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Can the embryo “fall out” after transfer?

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After the embryo “fall out” has been transferred and inserted between the uterine walls, it’s not possible for the embryo to fall out as it is deep within the uterus and therefore you can safely continue with your normal routine after having an embryo transfer.

The transfer itself is a fairly simple procedure with very little discomfort. A thin, soft catheter is threaded through the cervix under ultrasound guidance, to be very exact in the embryo placement location, generally 1 to 2 cm from the top of the uterine cavity. After cleansing the cervix with solution, the fertility doctor will place an empty transfer catheter through the cervix into position inside the uterine cavity. Then the embryologist will bring the catheter containing the embryo(s) from the lab a few feet away, so we can minimize the time that the embryos are exposed.

Once we have the embryo(s), we feed the catheter with the embryo(s) fall out through the empty catheter that is in place. On the ultrasound screen, the patient will be able to watch the bubble of air and fluid the embryo is contained in getting placed gently into the uterine cavity. After placement of the embryo(s), the embryologist checks the catheter under the microscope to make sure that the embryo(s) is transferred properly. Then the patient can get up and go straight to the bathroom if needed.

After that, the embryos “fall out” have to implant into the uterine lining on their own over the next few days, with the goal of developing into a successful pregnancy.

But Shouldn’t I Go on Bed Rest?

Several recent studies have confirmed that immediate bed rest after embryo transfer is completely unnecessary. It may seem counter-intuitive, but, in fact, a study published in a well-respected peer-review journal, Fertility, and Sterility (Fertil Steril 2013; 100: 729-35), demonstrated better pregnancy rates with the immediate resumption of normal activities (including the bathroom) compared to bed rest right after the embryo transfer.

What is a Pessary??

Pessaries. A very messy and unpleasant part of many IVF cycles. What is a progesterone pessary? It’s a sort of wax-coated hormone delivery device that can be inserted into the vagina and or anus. The wax coating melts with your body heat to release the hormone you need. ⁠

When the wax coating melts, some of it will inevitably drop out. Vaginal insertion will likely be easier, but messier. Anal insertion will likely be a bit more awkward but overall less messy. In both scenarios irritation can occur- either of the cervix or bowels, causing you to have to switch routes. ⁠

The Preggars Kitchen has a wonderful and lighthearted essay on this topic. “Pessaries are the enemy of pants!” ⁠

http://www.thepreggerskitchen.com/blog-1/2018/3/31/embryo-transfer-and-progesterone-pessaries-could-ivf-be-any-more-fun-the-preggers-kitchen-ivf-series⁠

What is Anovulatory Infertility? 

Anovulation is when the ovaries do not release an oocyte during a menstrual cycle. Read through to find out what medications might cause anovulation.

The menstrual cycle involves a delicate dance of hormones in a woman’s body. hormone levels must rise and fall at certain times to achieve ovulation. Ovulation happens when an ovary releases an egg in preparation for pregnancy. Most treatment for anovulation falls into one of two regimens: clomiphene citrate (clomid) human menopausal gonadotrophins (hMG) or follicle stimulating hormone (FSH) with or without clomiphene. However, certain medications designed for other purposes can still cause anovulation. examples include:

  • NSAIDs
  • herbs and natural remedies
  • skin creams and other topical products with hormones
  • steroids
  • cortisone and prednisone

NSAIDS (non steroidal anti-inflammatory drugs)

NSAIDS include many over-the-counter pain relievers such as ibuprofen and naproxen. one study suggested that nsaids can cause anovulation after taking them for just ten days.

Skin creams and other topical products with hormones

Some products contain estrogen or progesterone that are designed to fight aging or help with problems such as premenstrual syndrome (pms). These products can be absorbed into the body causing anovulation or hormone imbalances.

Steroids

Steroids are a type of hormone that can reduce inflammation. they can also interfere with the hormones needed for ovulation.

Cortisone and Prednisone

These are common types of steroids that are Prescribed for a variety of illnesses, such as allergies, lupus, asthma, and more. Topical steroids are used on the skin to treat inflammation and allergic reactions.

Herbs and natural remedies

Some herbs contain hormone-like substances that can disrupt ovulation. if someone is trying to get pregnant or is not ovulating regularly, they may wish to discuss any herbs or supplements they are taking with their doctor.

What is Sperm Agglutination? 

It’s always good to remind ourselves that male factor infertility plays a significant role in determining a couple’s chances of conceiving. It’s therefore crucial we get familiar with some terminology in the world of male fertility. Today’s post defines sperm agglutination and why it may arise in men.

Male factor infertility is present in up to half of couples. The prevalence of male infertility makes the semen analysis one of the most important fertility tests, and it should be performed prior to any female therapy. ⁠

Male infertility means that a man may not deliver the appropriate quantity or quality of sperm to reach and fertilize an egg. Sperm are manufactured in the testicles and travel through the epididymis and the vas deferens when ejaculated. Sperm requires three months to develop, which means a semen analysis done today is reflective of the conditions three months earlier. The conditions that originally caused male infertility may no longer be present.⁠

Male infertility is sometimes caused by the male developing antibodies to his own sperm, which increases agglutination in the semen. This usually results after a trauma to the testicles or surgical procedures such as a vasectomy reversal. When present, antisperm antibodies can bind to the sperm, essentially interfering with fertilization and motility.⁠

“No Result” after PGT testing your embryos? 

Today’s post is all about no result embryos “fall out”. What causes them? Are they safe to transfer? 

When an embryo returns with a pgt result of inconclusive or no result, that often means that the trophectoderm biopsy sample was insufficient to be used for PGT or that it did not meet the quality control standards for analysis. a study by cimadomo et al. (2018) showed that inconclusive results occur about 1.5-5% of the time because the

  • cell sample was not loaded properly and the tube is actually empty
  • that the sample was degraded.

Inconclusive or no result embryos have a good chance of being “normal.” A large study (Demko et al., 2016) found for women <35 there is about a 60% chance of a blastocyst being euploid (normal) to 30% by age 41. The chance of getting no euploid (normal) embryos was about 10% for <35 and about 50% by 43. Unfortunately, “no result embryos” are unavoidable. Embryos can be thawed and tested again, but this does damage the embryo a bit more, resulting in lower pregnancy rates.

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