the reproductive endocrinologist directs the patient to begin taking progesterone to mimic the luteal phase. The patient is typically prescribed some form of estradiol to develop the uterine lining, which is monitored via transvaginal ultrasound until it ideally reaches the 8- to 10-mm range and has a multilayer appearance. Just as with fresh embryos, the patient usually begins with the priming phase, followed by a baseline appointment. According to the Society for Assisted Reproductive Technology (SART)'s 2016 report, the LBR was 36.7 percent for women under 35, 26.6 percent for women 35-37, 15.6 percent for women 38-40, and 9.3 percent for women 41 and older.Ī frozen transfer is much simpler for both the patient and reproductive endocrinologist. Live birth rates (LBR) following a fresh embryo transfer depend partly on patient age. Any embryos not transferred are cryopreserved. However, if the embryos do not develop well in the lab, the transfer may take place three days later instead. Most fresh embryo transfers take place under ultrasound guidance at the blastocyst stage, five days after the egg retrieval. Approximately 36 hours later, the reproductive endocrinologist retrieves the eggs and an embryologist attempts to fertilize them with sperm, either naturally or via intracytoplasmic sperm injection (ICSI). That improves the IVF result."Īfter seven to 14 days of stimulation, the patient takes a trigger injection at a specific time to help the eggs reach final maturation. "We get more good follicles with mature eggs-which is what we want. "It's a better way," Palumbo says, that may increase patients' chances of a healthy pregnancy. ![]() This tool allows a provider tosimply select an ovary and scan, removing the need for a manual count in most cases. Stimulated follicles analyzed with SonoAVCfollicleįIVAP providers use Voluson's SonoAVCfollicle to reduce potential errors in follicle counts. Angela Palumbo, director of the Centro de Fecundación In Vitro FIVAP. ![]() On the other hand, if it becomes too big, the egg might not be suitable for fertilization," says Dr. If a follicle is smaller than what you measured, you cannot use the egg to be fertilized. More important than the number of follicles is the size. ![]() 'We need to have precise measurements, so we can interrupt stimulation at the right time. This allows a gynecologist to monitor stimulation and pinpoint the optimal time for retrieval. The goal is to produce as many mature eggs as possible - monitored via transvaginal ultrasound - without overstimulating the patient.ģD ultrasound tools like SonoAVC follicle automatically calculate the number and volume of stimulated follicles. Then, the ovarian stimulation phase begins. Once the patient has a menstrual period, a baseline appointment checks for "quiet" ovaries via transvaginal ultrasound. In vitro fertilization (IVF) providers should familiarize themselves with the current research and statistics surrounding embryo transfers and learn how each method impacts the IVF process for patients and clinicians.Īlthough there are many different approaches, fresh embryo transfers generally begin with a priming phase to suppress the patient's natural hormone production and ensure each follicle has the same likelihood of maturing. One hotly debated topic among fertility patients and the reproductive medicine community at large is whether a fresh or frozen embryo transfer results in more live births.
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