Sunday, March 30, 2014

Facts about embryo transfer and embryo implantation

Even though Embryo transfer and Embryo implantation are entirely different, many IVF patients are often confused between the two.  Embryo transfer is a medical procedure wherein the embryo is transferred to your uterus using a plastic hollow tube called an embryo transfer catheter. By contrast,  embryo implantation is a biological process of the reproductive system. The two are different , but both are related because in a successful IVF cycle, the transferred embryos will implant and result in a pregnancy. During an IVF cycle, the doctor transfers the embryo into your uterus , where it then develops into a  blastocyst and then embeds itself into the uterus lining. This is embryo implantation. Embryo transfer is a mechanical procedure, and how well it is done does depend upon the skill and experience of the doctor. Implantation , on the other hand, is an in-utero biological process which in Nature's control - not the doctor's.

After the embryo transfer ( ET) starts the dreaded 2ww ( 2 week wait), where your mind plays all kinds of games with you, and you wonder what's happening to your precious embryos in your uterus ! Are they safe ? growing well ? being nourished properly ?

The implantation process involves three steps namely apposition, adhesion and invasion. All these steps are based on various hormonal and molecular signals in the uterus. This biological process cannot be controlled externally – and is not impacted by physical activity or diet or stress levels.  We give you given hormonal therapy to prepare the uterine lining for implantation, but it not possible to control the process or guarantee implantation. We still cannot control or pinpoint the complex mechanisms involved in this process.All we can do is hope and pray. It's only  after the 2 week wait, when you get your HCG results, will you know if your embryos have implanted or not !

In many cases it so happens that the embryo fails to implant – after all, the human reproductive system is not perfectly optimized. Though the reason for a failed implantation in IVF cannot be deduced every time, most of the times the reason is a genetic abnormality in the embryo. Often, these are subtle defects , which cannot be diagnosed even after using sophisticated modern genetic technology such as CCS ( comprehensive chromosomal screening). However, we do know that the eggs of older women are at higher risk of having genetic defects due to the aging process.

When the embryos fail to implant after the transfer, this does not mean that the IVF lab was bad or that your uterus is “rejecting” the embryo. It just means that implantation is not a sure shot process, and it’s important that patients understand this, so that they have realistic expectations of IVF success.

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  1. Hello dr.malpani, I had a FET on Jan 28th after which the HCG tests have turned out positive ( since Feb 11)
    am around 5-6 weeks now approx - However , last 3 days have been having brown mucous spotting/ discharge and it's really worrying me - is it cuz of the Alivher tablets ? Some sort of cervical irritation ?

    Am taking progynova( 4mg) thrice a day, duphanston twice a day, susten200mg thrice a day and Alivher 25 mg thrice a day - also had taken Lupenox 60iui after FET up to until a week after positive HCG

    my Doc says nothing to worry unless there is proper bleeding but am constantly worried about the brown spotting - can you pls share your views from your experience ?

    1. 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


  2. Anonymous11:11 PM

    Hello Dr

    I am 38 year old woman and i am on day 3 of 5day embryo transfer(2ww). This is my second time. First time i went for fresh ET but it did not work out and i got period after 7days. now i am worried because i am feeling sore and tender breast and it happens when period about to come. Is sore breast common after eft? i am taking prgyanova 2mg thrice a day and Cyclogest 400mg twice a day.i am so worried please help.



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