How to make sure your embryo transfer isn't difficult - the IVF patient's guide to easy ETs

Embryo transfer is the final medical procedure in an IVF cycle , and normally this is very straight forward , because all it involves is transferring embryos back into your uterus using a flexible , soft sterile plastic catheter called the embryo transfer catheter, which the doctor which the doctor negotiates under ultrasound guidance , through your cervix into your uterus.

However in some patients , doctors will have technical difficulties in positioning the catheter into the uterus . This is because the cervix was not designed to allow doctors to insert plastic tubes through them, as a result of which the procedure becomes challenging.

The cervical canal is not a straight passage, and in some women it becomes narrow - a condition which is called cervical stenosis , as a result of which the doctor will not be able to pass the soft ET catheter into the uterus without causing bleeding and trauma.

Doctors want to avoid a difficult transfer , because the trauma and bleeding this induces can cause uterine contractions , which will cause the embryo to get expelled , and result in a failed IVF cycle. 

Fortunately , we do have strategies to deal with this uncommon problem .

This is why many clinics do a mock transfer ( dummy transfer ) prior to the actual embryo transfer , so we can map the cervical canal and make sure the catheter goes through easily . In case, there is technical difficulty , we are prepared, and can use more rigid embryo transfer catheter sets , which make it possible for us to negotiate the stenosis, and deposit the embryo safely inside the your uterine cavity . We obviously don't want to be experimenting with catheters during the actual transfer itself !

In some patients , we need to do the embryo transfer under general anaesthesia , so that you are relax , and don’t have any pain. This is safe, but is needed in only a small minority of patients.

Rarely, we may need to do a hysteroscopy , if the transfer is persistently difficult, in order to check the cervical canal, and dilate it .

If this doesn’t work, then we may need to bypass the cervix completely, and deposit the embryos directly inside the uterine cavity , by using a special Towako transmyometrial embryo transfer catheter set , but the pregnancy rates with this are poor . 

If your IVF cycle has failed because the embryo transfer was difficult , and you need more help, please email me at [email protected]