Embryo transfer

Number of embryos to transfer

The care team tries to lower the risk of multi-fetal pregnancy while having high pregnancy rates each cycle. The goal is 1 healthy baby at a time. So, the care team has an embryo culture and transfer strategy:

Upper Limits for Number of Embryos to Transfer
  Fresh Transfer Frozen Transfer
Age of person (or oocyte donor) Day 5 Day 5
37 and less 1 or 2* 1or 2*
39 and above 2 2

*Only 1 embryo will be transferred if inclusion criteria met for blastocyst (day 5) single embryo transfer.

Inclusion criteria for single blastocyst embryo transfer (1 embryo will be placed):

  • The oocyte provider must be 37 years of age or younger at the time of retrieval.
  • You have at least 1 embryo rated as good or excellent on day 5 of culture. If there is not at least 1 good embryo, then 1 or 2 embryos may be transferred.
  • You have not had a failed fresh IVF cycle (oocyte retrieval and embryo transfer) with the same oocyte provider at UI Health Care.

Inclusion criteria for frozen single blastocyst transfer (1 embryo will be placed):

  • People who delivered after a single blastocyst transfer in the fresh cycle and have had no failed cryopreservation transfers will have a 1 blastocyst transfer if the embryo is good or excellent. 
  • The intended parent(s) did not have a transfer in the fresh cycle and the embryos were cryopreserved. Also, have not had failed transfers at UI Health Care.
  • The intended parent(s) have at least 1 euploid blastocyst (normal embryo by PGT-A testing).
  • A times the team may only allow transfer of 1 embryo after a failed transfer. This lowers the chance of a multiple gestation pregnancy.
  • Criteria for transferring 2 blastocysts (if wanted):
    • The oocyte provider is 38 years of age or older. Then the intended parent(s) may choose to transfer 1 or 2 embryos. 
    • The oocyte provider had an unsuccessful fresh IVF cycle (oocyte retrieval and embryo transfer) at UI Health Care. Then the intended parent(s) may be eligible to transfer 1 or 2 embryos no matter the grading. Your provider will talk with you about this before an embryo transfer.
    • The oocyte providers of any age have no embryos rated as good or excellent on culture Day 5. Then intended parent(s) can transfer 1 or 2 embryos. The care team recommends 2 be transferred for higher chance of pregnancy.

The procedure

Steps in the transcervical transfer are:

  1. You lay on your back with knees bent and resting on leg supports.
  2. A speculum is placed in the vagina so the cervix can be seen and cleaned.
  3. Embryo(s) and a little culture media are drawn into a transfer catheter.
  4. The transfer catheter is threaded through the cervical canal into the uterus. The embryo(s) are deposited. This is done under ultrasound guidance.
  5. You sit up, dress, and go home.

After transfer

  • In most cases, you may leave Iowa City after transfer.
  • You have no activity or lifting restrictions unless told differently. The care team recommends you only do light activity the day of transfer.
  • You start daily medicines as instructed. Keep taking them until pregnancy test results are known. Based on your protocol and lab results on pregnancy test day, these medicines may be taken until 8 or 10 weeks of pregnancy.
  • About 10 days after embryo transfer a pregnancy test is done. This is a blood test for hormone levels. It can be done at UI Health Care or your local lab.

Thank you again for your interest in our program. Please write down any questions you have. Talk about them with your care team at your visit.

Last reviewed: 
February 2022

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