Chester Clinic

Sandiegomommymaker.com

Lila L. Schmidt, MD
OB/GYN, Reproductive Endocrinology/Infertility
3969 4th Avenue, Suite 207
San Diego, CA 92103
EMBRYO TRANSFER
Procedures, Instructions and Expectations How is the embryo transfer performed?
A speculum is placed in the vagina to provide access to your cervix, much like the way it is during your annual pap smear. A catheter, similar to this one: is then placed through the opening of the cervix, into the uterus. The catheter is placed in a location that has been predetermined and measured carefully prior to the beginning of your embryo transfer cycle. Whatever number of embryos you've chosen to implant are deposited into the uterus through this catheter. An abdominal or vaginal ultrasound may be done to allow you to observe the transfer as it happens. The embryologist will check the catheter under a microscope to ensure that all embryos were released from the catheter into the uterus. Where is the procedure performed?
Although Dr. Schmidt is the physician performing the transfer, this is one of the few procedures we don't do in our office. The embryo transfer is done at our embryology lab site. Your partner is encouraged to be in the room with you for the length of the procedure. Anesthesia is not necessary, however, a Valium is recommended 1 hour prior to the procedure. You are given a prescription for the Valium when you begin your cycle. How long does the embryo transfer take?
The transfer takes about 15-30 minutes. It is done when the eggs have been fertilized and have developed into embryos and when the uterus is ready to receive them. These parameters align usually 3-5 days after your egg aspiration. Before the procedure, please:
• Take your medications as usual. • Bring your medications (including your Prometrium and Valium dosages) to the embryo transfer for review by Dr. Schmidt. • Do not wear any scented products (perfume, cologne, deodorant) to the embryo transfer. • Eat meals as normal. • Discuss with Dr. Schmidt, and/or the embryologist, the ideal number of embryos to transfer. • Wear loose fitting clothing and slip-on shoes to reduce use of abdominal muscles after the procedure. • Bring a favorite CD, if desired, for relaxation during and after the embryo transfer. • Arrive no later than 1 hour prior to your scheduled procedure. • Sign the consent form regarding the number of embryos you agree to transfer. • After arriving at the embryology lab site, and signing all forms and consents, take your Valium.
Embryo Transfer – Procedures, Instructions and Expectations What to expect after the procedure:
• You MAY NOT drive yourself home.
• You should not be alone for 8-10 hours, until the Valium wears off.
• You may experience some cramping, most experience no discomfort. You will remain flat for 30-60
minutes in the procedure room. • Do not smoke or expose yourself to second-hand smoke. Avoid exposure to chemicals, such as hair products, perms or dyes. • Showering is fine, but do not immerse yourself in water. (ocean, bathtub, jetted tub) • No caffeine, no alcohol, no artificial sweeteners. Avoid any foods that would usually cause you abdominal cramping, diarrhea or constipation. • Stay well hydrated by drinking 6-8 glasses of water a day
• Continue to take 1 prenatal vitamin every day. Take Tylenol for headaches.
• Continue to follow the medication protocol you received following your embryo transfer. DO NOT
STOP ANY MEDICATION WITOUT FIRST CONSULTING DR. SCHMIDT.
• Follow instruction schedule for blood testing. You and Dr. Schmidt will discuss the results of your tests once they are received and whether or not any medication changes need to be made. • Keep accurate accounting of your medications and supplies, especially as weekends and holidays approach. DO NOT REUSE YOUR NEEDLES. This could result in contamination of the medication in
the bottles or infection.
• Medications and supplies: (depending on your area, supplies are usually delivered the next day) o IVP: call in the AM 800/483-8001 o MDR: 818/788-5858 o Freedom: 800/660-4283 o La Jolla Discount Pharmacy: 858/662-1800 • Do not use home pregnancy tests. They are not recommended for IVF conceptions, as their results are too frequently inconsistent. Call the office (619/295-4050) with any questions or concerns and if any of the following occur: • Temperature greater than 100.4°F • Call for vaginal bleeding, but DO NOT STOP MEDICATIONS. (70% of pregnancies bleed and continue • If you need any sort of x-ray, warn the radiologist that you may be pregnant. • Check with Dr. Schmidt regarding the safety of over-the-counter medications • Dr. Schmidt may recommend freezing the unused embryos for future use (a Frozen Embryo Transfer or FET) if you desire another pregnancy down the road, if you miscarry or if the initial transfer does not result in pregnancy. (Note: this is how Dr. Schmidt conceived.) ☺ I HAVE READ AND UNDERSTAND THESE INSTRUCTIONS AND HAVE RECEIVED A COPY TO TAKE HOME. Embryo Transfer – Procedures, Instructions and Expectations Lila L. Schmidt, MD
OB/GYN, Reproductive Endocrinology/Infertility
3969 4th Avenue, Suite 207
San Diego, CA 92103
CYCLE GUIDELINES: FET (Frozen Embryo Transfer)
Previous Month
Call Day 1 of cycle for appointment by Day 3 Schedule an appointment with Dr. Schmidt Appointment
Do STD blood and cervical cultures on female and uterine sound (measurement ofuterine cavity depth) Do STD blood check (or get lab slip) for male partner Learn how to do injections Get medication pharmacy slip (to begin day 3 of transfer cycle) Call DAY 1 to schedule an appointment by Day 3 of cycle Appointment with Dr. Schmidt Vaginal ultrasound FSH/Estradiol blood draw Review injections ** Remember to bring in all medications and this Cycle Guideline sheet** Evening of Day 3
We will call you at am/pm with lab results and schedule medication(i.e.,estradiol) Your calendar has now been changed to day of stimulation (day 1) and no longer your period (cycle day 3=stimulation day 1) Appointment with Dr. Schmidt Stimulation
Estradiol blood draw (possibly) Bring your Ganirelix (Antagon) *You might begin your Ganirelix (Antagon) this morning at the appointment with Dr.
Schmidt.
Cycle Guidelines: IVF (In Vitro Fertilization) Appointment with Dr. Schmidt Stimulation
Estradiol blood draw (possibly) *You may be starting daily appointments with Dr. Schmidt until Estradiol blood level,and uterine lining are ready.* 3-5 Days Prior
Start Medications on as instructed by Dr. Schmidt Heparin (if you are to be on it) Progesterone (i.e., Prometrium suppository, Progesterone in oil injection) No sex (coitus) until OKed by Dr. Schmidt Embryo Transfer Arrive to OR at
am/pm for embryo transfer (half hour prior to procedure) Bring Valium (20mg) pill(s) Bring signed patient consent forms 2 weeks after
Get your blood pregnancy and progesterone test embryo transfer
If pregnancy test is positive, repeat tests in 48 hours DO NOT STOP any meds unless directed by Dr. Schmidt.
Goal: pregnancy (HCG quant) to increase 70% in this 48 hour period 1 week after
Appointment with Dr. Schmidt positive
Ultrasound (to ensure pregnancy is in the uterus) pregnancy test
NOTE: bleeding is common even if you are pregnant. Do not stop any meds. Call Dr. Schmidt immediately. Please feel free to call us with any questions or concerns during this cycle. We are here to help you. Cycle Guidelines: IVF (In Vitro Fertilization)

Source: http://sandiegomommymaker.com/imgs/doc_EmbryoTransfer_v1.pdf