Thursday, January 06, 2011

Testing for pregnancy after an embryo transfer in an IVF cycle

While all IVF patients understand with their heads that not every IVF cycle results in success, in their heart of hearts, every patient expects to get pregnant every time they do IVF ! This is why the 2ww after the embryo transfer can be so nerve-wracking ! Am I pregnant or not ? Have the embryos implanted or not ? The suspense during the 2ww can be even worse than the pain of the IVF injections !

Most patients would love to have a test which will allow them to find out if they are pregnant immediately after the embryo transfer ! Have the embryos stuck or not ? Why can’t we do a pregnancy test and find out right now ? Even if I am not pregnant, at least it’s better to know than to be unsure.

To understand why patients ( and their doctors ) still have to suffer through a 2 week wait to find out the outcome of an IVF cycle, let’s look at the biological basis of pregnancy tests and how they work.

A pregnancy test measures the amount of beta hCG ( human chorionic gonadotropin) that is in your body. HCG is a hormone which is produced by the trophectoderm cells of the embryo. It is produced in detectable quantities only after the embryo implants. Since implantation occurs 3 - 8 days after the embryo transfer ( depending upon whether you have had a Day 3 transfer or a blastocyst transfer), this means that the HCG produced by your embryo will be first detectable in your bloodstream only after this time.

As your pregnancy progresses, the amount of hCG in your system will increase. At 10 days past ovulation ( DPO) , for example, the average woman has an hCG measurement of around 25 mIU. This amount doubles to 50 mIU at 12 days past ovulation, and then doubles again to 100 mIU at around two weeks past ovulation. Every woman’s body is different, and there’s a lot of variation in HCG levels from woman to woman !

Home pregnancy tests measure the level of HCG in urine. Different pregnancy tests have different levels of sensitivity which means if you use a home pregnancy test that is sensitive to 100 mIU, it will not tell you that you are pregnant if your level of hCG is only 75 mIU. These tests cannot measure a level lower than 25, so they do not become accurate until a few days after embryo implantation. A negative result before then is meaningless, since there would not be a high enough level of HCG to detect even if you were pregnant. If your test is negative, you should retest after 2 days. This is why taking a pregnancy test too early can lead to inaccurate results. I know it’s hard to wait those extra days and you may want to try much earlier. It’s fine to do this, but please don’t assume that a negative results means that you are not pregnant.
This is also why blood tests for HCG are much better than urine tests. Not only are they more reliable, accurate and sensitive, they also give the doctor a number which he can measure and monitor.

If blood tests are so sensitive, then why not do a blood test for HCG 1 week after the embryo transfer ? Unfortunately, doing a blood test for HCG so soon does not make any sense. This is because there will still be some HCG in your body as a result of the HCG trigger shot ( Choragon or Ovidrel) which the doctor gave you to trigger off ovulation 36 hours prior to egg collection. If you test too early, the test will always be positive, as this HCG will show up in the test and give rise to false hopes ! This is why the doctor needs to repeat the blood test for HCG after 48-72 hours. In a healthy pregnancy, the HCG levels will continue to rise. If they do not do so, this means this is not a viable pregnancy.

The problem is that some IVF clinics will fool their patients into believing they are pregnant by giving them a HCG injection 7 days after the embryo transfer. Then, when the patient does the urine  pregnancy test 14 days after the transfer , the result is often a false positive . because the HCG given in the injection appears in the blood stream and the urine. The patient is very excited, believes she believe that her IVF cycle has worked. However, when the second HCG level falls, the doctor says - We got you pregnant, and our treatment was successful , but unfortunately you miscarried. Patients get duped, and are happy to try another IVF cycle at the came clinic, because they don't realise they are being taken for a ride.

Finally, remember that you should do the test even if you bleed. Bleeding can sometimes occur during pregnancy as well – and just because you have had bleeding or spotting does not mean you are not pregnant !

Please register at www.hcgexpert.in so you can track and monitor your pregnancy


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323 comments:

  1. Anonymous1:25 PM

    Wat abt egg donor cycle ivf.? can they do pregnancy test after 1 week?

    ReplyDelete
  2. A HCG blood test is best done 12 days after a Day 3 transfer. Even though it can give a positive result before this, doing it too early does not help.

    ReplyDelete
    Replies
    1. I had a transfer on 12/12/15 day 5 embroy they pit in 2 of the best Good eggs, but I also did hcg trigger shot on the same say of transfer, now I test today and it say negative can it be to soon fir urine .

      Delete
    2. I had a 5 day embroy transfer on 12/12/15 # 9:30am then after doctor want me to take a 1ML of hcg trigger shot which I did, then I test today 12/ 16/2015 which is negative reault, can it be too soon for urine. How about I do blood beta

      Delete
  3. Anonymous10:12 PM

    Pls Dr does a -ve result from a home urine test on day 12 after ET mean it's over? I had some brownish spotting today day 12. Had a day 3 transfer of 3 embryos. Thank u.

    ReplyDelete
  4. I am sorry, but a negative urine test is not a good sign and suggests the cycle has failed.

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
    Replies
    1. I had a 2 baby place on a 5 blast stage embryo transfer on 12/12/15 and I did a blood beta on 12/16 and 12/19 a urine all negative can it be to soon

      Delete
  5. Anonymous7:14 PM

    Dr..today is 7th day after embryo transfer.my E2 level is 61..madam prescribe me progynova( daily 2).is there any hope? Can i became pregnant?

    ReplyDelete
  6. It's very unusual to test for E2 levels after the transfer !

    We routinely provide luteal phase support with estrogen and progesterone to all our IVF patients.

    Best of luck !

    ReplyDelete
  7. dis is my second ivf cycle with frozen embryos..my bhcg test is negative..but doc asked me to continue meds till upt..but on 10th day i started noticing spotting..today is day 12..why is it so??

    ReplyDelete
  8. How many days back was the ET done ? Was this a Day 3 or Day 5 transfer ?

    If the blood test is negative , there's little point in doing a UPT

    Can you send me more details about your IVF cycles ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  9. Anonymous4:31 PM

    Hi Dr, today is my 10 day of ET. 3 EMBRYO, 3 day embryo transfer. before i had 2 pregnancy with miss abortion. both the time it was chromosome abnormality. so this time we did IMSI. now after 8 day of transfer i feel little cramp in lower abdomen right side. I m still on progestrone suppliment, when can i do home pregnancy test?

    ReplyDelete
  10. How will IMSI prevent a chromosomal abnormality ??

    Do a blood test for HCG to find out if you are pregnant.

    Read more at www.drmalpani.com/hcg.htm

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Bombay 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    My Facebook page is at www.facebook.com/Dr.Malpani

    You can follow me on twitter at https://twitter.com/drmalpani

    Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby - A Guide for the Infertile Couple,
    online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    relationship at http://blog.drmalpani.com



    ReplyDelete
    Replies
    1. Anonymous5:15 PM

      I had 3 good eggs transfered 11 days ago, 5 day blastocycts transfer on march 21st... and this morning I took a clear blue easy digital hpt and it says Not Pregnant. Im sooo upset. I would think from everything Ive read that my hcg levels would be detectable by now, no? This will be my 3rd failed cycle if this doesnt work, and im just beside myself. :(

      Delete
  11. Anonymous6:25 PM

    embryo transfered after 3 dys of retreival,today negative urine hpt test today also we have the blood test ,medicines taken suprefact and puregon ,other supplements for progesterone cyclogest and progynova,first 2 blood test showed 190.8 progesterone the third went down to 56 and 17.9 ng/ml ,2 fertilized were transferred .

    ReplyDelete
  12. 8dp3dt fresh three 10 cell grade 1.5 embryos (ICSI & AH)
    Remaining 6 all fertilized & made it to cryopreservation
    10,000U Pregnyl given 1.5days b4 ER (13 days ago)
    HPT + today
    Beta in 3 days
    Pregnant?

    ReplyDelete
  13. Dear doctor,I had my ET On 5th of April-2013,it was in day 3rd after ER on 2nd of april,befor the transfer my doc said I Have high progesteron lable in my blood i.e.1.38,she suggested me to wait untill next cycle as they had 8good quality of embroy,the chief embroylogist asked me to frozen it.but as being dipress i insisted to go for this time only.they transfered 2embroys out of 8,and rest 6they kepted fr frozen,i am taking geston 100mg evryday as in inj.ang fragmin2500IU evryday along with following medicines,tab progynova,duphoston,ecosprin,empholic dha for next 17days,so still even after having high progesteron lable do ihavr chance to get positive result?I get some cramps during the day,and feel heavy in mylower abdomin,can you please help me out,i also had mild PCo due to that i m also taking metformin 500mg three times a day from past 3years.

    ReplyDelete
  14. Dear Vanishka,

    A progesterone level of 1.38 is very low !

    Do you have photos of your embryos ?

    ReplyDelete
  15. Anonymous11:16 AM

    Dear Dr, E2 level of 254 and progesterone level of 16.1, 7 days after embryo transfer (5 day), can it be considered as the enough level to conceive? Please suggest, if u think that my progesterone dose should be increased.
    Thank you!

    ReplyDelete
  16. Anonymous2:13 AM

    respected Dr
    i had my ET on 5th April...transfered 2 embrios on day 5. i am on utrogestane. on my 9dpt i started to spot which become heavy bleeding on the next two days. my dr said continue utrogestane until the test day. im very upset. does bleeding means its over.

    ReplyDelete
  17. Heavy bleeding is usually a bad sign and suggests your Day 5 embryos have not implanted, sorry !

    ReplyDelete
  18. Anonymous12:14 AM

    I am 6dpt (1 frozen blastocyst). When do you think I could expect to see my first positive home pregnancy test?

    ReplyDelete
  19. You can start testing 9 days post transfer, but home pregnancy tests are not always reliable !

    Read more at www.drmalpani.com/hcg.htm

    ReplyDelete
  20. Anonymous10:26 AM

    Hello doctor,
    I had my 3day embryo transfer. 2 embryo both grade A embryo were transferred on 18th April. I was given 2 hcg inj named ovipure hp 2000iu each on 18th and 22nd April after transfer. And was also given ovidrel 500 for ovalution before egg retrival. My 1st beta hcg was on 30th April result 49.8 and 2nd on 3rd may result 51.25. What was the reason my levels dint increased. Could it happen tht both embryo implanted and one dint survived or there was still traces of hcg in my blood on my 1st beta hcg test day. Or some other reason my hcg dint increased.plz reply

    ReplyDelete
  21. The fact that the HCG did not rise means this is not a viable pregnancy, sorry

    This maybe a chemical pregnancy . You can read more about this at www.drmalpani.com/chemicalpregnancy.htm

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  22. Anonymous12:25 PM

    Thanks for ur reply doctor but I m told to do another blood test on 6th April. Can my levels double or increase. Can it happen tht initially hcg levels doesn't rise but later it could rise.

    ReplyDelete
  23. Anonymous6:55 PM

    Hi l am just wondering if 7 days after day 2 embryo transfer is too early to do hpt ,l did one this morning with a very faint positive ?????

    ReplyDelete
  24. Anonymous4:24 PM

    This is my second ivf d first one fail coz of thin endrometrium but for d second one the thickness was 7.5 and 4 embryos were transfer after day 2egg retrival even my hubby saw d egg were so fine am supose to do my prg test en today is my 11 day but i just feel heavy at my bottom but i dont feel any cramp so am worried and am on cylgest and femoston to increase my endo thickness which am takin 4 tablets daily

    ReplyDelete
  25. Anonymous5:59 PM

    Hello Dr,
    Just did my pregnancy test after an ivf transfer which was done on the 27of april, I had no spotting, no bleeding and the test result is still negative. Is it possible to be pregnant and still have a negative result?

    ReplyDelete
  26. It's a bit too early . A faint positive urine pregnancy test could be because of the HCG trigger shot prior to egg collection

    ReplyDelete
  27. While a positive pregnancy test is encouraging, a negative test is not always reliable. However, a negative test 14 days after embryo transfer is usually not good news. However, it's important to do a blood test for HCG to confirm the results

    ReplyDelete
  28. Anonymous10:36 PM

    I am on day 9 of a 5 day egg transfer I done a test and it was negative just wondering if ihave done it to soon or has it failed

    ReplyDelete
  29. Anonymous3:46 PM

    Hello
    I have just had IVF my second treatment with 2 frozen embryos I did a pregnancy test 8 days after I had them transfers I also did a pregnancy test today. Day 12 and both have come up and said pregnant I know I have only got 2 days left for my blood test but is it a good sign the test said 3 min wait but the pregnancy sign came up way before that

    ReplyDelete
  30. Yes, this is a good sign and suggests you are pregnant - congrats !

    ReplyDelete
    Replies
    1. Anonymous3:29 PM

      Dr. I had my ET of 3 (5 days) embryo. Had tested positive for HPT on the 8th day after the ET, did the blood works and HCG was 101 then rechecked after 2 days, it's 172, had a fever that night and on the 3rd and 4th day after that. Had my HCG tested it went down to 14.7 and they said I am no longer pregnant, what happened Doctor? I admit going to that clinic is like 1 hour and 20 minutes drive back and forth with 300 bumps along the road, could it have contributed for my embryos not to implant?

      Delete
  31. Anonymous8:20 PM

    Hello Dr. Malpani, My Cryo-ET of 2 Blastocysts done on 09/05/2013. My Dr. prescribed me to take Inj. Corion 2000iu IM on 09/05/2013, 11/05/2013 and 14/05/2013 alongwith Gestum (inj. and capsule alternate day). My beta-HCG level on 18/05/2013 was 140.9 (fasting) and on 20/05/2013 was 189.1 (after lunch). How good is this for pregnancy?

    ReplyDelete
  32. Anonymous12:22 PM

    Hi i m having unocornaute uterus and low amh.I had soft ivf cycle produced,3 eggs from 3 follicles resulted into 3 embroys but had only 1 3day transfer.what are my chances to concieve?Can in next cycle i can have 2 fet?

    ReplyDelete
  33. Anonymous11:29 PM

    hello doctor,i undergo five times ivf treatment but results fail.now Iam 16weeks pregnant and now bleeding is coming sometimes with clotted blood but our doctor says just let that come out,she wont giving any tablets for that.But I consult other doctor for verification,she gives ecospirin-75 for 32weeks and maintane(allylestrenol tablets) for 10days to reduce the bleedin.i have doubt that shall I take those tablets.thank you in advance.

    ReplyDelete
  34. Anonymous12:47 AM

    Hi Dr, I had 2nd cycle of ivf done with 3 A grade n 1AB grade frozen embryos transferred on day 3. Today on 13 day after ET my hcg level is <1.2 . Is there any hope? I have no spotting or bleeding. Only cramps. I have undergone 3 iui n 2 ivf cycles. I'm depressed. Please guide.

    ReplyDelete
  35. Hi!
    I have a negative blood pregnancy test after 15 days of natural cycle ivf . 3 days old 6 cells embryo transfer. I
    Do I have any hope of being pregnant ?

    ReplyDelete
  36. Dear Mariely,

    No, sorry, this means the embryo did not implant :(

    Can you send me more details about your IVF cycle ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  37. Anonymous8:58 AM

    I did by home urine preg test (using a kit which claims to be sensitive to 10 mIU) after6days post 5day embryo transfer . It is negative . Is the test reliable at this stage so does this mean cycle failed?

    ReplyDelete
  38. Please do the HCG blood test as planned. This is much more reliable. Read more at www.drmalpani.com/hcg.htm

    ReplyDelete
  39. Anonymous11:13 PM

    i had 2 embryos transferred on 6/12/13. first test positive hcg 530.2nd test hcg 1200 and 3rd blood test 2400.today 7/1/13.after using the bathroom,saw a little blood clot on the tissue.does it mean that i LOST THE PREGNANCY.

    ReplyDelete
  40. Spotting and bleeding during pregnancy is quite common. This usually comes from the uterus and does not harm the baby, so please
    Do not worry about it ! Just rest and drink lots of fluids and it should stop.


    You need to do a vaginal ultrasound scan to confirm the pregnancy is healthy

    Read more at http://www.drmalpani.com/early_pregnancy_scans_atlas.htm

    Dr Malpani

    ReplyDelete
  41. Marilynn11:59 AM

    Hi Doc,
    I have my embryo transfer on 26th June 2013. I had 9 embryos, 3 fertilized and only 2 transferred on day 2...grade 3 and grade 4. I don't have much symptoms, laps of mild cramps. My blood test will be on 12th July. My 1st time doing ICSI and I'm quite worried if it doesn't work. I'm on utrogeston vaginal. 3 times a day. Will that help me getting pregnant? I've been trying to conceive for the past 8years. Did 2 rounds of IUI in 2009 which failed. The embryo was transfer 3days before my period. And I'm now 4 days late for my period. Does that mean implantation doing well and I will be pregnant? Can I do a home pregnancy test?

    ReplyDelete
  42. Dear Marilynn,

    These seem to be poor quality embryos, which is worrisome.

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  43. Anonymous4:54 PM

    Dr good afternoon, pls I had my 5day ET on the 22nd of june, 3 grade A and 3 grade B . six embryos in all. my pregnancy test is scheduled in the clinic on the 5th of july. but I did a home pregnancy test this monrn 3rd of july which said positive. I did yesterday and the day before, and they were all positive. does it mean am pregnant? pls reply me am so anxious!!!

    ReplyDelete
  44. ifeoma5:01 PM

    hello, Dr malpani I had my ET on the 22/6/13. I had 6 embryos transferred. 3 grade A and 3 grade B. my blood pregnancy test is scheduled on the 5/7/13. but I did a home pregnancy test this morning, 3/7/13 and it was positive. I did yesterday and a day before it was all positive. does it mean am pregnant or is it the follicle stimulating homrmones I took prior to egg collection. pls reply.

    ReplyDelete
  45. Marilynn5:37 PM

    Hi doc,
    My icsi was in Singapore and the embryologist told me that grading is 1-5 and 4 is consider very good as the best is 5.
    Probably it's different.

    ReplyDelete
  46. A positive home pregnancy test is usually a good sign and means you are pregnant.

    Is the test band becoming darker with each day ?

    Why would any clinic transfer 6 blastocysts ? That's very worrisome because of the risk of multiple pregnancies.

    ReplyDelete
  47. Dear Marilynn,

    I most clinics, Grade 1 is the best !

    That's the advantage of having photos - these are objective and much more reliable !

    How many cells did your embryos
    have ?

    Of 9 eggs, why did only 3 fertilise ?

    Fertilisation rates are usually much better

    ReplyDelete
  48. Marilynn6:16 PM

    Hi doc,
    In Singapore you are only allowed max 2eggs to be transferred. I have checked your embryo page. It's exactly like my embryo pic 2days 4cells. I do have my embryo pictures given to me.
    Over here they don't give us the reports and if egg quality is bad no transfer will be done as our govt co fund half of the cost.

    ReplyDelete
  49. In most clinics, the transfer is done on Day 3 or Day 5

    Best of luck !

    Dr Malpani

    ReplyDelete
  50. Anonymous10:09 PM

    I had 2 embryos transfered and I do my HPT tomorrow (day 17) all the other HPT's iv done recently have either been negative or had a barely visible line to the eye!! I started spotting 12dpt and have been lightly bleeding ever since. I am so confused because I have lost a few clots (sorry tmi) but the colour has turned dark red yet its still not heavy! What are my chances? Please reply Dr...

    ReplyDelete
  51. The fact that you are bleeding and that the HPTs are negative is not a good sign, sorry

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  52. miracle6:50 PM

    Hello dr.

    Did a day 2 ET four days ago. 3 grade 1-(4 cell) and 2 grade 2(3 cell).
    After ET is there any feeling or symptoms i may feel to know that implantation has started? And when does implantation in my uterus really starts?

    Praise God for a successfull result!
    Awaiting your reply dr.

    Thanks!! -- miracle

    ReplyDelete
  53. No, unfortunately, there is no symptom which will tell you if and when the embryos are implanting, sorry.

    This is hardly surprising - and embryo is just a microscopic ball of cells !

    ReplyDelete
  54. i have ET after 5 day on 2nd July, On 9th July, i had some stomach pain for 3-4 hours. I called doctor, she told me to do UPT on next morning. I did on 10th .It was negative. Is this very early to do test ??

    ReplyDelete
  55. Hi dr. I am in 8th day transfer of two 3d+2d PGD, today I start bleeding, not havy but I have pain in low abdomen. Is it normal, when can I do a test?

    ReplyDelete
  56. Anonymous9:41 PM

    Hi Dr. I had 2 perfect day 5s implanted 8 days ago. I took a HPT this morning and it was negative. Is this too early or a bad sign?

    ReplyDelete
  57. Anonymous1:40 PM

    hi dr i had embryo tranfer 11 days ago i have had few signs of pregnancy so i did a 2 tests yesterday and they had faint lines and done 1 this morning and got a darker line does this mean iam pregnant 3 positive results

    ReplyDelete
  58. Anonymous12:10 AM

    Hello Dr. I had a 3 day transfer with 2 embryos done yesterday. one grade A with 8 cells and the other grade B with 9 cells. I'm not able to do my
    blood work on day 7 so I was told to have it done on day 6 instead of day 8. I think day 8 would be better but do you think day 6 could tell me if implantation occurred as opposed to day 8?

    ReplyDelete
  59. What blood work have they asked you to do ? Estrogen and progesterone levels ?

    You cannot test for implantation so soon after an embryo transfer, sorry

    ReplyDelete
  60. Anonymous8:09 PM

    Dr Dr,
    I had a 3 day embryo transfer of 2 embryos 11 days ago and had my blood test today. I have been informed that it was negative.
    Naturally I am devastated. It is it possible that I was tested too early?
    If the test result is correct how soon could I expect my period. I have beem taking Cyclogest 400mgs BD.

    Thanks

    ReplyDelete
  61. A negative beta HCG blood test 11 days after a Day 3 transfer confirms you are not pregnant, sorry

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  62. I had 1 embryo transferred on day 5 blostocysts and it was grad A it was verry good am day 11 of my 5 day transfer and I took a test day 9 and I got a positive result and am get lower bake pain and cramps is this a good

    ReplyDelete
  63. dera doctor, i had my frozen ET on 13 july 13 n my serum beta HCG on 1st aug 13 has come out to be 13,913 mIU/ml. Is it too high for day 19 post FET? i had three day 3 embyos transfered.

    ReplyDelete
  64. This is a very high HCG level and suggests you may have a multiple pregnancy


    You need to do a vaginal ultrasound scan to confirm this

    Read more at http://www.drmalpani.com/early_pregnancy_scans_atlas.htm

    ReplyDelete
  65. Anonymous7:20 PM

    Hi, doc. I have the 3 days transfer on 17 July with 3 embryo. On 28 July I start spotting and start bleeding on 30 July until today (9 Aug).
    I had took the pregnancy test on 3 Aug, 7 Aug and 9 Aug all is positive result. Now I quite worry what's wrong with me, why still bleeding? Will it affect the baby?

    ReplyDelete
  66. Can you send me your HCG levels ? Read more at www.drmalpani.com/hcg.htm

    If this is a healthy pregnancy, the levels should double every 3 days

    We look forward to helping you to have a baby !

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Bombay 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    PS Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby – A Guide for the Infertile Couple,
    Online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    Relationship at http://doctorandpatient.blogspot.com/

    ReplyDelete
  67. Anonymous12:27 PM

    Hi doctor,
    I had fet with 2 grade 1 embroys on 30/07/13.Today is 11day post et but my hpt
    is -ve.Does it means cycle got failed.

    ReplyDelete
  68. Was this a Day 2 or Day 3 or Day 5 transfer ?

    ReplyDelete
  69. Anonymous4:03 AM

    i done my 1st ivf as i am nearly 39 got 1 child already i had 2 embroys transfer done a blood test on day 12 snd it came out negative . i think ivf is too expensive shoul i try again?

    ReplyDelete
  70. Anonymous4:05 AM

    it was a day 2transfer.

    ReplyDelete
  71. Anonymous6:06 PM

    Hi dr, I had a grade 1 embryo transfer on day 3 - today is 10 days past transfer and my B-hcg was 0, 7. Did we test to early?

    ReplyDelete
  72. A negative HCG 10 days after a Day 3 transfer is bad news :(

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  73. Anonymous7:20 AM

    I had a 5day embryo transfer I started to bleed on 10th day so I had a blood test witch came back negative, was the blood test to soon,its like I have my period but not as heavy as usual I also have cramps dose this mean the embryo transfer failed I cant stop crying has anyone been threw the same and still been pregnant

    ReplyDelete
  74. Anonymous2:07 AM

    I had a 5th day ET after 12 days (yesterday) HCG came out to be 562. now i am feeling severe cramps in all my body what could be the reason? m i pregnant. pain is in all body.please reply soon
    tafer

    ReplyDelete
  75. Good, this is a positive test which confirms you are pregnant.

    Please do not worry about the cramping !

    Read more at www.drmalpani.com/hcg.htm

    Repeat the test in 2 days. If this is a healthy pregnancy, it should double

    We look forward to helping you to have a baby !


    ReplyDelete
  76. Anonymous1:21 AM

    Hi Doctor,
    I had my day 3 FET on the 30th of September and starting testing on the night of 7th Oct and Have Got positive results till tonight (day 9 post transfer and day 12 post HUCOG 5000iu). 1 Grade A and 1 Grade B Embryos were transferred. Could this be an actual pregnancy or the HCG?

    ReplyDelete
  77. Hard to say. Was the FET done in a natural cycle after you ovulated ?

    Are the test results getting darker ?

    Dr Malpani

    ReplyDelete
    Replies
    1. Anonymous2:37 PM

      No it was a stimulated cycle in July and embryos were frozen on day 1 itself due to fluid in endometrial cavity. I have tested again today I.e. Day 11 of 3 day transfer and day 14 of HUCOG 5000. Still positive. They lines seem darker but could be also because the earlier ones have faded away. Please advise.

      Delete
    2. Dr Malpas bhcg level at 5 day et 15 can you please interpret urine pregnancy test is positive doctor calling after 3 days on 31. Sir it was the donor embryo and sperm et done with 4 eggs on 14/12/2015

      Delete
  78. Anonymous3:14 PM

    No it was a stimulated cycle in July and embryos were frozen on day 1 itself due to fluid in endometrial cavity. I have tested again today I.e. Day 10 of 3 day transfer and day 13 of HUCOG 5000. Still positive. They lines seem darker but could be also because the earlier ones have faded away. Please advise.

    ReplyDelete
  79. Anonymous8:38 AM

    Hi Doctor just to update. Today is 11 days post transfer and 14 days post HUCOG 5000 and morning test still positive. Can HCG 5000 stay in the system for 14 days?

    ReplyDelete
  80. Anonymous4:47 PM

    Dear Dr my wife had 3 day transfer on 11/10/13 & beta was done on 24/10/13 and the result was 47.28. now she is having great nausea feeling can we expect that pregnancy is +ve

    ReplyDelete
  81. Read more at www.drmalpani.com/hcg.htm

    Repeat the test in 2 days. If this is a healthy pregnancy, it should double

    We look forward to helping you to have a baby !

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Bombay 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    PS Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby – A Guide for the Infertile Couple,
    Online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    Relationship at http://doctorandpatient.blogspot.com/

    ReplyDelete
  82. Anonymous10:24 AM

    hello DR. i had 3 frozen embroy transferd on 9-Nov-2013..and on 20-Nov-2013 i did first hcg test and result is 1.5 so my doctor suggested me to do another test..so what is chances of getting pregnant..?

    ReplyDelete
  83. This is a negative HCG and confirms you are not pregnant, sorry

    Repeating the test will not help

    Can you send me more details about your IVF cycles ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  84. Anonymous7:49 PM

    Sir, is it usual to give inj choragon after embryo transfer? I had my ET on 1st march and was given choragon shots on 3rd and 6th. My test is scheduled for march 18

    ReplyDelete
  85. Some doctors do use HCG injections to provide luteal phase support after the ET in a fresh IVF cycle. These are expensive. Most use only oral estrogen and vaginal progesterone to achieve the same goal

    ReplyDelete
  86. Anonymous8:40 PM

    Hello Dr had a 5days Grade A blastocysts transfer on the 9th of April. Did a test today and came out negative . When does the embryo usually implant and whats the soonest date to do a test.. Really worried to wait these 2weeks. I am also getting some sharp pain in my stomach now and then and have a terrible back pain.

    ReplyDelete
  87. You did the test too early. You need to be patient !

    Read more at www.drmalpani.com/hcg.htm

    ReplyDelete
  88. Anonymous7:40 PM

    Dear Dr, when does a blastocysts implant in the womb after ET and after how long the hcg hormone is released

    ReplyDelete
  89. Anonymous3:02 AM

    hello doctor I had a 3day 2et 4 days ago I have other kids but my husband had the abnorm sperm shape. did a hpt today and there was a faint positive result is it too soon to be positive

    ReplyDelete
  90. Anonymous10:04 AM

    Nagative test after 7dpt of 5day embryo does it mean the embryo did not implant and the cycle was'nt successfull. Were I live they do not do beta test.

    ReplyDelete
  91. I agree this is not good news and suggests the cycle has failed. Please repeat it again after 2 days.

    Normally a HPT should be positive 14 days after egg collection.
    At this time the HCG level should be more than 100 mIU/ml in a healthy pregnancy. HPT tests are positive when the HCG level is more than 50 mIU/ml. There can be false negatives, which is why it's worth repeating it again

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    ReplyDelete
  92. A positive HPT 3 days after a ET maybe a false positive ( because of the HCG trigger injection given prior to egg collection)

    ReplyDelete
  93. Anonymous12:43 AM

    my wife underwent ivf on 16th day 28 day she got bleeding 3 drops per day immediately we reached hospital on 31st day 32nd day they tested blood hcg level,, it comes 45 means what(after 13th day of ivf)

    ReplyDelete
    Replies
    1. This is a positive HCG level but is a little low. Read more at www.drmalpani.com/hcg.htm

      Did the doctor give her an HCG injection after the transfer ? This can fool you


      Repeat the test in 2 days. If this is a healthy pregnancy, it should double

      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India
      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      PS Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby – A Guide for the Infertile Couple,
      Online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      Relationship at http://doctorandpatient.blogspot.com/

      Delete
  94. Anonymous3:44 AM

    Hi Dr, had a 2days transfer of 6cells nd started bleeding on the 12th day called my clinic immediately and was asked to come for a test,did a blood test that came out positive but still bleeding, d Dr said I should repeat d test 4days later, can anything be done to stop d bleeding seriously worried.thanx

    ReplyDelete
  95. What was your actual beta HCG blood test result ?

    Lots of IVF clinics call a result of more than 10 mIU/ml "positive" when actually this is just a result of the HCG injection given to you during the treatment cycle.

    Read more at www.drmalpani.com/hcg.htm

    Repeat the test in 2 days. If this is a healthy pregnancy, it should double

    Can you send me more details about your IVF cycle ? What were the meds which were used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
    Can you please send me the printed treatment summary from your IVF clinic ?

    We look forward to helping you to have a baby !

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Mumbai 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    PS Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby – A Guide for the Infertile Couple,
    Online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    Relationship at http://doctorandpatient.blogspot.com/

    ReplyDelete
  96. Anonymous10:58 PM

    Hi Dr, Just did my beta hcg blood nd it came as 33 after 16 days of transfer of 3embyro nd d clinic did a blood test dt came out positive after I bled from d 12th day after d transfer to 15th day. Still feel sick nd tired like am pregnant.Does dis result look good?

    ReplyDelete
  97. This is a low HCG level and this is worrisome

    Read more at www.drmalpani.com/hcg.htm

    Repeat the test in 2 days. If this is a healthy pregnancy, it should double

    We look forward to helping you to have a baby !

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Mumbai 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    PS Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby – A Guide for the Infertile Couple,
    Online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    Relationship at http://doctorandpatient.blogspot.com/

    ReplyDelete
  98. Anonymous1:19 AM

    I had 5 days transfer of 2 embryos 11 days ago can I use home pregnancy test to check? in case how truthful can be the result?

    ReplyDelete
  99. Anonymous4:26 PM

    First bhcg positve after frozen day 5 embryo. I did on 4.5 day its negative. Is it too early?

    ReplyDelete
  100. Anonymous8:28 AM

    Hi Doctor,
    Thank you for taking the time for all of us. I received a negative Beta today at 9 days post 3 day transfer of a frozen 10 cell grade 1 embryo using assisted hatching. I received conflicting instructions about when to have my blood work, but went today as it was the earlier by 5 days and I was anxious. Was this too early? I was told I was not pregnant and to stop my meds. Is there a chance I could be?

    ReplyDelete
    Replies
    1. I agree this is not good news. Do repeat the beta HCG after another 3 days please. If it's still negative, this means the cycle has failed :(

      Can you send me more details about your IVF cycles ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  101. Anonymous7:01 AM

    Hi dr . I am 45 and had a donor egg 5 day transfer. I am 9 days post transfer. My estrogen levels jumped up from 700 to 1007 and my progestrone was 45 to 41. I am on estrogen of 0.28 every three days and one ml of prog daily. My med level has stayed the same. Is it a possible sign of implantation that my estrogen level went up on it's own?? I go for my beta in three days . I did a hpt on day 8 and was negative . I threw out other hpt since I dont want to make myself crazy !! I look forward to hearing from you !!

    ReplyDelete
  102. There's no point in measuring estrogen and progesterone levels - they do not provide us with any useful information.

    The HCG level will tell us what's happening. Best of luck !

    ReplyDelete
  103. Hi Dr Malpani. Forgive me for asking you here in Facebook but can you please help me answer my queries. I had a FET last June 6, 2014 (5 day blastocyst) and was asked to have my blood tests check today the 17th of June. It came out negative. I was wondering, isn't it too early to have the tests done? Knowing that I am only 11 days post fet. Dr Malpani...I am confused with the way they calculate the dates. It says on the paper I have received on the day of my FET, that I need to have my blood tests approximately 14 days after embryo transfer. When you count it from the day of my FET (June 6) to the day of my blood tests earlier on (June 17), I am only 11 days post FET. Am I correct? When I spoke to my IVF Nurse, she said that they count it on the 1st day I ovulate, is that right? I was on progesterone pessaries for almost 2 weeks now and the nurse has asked me to stop using it. Please help me Dr Malpani. I am shattered beyond belief. Is it possible for me to check or use HPT on the 21st of June which is the 14th day post embryo transfer? Thank you Dr Malpani. Hoping to get answers from you.

    ReplyDelete
    Replies
    1. We do the beta HCG 14 days after egg collection. If it is less than 10 mIU/ml 14 days after egg collection, this means you are not pregnant, sorry

      If you did a Day 5 FET on 6 June, then you should consider 1 June as your day of egg collection ( conceptually)

      Can you send me more details about your IVF cycles ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  104. Hi Dr Malpani ,
    I got 2 embryos transferred 10 day ago. One was 8 cells embryo and second one was 4 cells embryo. I did blood test for pregnancy on 7 th day post transfer . It came negative . How reliable this test is ? Should I think cycle failed ?

    ReplyDelete
    Replies
    1. You did the test too early. You should do the HCG test 14 days after egg collection.

      Was this a Day 3 transfer ? A 4-cell embryo Day 3 has arrested and should not be transferred

      Can you send me more details about your IVF cycles? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  105. Sarmistha2:47 PM

    Hi had a failed ivf before when a single blastocysts was transferred .
    On 28/7/14 had 2 frozen blastocysts transfer. No symptoms at all. When does the blastocysts implant and when can I do a home test . Found a strip which measures upto 10ml/u.
    Thanking you

    ReplyDelete
    Replies
    1. Dear Sarmistha,

      I agree this is frustrating.

      You can do a home test 10 days after a blastocyst transfer. A positive test is reassuring. A negative test is not always reliable, however.

      I need more information to be able to provide you with intelligent advise.

      Do you have photos of your embryos ?

      We look forward to helping you to have a baby !

      Delete
    2. Sarmistha3:35 PM

      in india do they do endometriosis scratch

      Delete
    3. Yes, an endometrial scratch is an easy procedure

      Dr Malpani

      Delete
    4. Sarmistha6:16 PM

      Hello Dr , did a test 4 dpt and it was BFP. Today as well it is BFP. Today I am getting pinkish brownish discharge called the clinic they said I have to wait 3more days to do a official test. But since I was on oestrogen and progesterone that means I am surely pregnant? Is getting discharge is common? Please help

      Delete
    5. A positive HPT done so soon after the ET may be a false positive as a result of the HCG trigger shot

      Delete
    6. Sarmistha2:51 PM

      it was a blastocysts frozen embryo transfer so did not get any hcg trigger shot.

      Delete
    7. Dear Sarmistha,

      In that case, this suggests you are pregnant. You can easily confirm this by doing a blood test.

      Best of luck !

      Delete
  106. Anonymous10:38 PM

    Hello sir,I have got day 5 ,4blastocyst transfer on 17/7/2014 and today on 31/07/2014,I got negative urine test ,my endometrium was 9.7mm...then why did not I conceive,even I hv got done endometrial scratching,prior to stimulation

    ReplyDelete
    Replies
    1. IVF does not have a 100% success rate, sorry

      I need more information to be able to provide you with intelligent advise.

      Can you send me more details about your IVF cycle ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  107. Anonymous1:09 AM

    I did a FET with 3 day donor eggs 10 days ago and HPT came back negative. Is there a chance for positive blood test on day 11?

    ReplyDelete
    Replies
    1. I agree this is not good news. The chances are poor, but please do the blood test anyways - this is much more reliable than a HPT

      Best of luck !

      Delete
  108. Anonymous5:53 PM

    Dear Dr
    Can my clinic refuse to give me my I VF paper and documents? All i hsve is bills and medicines given.
    Iam planning to relocate .
    This is my 4 and last FET 5 day single transfer which took place on 4 /08/14 .

    ReplyDelete
    Replies
    1. Your clinic has to give you all your IVF papers and documents. This is your legal right since these records are your property. They can charge you for making copies.

      Delete
  109. Anonymous5:37 PM

    Dear Dr

    I have had my FET a 5 day single transfer done on 4 of august. I have been called for a blood test on 15 of august.
    My doctor had started m on progonova 2 mg on the 3 day followed by ultrasound andvaginal progestrone gel on the 18 day, followed by enoxaparine sodium40 mg and aspilet 81 mg tablets from day 19. This was followed by a FET of 5day single transfer on 4 august.
    how soon can i travel by air due to a family emergency ?
    Any specific precaution to be taken ?

    Warm regards

    ReplyDelete
    Replies
    1. It's safe to travel now

      Your embryo is safe in your uterus, like a pearl in an oyster. Nothing you do can harm it , so please do not worry about this.

      Please lead a normal life

      I know the 2ww takes a long time, but please do not let your mind play games with you !

      Read more at http://drmalpani.com/care-after-embryo-transfer.htm

      We look forward to helping you to have a baby !

      Delete
  110. Anonymous1:28 PM

    Hi dr, i had 2 ET day3 grade A 8 days ago i did home test its -ve on day 8 shall i give up hope

    ReplyDelete
    Replies
    1. You did the test too early. Please test it again. A blood test is much more reliable than a home test

      Delete
  111. kanchan5:38 PM

    Hi doc. I had don't HCG test on the 14th day of my et and it came 10.6 I have still no bleeding or sporting is it possible I'm pregnent and wuld it be a healthy pregnancy.

    ReplyDelete
    Replies
    1. Dear Kanchan,

      This is a negative test which means you cycle has failed, sorry

      Can you send me more details about your IVF cycle ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  112. Anonymous3:58 PM

    Dear doctor i had a3day embryo transfer....1secondary embryo transfered.i did bhcg on my 5day of transfer result was 8.19...i did again on my day 9 poat transfer result 1.9..today i did upt at home had negative result...is this means i had failed ivf procedure...much worried...i need ur reply soon.thank you so much..

    ReplyDelete
  113. I agree this can be very frustrating.

    Can you send me more details about your IVF cycle ? What were the meds used for
    superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? What was the endometrial thickness ?
    Can you please send me the printed treatment summary from your IVF clinic ?

    Repeating the ICSI cycle in our clinic with better superovulation and careful monitoring and transferring better quality embryos would be your best treatment option
    as it would maximise your chances of conceiving. You can read more about our approach at www.drmalpani.com/failedivf.htm

    Treatment takes about 20 days. Should I send you the treatment plan ?

    Could you please send me your medical details by filling in the form at
    www.drmalpani.com/malpaniform.htm so I can guide you better ?

    Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

    You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

    We look forward to helping you to have a baby !

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Mumbai 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270

    Helping couples build families !
    PS Read our book, How to Have a Baby - A Guide for the Infertile Couple, online at www.DrMalpani.com !


    ReplyDelete
  114. Nicks2:18 AM

    Dear Dr Malpani,
    My doc has advised me to take Inj HCG once every 4 days post embryo transfer. How reliable would the Blood HCG measurement be when taken 2 days after the last injection?

    ReplyDelete
  115. Anonymous2:00 PM

    I had a fresh 5day transfer of 1 embryo. My hcg level at 14 days was 28, then 3 days later it was 108. And then at 22 days it was up to 932. The ivf clinic called it unsuccessful though and just had me stop all meds. I know the numbers are low but does that suggest the pregnancy wouldnt last or that something is wrong with the embryo and is not growing properly?? I am confused!

    ReplyDelete
  116. You should ask them to rule out an ectopic pregnancy !

    Read more at www.drmalpani.com/ectopic.htm

    ReplyDelete
    Replies
    1. Anonymous7:37 PM

      I had a tubal ligation 13 years prior, can an ectopic pregnancy still happen with ivf transfer?

      Delete
    2. Yes, it can. The embryos which are transferred into the uterine cavity can travel into the fallopian tube, even after a tubal ligation, though the risk is low

      Delete
  117. I had 5days transfer with 2 frozen embryos on 27th Aug and my blood test is on 10th September. I did home test on 11th day with faint line and next 2 days lines became darker. Is this a good sign for pregnant.

    ReplyDelete
    Replies
    1. Dear Preetha,

      Yes, this is a good sign. Do a blood test for HCG to confirm you are pregnant.

      Read more at www.drmalpani.com/hcg.htm


      Delete
    2. Hello Doctor

      I did my HCG blood test today, it is 2247mIu/ml. They have asked me to come for scan after 15days and continue medicine. What does it mean.

      Delete
  118. Anonymous7:37 PM

    Hello Doctor
    I had my last period on 6 August 2014. I had grade 3 grade A embryos 8 cells and all 3 were transferred 3 days after egg retrieval. Egg transfer was done on 26 august. I was asked to come for PT on 9 September. They didn't get a positive result and asked me to come next week for another PT test. I asked for my hcg level and they said they don't have kit for that. They only have hcg positive and negative. Is it ok to ask me to come back after 1 week?
    Secondly, my rhesus factor is negative and I had a termination years ago which I informed the clinic about. They didn't give me any rhogam injection before treatment started. Should I be worried

    ReplyDelete
    Replies
    1. A negative pregnancy test 17 days after egg collection suggests you are not pregnant, sorry

      Repeating the test will not help.

      Can you send me more details about your IVF cycle ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      You don't need 1 RhoGam injection when doing IVF

      Delete
  119. Anonymous8:38 PM

    Dear Dr,

    I had a 5 day transfer last Thursday Sept 4 after PGD. The embryo quality was excellent. I woke up this morning and did a home pregnancy test. The test came back negative. My blood test is scheduled for Sept 13. What are the chances that the HPT is false negative?
    Thanks.

    ReplyDelete
    Replies
    1. A negative test 12 days after egg collection is always worrisome and suggests you may not be pregnant, sorry

      Delete
  120. Anonymous7:39 PM

    Dr sir my wife hsd transferd three 3days embrios .one A grade and two B grade on 20 th of sep.endometrium thickness is 9.9 .To day is the 15 day .we are wait for be hcg blood report.but the urine test result is negative .It is 100% believable? please ans me.

    ReplyDelete
    Replies
    1. A negative urine pregnancy test 15 days after embryo transfer usually means the cycle has failed, sorry

      Can you send me more details about your IVF cycle ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/embryos.htm
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  121. Anonymous9:10 PM

    Sir i am the above person. The urine test was donewith a pregna card is it correct?

    ReplyDelete
  122. Anonymous9:53 AM

    Dear Doctor
    I did my 3 day embryo transfer on 8 days ago and we did a blood test on day 7 after embryo transfer which was yesterday. My hcg level was 2.8. Does this mean anything? Is this an indication of a pregnancy? I have to repeat the test on Monday (10 days after ET).
    Thank you

    ReplyDelete
    Replies
    1. This is a negative HCG . However, it was done too early. Normally, you should do the HSG at least 14 days after the egg collection - there's no point in doing it before this in my opinion

      Delete
  123. Anonymous6:36 PM

    Hello Doc. ....
    I had 2 cycle of IVF on 25th September Et with 4 grade 1 embryos. I did my beta hcg yesterday 10 / 10 which was 583. My doc is out of town she told me to continue the medicine and repeat the test on 16/10. What does it mean?

    ReplyDelete
  124. This is a positive HCG which confirms you are pregnant, congrats !

    Read more at www.drmalpani.com/hcg.htm

    ReplyDelete
  125. Anonymous9:41 PM

    Thank you Dr. But then y am I suppose to repeat the test. I don't hv any symptoms.

    ReplyDelete
    Replies
    1. You may not have any symptoms because the pregnancy is so early.

      The reason we repeat the test is that if this is a healthy pregnancy, it should double every 2 days

      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India
      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      PS Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby – A Guide for the Infertile Couple,
      Online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      Relationship at http://doctorandpatient.blogspot.com/

      Delete
  126. Anonymous10:31 AM

    DR. SIR MY WIFE'S E.T WAS DONE ON 20/09/14.BUT IT IS FAILED.3 GRADE A FROZEN EMBRIOS ARE READY TO TRANSFER. WHAT ARE THE CORRECT HORMONE LEVELS AND CYCLE. PLEASE ANS ME.

    ReplyDelete
  127. Anonymous7:52 PM

    Et on 26 Jan. 3 embryo. Tranfered. Now 7 the day feeling cramps in lower abdomen. Wht r the chances

    ReplyDelete
  128. Anonymous11:17 AM

    Hello dr...i hav done my et on 20th march...just dat my ivf cycle shud nt fail...my hubby has askd me to tak rest...however during des few days i felt like my tummy is too tight n wen i try to gt up...i gt slide pain...wen i sleep sideways i gt a bit pain der also....

    ReplyDelete
  129. Hi doc,
    I am 10 days past 3 day transfer of 3 eggs, 1-7cell, 1- 5cell and 1-2cell, I did a hpt this morning and it came up negative, am I out for this cycle? I'm 40 and have low ovarian reserve and have been trying for 3 yrs

    ReplyDelete
    Replies
    1. I agree a negative HPT is worrisome
      Do a blood test for HCG to find out if you are pregnant.
      This is much more reliable

      Read more at www.drmalpani.com/knowledge-center/articles/hcg


      Delete
  130. Anonymous9:43 PM

    Frnds, this is my 2nd IVF and today is 12th day, Doctor asked me to check blood test on 15th day, But I am not having that much patience to wait for another 3 days. And please pray for me, If i havent get positive this time, my life gets over. Please i need all your blessings and prayers.

    ReplyDelete
  131. Anonymous7:11 PM

    Hello doctor ...this my 3rd ivf cycle....and this time it is fet n they are 3...n they looks like one with 6 cell and the other 2 like blostosyt ...and its 6th day after et...can I go for bhcg on 9th day after et...

    ReplyDelete
    Replies
    1. Day 3 embryos cannot be blastocysts !
      Can you send me more details about your IVF cycles ? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/knowledge-center/ivf/embryos
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  132. Hello Doctor,
    I have a 5 day blastocyst transfer and I did a home test on 9 th day of transfer and found a faint 2nd line. Is it a chemical pregnancy?

    ReplyDelete
    Replies
    1. Do a blood test for HCG to find out if you are pregnant.

      Read more at www.drmalpani.com/knowledge-center/articles/hcg

      Repeat the test in 2 days. In a healthy pregnancy, it should double

      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Bombay 400 005. India
      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      PS Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby – A Guide for the Infertile Couple,
      Online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      Relationship at http://doctorandpatient.blogspot.com/


      Delete
  133. Dear Dr,

    I had spontaneous conception in May 2014 but I started bleeding after 2.5 weeks of positive HPT--the HCG was only 67 and the pregnancy miscarried on its own.

    After 7 months, Dr gave me 50 mg Clomid and I conceived again but the Dr suspected ectopic pregnancy due to adnexal mass. The HCG was rising in this pregnancy and increased from 600 to 850 in 24 hours--however Dr gave me methotrexate as I was spotting slightly.

    After 4 months I started having heavy bleeding at the time of period,so I thought that period has arrived...however 7 days after the bleeding the HPT came positive with HCG of 430...however it was slowly decreasing and the Dr said that it will resolve on its own.

    I wish to know hw shud I proceed from here---I have done various tests like anti phospholipid,homocysteine,IgG,IgM,RH antibody etc and they all are normal.

    I need your advise!

    ReplyDelete
    Replies
    1. You seem to have had multiple chemical pregnancies / early miscarriages

      I agree this is a very frustrating problem. You can read more about this at
      http://www.drmalpani.com/knowledge-center/articles/recurrentabortion

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin), AMH ( anti-Mullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
      and

      a HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
      your uterine cavity is normal);

      A vaginal ultrasound scan on Day 10-11 which should check for the following.

      a. ovarian volume
      b. antral follicle count
      c. uterus morphology
      d. endometrial thickness and texture


      karyotype ( chromosomal blood study) for you and your husband

      Please send me the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Delete
  134. Anonymous7:18 AM

    Hi Dr,
    After 16days of ET,we got 550 hcg but next day it become 150.I am worried.Today we will go for another hcg test.I am getting tensed whats happening.

    ReplyDelete
    Replies
    1. A drop in the HCG suggests your pregnancy is not viable, sorry

      Did the doctor give you a HCG injection ?

      Can you send me more details about your IVF cycle? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/knowledge-center/ivf/embryos
      Can you please send me the printed treatment summary from your IVF clinic ?

      Delete
  135. Anonymous2:00 AM

    Hello sir, on 5th Oct frozen embryo was transferred blastocyst stage and during this 2 ww doc gave me 3 hcg injection 5000 iu at around 9 dpo my hpt was positive but from last two days they are coming up negative. My beta is on 16 th still one day to go.I am getting tensed whether m pregnant or not. I am taking aquagest injection and lonopin injection daily beacause I had a missed abortion in June but karyotype reports were normal

    ReplyDelete
    Replies
    1. Anonymous1:38 PM

      waiting for ur reply sir

      Delete
    2. Your HPT was positive because of the HCG injection your doctor gave you - not because you are pregnant, sorry

      Delete
    3. Anonymous1:47 AM

      Sir, I am based out of gurgaon and suffered a lot in past three years had my laproscopy, hysteroscopy to remove fibroid nd polyp since than I am not keeping well. In 2015 doc suggested me to go for ivf I first frozen embryo transfer I fall pregnant but it was a missed abortion at 7 weeks now this cycle has also failed no frozen embryos left. I am a pcod patient. sir my request is to please suggest me any good doc or ivf clinic around gurgaon.
      Thanks in advance

      Delete
    4. Anonymous11:00 PM

      Sir please suggest.

      Delete
    5. I don't know anyone personally. sorry

      Please make sure you select a clinic which provides embryo photos routinely and proactively !

      Delete
  136. dear Dr.
    am 3 day embryo transfer on 10 days ago and I get positive result from 2 days 8 , 9 after transfer , so can I consider the result is positive
    the line came darker

    ReplyDelete
    Replies
    1. Congrats ! A positive pregnancy test is always a good sign and suggests your IVF cycle has worked

      Read more at www.drmalpani.com/knowledge-center/articles/hcg

      Delete
  137. Anonymous10:21 PM

    Hi Sir, My last ivf in sep failed this mobth we tried naturally and my last period was on 24th Oct.. In this month I experienced very light pink spotting that too only when I wipe no periods yet. I also examined that this spitting is not continous sometimes when I wipe I found nothing.. I did urine pregnancy test and its negative.I hv pcos and m taking glyciphage sr 500 mg twice.can you pls suggest what's going on??

    ReplyDelete
    Replies
    1. The reason you missed your periods is because you did not ovulate. This is called anovulation.

      Read more at www.drmalpani.com/knowledge-center/articles/anovulation

      You may need to induce a period with meds.

      Read more at www.drmalpani.com/knowledge-center/articles/missed-periods

      Please do a vaginal ultrasound scan . This should check for the following.

      a. Ovarian volume
      b. B. antral follicle count
      c. C. uterus morphology
      d. D. endometrial thickness and texture
      Please send me the detailed test results and medical reports . You can scan them in as a single Word file and email them to me.

      Please find a digital ultrasound scanner for your next scan .
      They will burn the images as a jpeg file on a CD or flash drive.
      I want the raw images as jpeg files please - not scanned in copies of the paper printout – too much loss of resolution with this !

      Based on the scan results, we can prescribe meds to induce a period

      You can read more about how we treat PCOD at
      http://www.drmalpani.com/knowledge-center/the-infertile-woman/how-to-manage-your-pcod

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      HSG ( hysterosalpingogram, X-ray of the uterus and tubes, www.drmalpani.com/hsg.htm) on Day 8 of your cycle ( to confirm
      your fallopian tubes are open);

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently


      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com


      Delete
    2. Anonymous1:17 AM

      Sir,could it be implantation spotting as today also when I wiped I saw red pink spotting with mucus..sir after how many days of implantation bleeding one can take pregnancy test?

      Delete
    3. Read more when to do the pregnancy test at www.drmalpani.com/knowledge-center/articles/hcg

      Delete
  138. sir
    progesterone & e2 levels are 13.5 & 436 after 8th day of 3 day embryo transfer which was 45 & 540 on transfer date.
    which mean this? plz plz plz ans..

    ReplyDelete
  139. E2 and progesterone levels do not provide any useful information, sorry

    ReplyDelete
  140. Anonymous2:48 PM

    My wife's 2nd time ET done on 9/12/15.The hpt urine result is afaint 2nd line on 10th day.but the 14 day (today)results are same
    Tomorrow is our beta hcg.what are results meaning?please and.

    ReplyDelete
    Replies
    1. Urine tests are not always reliable. The blood test will give us more accurate information

      Read more at www.drmalpani.com/knowledge-center/articles/hcg

      Can you send me more details about your IVF cycle? What were the meds which were used for
      superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood at the time of the HCG trigger? What was the endometrial thickness ?
      How many embryos were transferred ?
      What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/knowledge-center/ivf/embryos
      Can you please send me the printed treatment summary from your IVF clinic ?

      Best of luck !

      Delete
  141. Anonymous8:42 AM

    Hello sir,I had 7 days 2 embrayos transfer on 17/12/15, through egg donor, I tested my PG yesterday on 24/12/15, and it is negative. I am continue with progesterone inj and jel. What to do sir..?

    ReplyDelete
  142. You should do your test 12 days after the transfer. Read more at www.drmalpani.com/knowledge-center/articles/hcg

    I cannot believe your doctor transferred 7 embryos at one time ! This is the sign of a bad clinic !

    Can you send me more details about your donor egg IVF cycle? What was the endometrial thickness ?
    How many embryos were transferred ?
    What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? You can see what embryos should look like at http://www.drmalpani.com/knowledge-center/ivf/embryos
    Can you please send me the printed treatment summary from your IVF clinic ?

    We look forward to helping you to have a baby !

    ReplyDelete
  143. Anonymous5:53 PM

    Respected sir
    On day 3 after egg retrieval I had signs of bleeding in morning on the day on which et was to be done..I had also pain in right lower abdomen region...It was looking that my periods are starting even though I was given 50mg progesterone Injections..but doc said that this bleeding was due to egg retrieval procedure and tbey did my et and put me on 100mg progesterone injections everyday..but doc I didn't had any bleeding the day after egg retrieval then how can bleeding occur one day after egg retrieval. .I felt that my periods had started but doc still did et telling it bleeding due to egg retrieval and put me on progesterone. ..I m 7 days post etand I keep feeling that I 'll get my periods any time...please tell

    ReplyDelete
  144. Hi doctor. I had my first ivf last february 3,2016 egg collection, 5 embryos, only one got fertilised, it was 5 day blastocyst transfered on february 8,2016. On february 17, i did my first digital home pregnancy test it says pregnant 1-2 weeks.l then i did test again on february 18, it says positive again. On the 19 th and 20... It says positive again and on the 21 it says positive again..so all the 7 test are all positive, in 2 days i will have a blood test. Do you think im pregnant? Is this accurate? Thank you doctor

    ReplyDelete
    Replies
    1. A positive urine pregnancy test is always a good sign and is usually quite reliable ( provided the doctor has not given you a HCG injection after the ET)

      Best of luck !

      DR Malpani

      Delete
    2. Thank you Dr. I hope so.thank you and God bless you

      Delete
    3. No. My doctor gave me the trigger injection ovidrel that was before the egg collection february 1,2016... They collected eggs on the 8th february.it is now february 23.. So it has been 17 days past

      Delete
    4. Hi doctor.sorry for disturbing you. I just had my first blood test today. Nurse said hcg level is, 2,771. Is this good numbers ?

      Thank you Doctor,God bless u always

      Delete
  145. Ops hcg level is 2,371 correction

    ReplyDelete
    Replies
    1. Congrats - this confirms you are pregnant !

      Read more at www.drmalpani.com/knowledge-center/articles/hcg

      Please register at www.hcgexpert.in so you can track and monitor your pregnancy

      Delete
    2. This comment has been removed by the author.

      Delete
  146. Day after day2:52 PM

    I had my embryo Transferred On Day 17 Of My cycle Into My Uterus.today is day 30 of my cycle. I had a blood test for pregnancy and it came negative. For some reason I have a strong feeling I am pregnant.my cycle is 28 days, I am taking progynova and progesterone pastries but still my blood test came negative how and why? I am 40 yrs I had just had two embies and transferred them both.

    ReplyDelete

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