Embryo transfer for recipient
Ideally freezezing and quarantining any embryos created from egg donation for 180 days before transfer should be the standard. However, most IVF centers adopt fresh embryo transfer policy because of the higher success rates. In the absence of freezing and quarantine the recipient of donor eggs should be informed of the potential risk of transmission of infection through the transfer of fresh embryos.
How is fresh embryo transfer performed?
While the donor is going through her IVF treatment, the recipient will have her menstrual cycle synchronized with that of the donor. The recipient will be given a hormone replacement treatment to prepare her endometrium (lining of the womb) for implantation. The hormone replacement consists of estradiol pills or skin patches. She may or may not be given a GnRh agonist (depends on whether or not she is menstruating regularly), and later add progesterone in the form of injections, vaginal tablets, pessaries or gel. There are many different protocols for giving these drugs and the doctor will discuss the protocol with the patient.
It is very difficult to synchronize a recipient natural cycle with that of the donor IVF cycle. Two or three days after egg collection, the resulting embryos will be ready to be transferred into the recipient's uterus using a fine plastic catheter.
In the UK, a maximum of 2 embryos can be transferred regardless the woman’s age at time of transfer to reduce the risk of multiple pregnancies. Moreover, an increasing number of IVF centers adopt a policy of single embryo transfer in selected group of patients
For frozen embryo transfer, this can be carried either in a natural cycle or hormone replacement cycle. It is important to know that there is a chance that not all the frozen embryos will survive the thawing procedure. Natural cycle is only suitable for young women with regular menstrual cycles and regular ovulation. Embryo replacement must be carried out at exactly the right time in the cycle. Some centers allow the recipient' s couple to see the embryos on TV monitor before being transferred.
The recipient needs to continue taking her estradiol pills and progesterone until a pregnancy test is performed about two weeks after embryo transfer. In the happy event that the pregnancy test is positive, the patient will be asked to repeat the blood tests at intervals between 2-5 days to check the rising levels of Beta hCG hormone. An ultrasound scan is usually performed about 5 weeks after embryo transfer or earlier. The scan will check the pregnancy is normally located, appears normal and viable, and to see if there is more than one fetus.
Recent evidence suggests that routine use of folic acid supplements may reduce the risk of neural tube defects such as spina bifida. It is recommended that egg recipients take folic acid tablets from the beginning of the treatment cycle.
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