C. IVF with donor eggs and sperm – donor embryos (IVF DE)

1. Preparation for donor embryo transfer

Preparation for the transfer of donor embryos can be performed in two ways:

a) during a natural cycle

• Utilizing your natural menstrual cycle and ovulation.
• 10-11th day of the menstrual cycle an ultrasound scan is performed, and if the uterine lining (endometrium) is thick enough and there is a follicle large enough on one of the ovaries, the Pregnyl or Ovitrelle injection is applied causing the follicle to rupture. Embryo transfer follows 4-9 days later (depending on the stage of development at which the embryos were frozen).
• This kind of preparation is used if the menstrual cycle and ovulation of a woman are regular.

b) during a medicated cycle (HRT)

• Preparation is performed with the use of hormone therapy, this is done when the menstrual cycle of a woman is not regular or if it is necessary to achieve a more precise timing of embryo transfer.
• From the 1.day of your menstrual bleeding, usually using hormone replacement therapy pills (Estrofem, Progynova, 2 mg twice a day) or patches (e.g. Estrahexal).
• 12. - 14. day of your menstrual cycle an ultrasound scan will be performed to measure the thickness of the uterine lining (endometrium).
• Embryo transfer will follow in 3-5 days (again depending on the stage of development the embryos were in when they were frozen).
• In case your uterine lining is not thick enough, you will continue taking your medications and an ultrasound exam will be repeated.

2. Embryo transfer

• Embryo replacement into the uterine cavity (ET) is performed without anesthesia, using a thin flexible catheter (hose). The tip of the catheter is under ultrasound guidance for its more precise positioning inside the uterine cavity.
• Embryo transfer is a completely painless procedure.
• The embryos are injected into the uterine cavity with a small amount of liquid (culture medium).
• After the procedure you will remain lying down until you are ready to be released from the clinic (about 1 hour).

3. Precautions after embryo transfer

• It is advised to take rest for a few days after the transfer (no strenuous physical activity, hot tub baths, and no intercourse are recommended) for 1-2 weeks.
• After 1-2 weeks you can go back to your normal lifestyle, but avoid strenuous physical activity.
• Take the prescribed medicines regularly as indicated in your discharge instructions.

4. Pregnancy test, medication intake and monitoring pregnancy

• 20 days after the transfer take a pregnancy test (using the first morning urine).
• If the pregnancy test is positive, book your ultrasound appointment (cca in 7-10 days) and continue to take your medications until the 12th week of pregnancy.
• After week 12 of pregnancy gradually discontinue the medications over 7-10 days.
• Standard prenatal screening and regular check-ups with your OB/GYN will follow afterwards.
• If the pregnancy test is negative, discontinue the use of all medications and after the end of your next period, contact us to start preparation for frozen embryo transfer or to discuss further treatment.

We kindly ask you to inform us of both positive and negative pregnancy test results. This kind of feedback is very important to us and is essential for improving the quality of our work!!!