Transferring embryos: what are the best practices?

After years of struggling with infertility, the big day has finally come. Everyone is thinking “sticky thoughts” in hopes that the embryo transfer to the surrogate mother will be successful. People are giving unsolicited “advice”, most of which is probably old wives’ tales. It can get overwhelming and stressful at a time that should be exciting and joyful. Unfortunately, there is not a one-size fits all answer to the embryo transfer process, but there are some factors that have been proven to increase success rates.

Healthy embryos are a major factor in the success rate of embryo implantation. The embryo quality starts with a healthy egg and sperm. Sperm and egg donation centers set high standards for their donors to ensure high quality. If the egg and sperm of the intended parents are used, then the fertility clinic will test the quality before embryos are made. The embryos are made by a process called in vitro fertilization (IVF). PGS, preimplantation genetic screening (sometimes called PGD), is a screening test that is used to determine if genetic or chromosomal disorders are present in the embryos before transfer. PGS is done at the request of the intended parents.

Frozen embryo transfer success rates can depend on how the embryos were frozen. Flash-freeze vitrification methods have better success rates than the traditional slow-freeze method. Some doctors claim that they have more success with blastocyst embryos transferred at day 5 rather than morula embryos transferred at day 3. The latest version of the American Society for Reproductive Medicine (ASRM) Practice Committee publication states that “a single blastocyst transfer should be the norm”.

The health of the gestational surrogate is an important factor. At Montana Surrogacy we take this very seriously. By the time someone is looking for a gestational surrogate, a lot of time and money has been spent, so we want to make sure our surrogates are held to high health standards. We review all previous labor and delivery records, and our gestational surrogates agree to a one day workup with the fertility clinic to rule out any factors associated with reduced success rates. The surrogate then starts a series of hormone supplements to get her uterus ready to accept an embryo. She needs to be vigilant about taking the medications and going to her monitoring appointments to ensure the lining of her uterus is ideal for implantation.

How the embryo transfer is performed and who performs it also plays an important role. Researching the statistics of the doctors in your own area is wise, and don’t be afraid to “interview” them about their procedures and policies. The ASRM Embryo Transfer Advisory Panel states that “The guideline finds good evidence to support trans-abdominal ultrasound guidance, use of a soft embryo transfer catheter, removal of cervical mucus, placement of the embryo transfer tip in the upper or middle areas of the uterine cavity and immediate ambulation (no bed rest) upon completion.”

At the end of the day, it can’t hurt to follow some of the old wives’ tales: wear the green or yellow socks, suggest that your surrogate eats french fries and pineapple, and think sticky thoughts! Having fun with the process can lower stress levels, and limiting stress can improve success rates. So, maybe there is some validity to such superstitions!

Amber Campanelli ~ The Honest Surrogate