What to Expect When It's Time to Transfer Your Embryo for Implantation

​In vitro fertilization (IVF) aims to produce a viable embryo for transfer into the uterus. When successful, implantation is a pivotal process that defines the official onset of pregnancy.

Preparing for implantation

Before implantation, mature eggs must be collected and fertilized. Your fertility clinic will guide you on preparing for the egg-retrieval process; in particular, the staff will administer hormone treatments to prompt ovulation. Every IVF step depends on precise timing, so you'll probably be heading to the clinic for several monitoring visits to ensure the best possible outcome. After the eggs are retrieved and fertilized in the lab, the resulting embryos will be tested for abnormalities. Testing helps reduce the risk of miscarriage and birth defects.

Ideally, you'll have multiple embryos to attempt to transfer. Although most modern fertility clinics transfer only one embryo per attempt to reduce higher-risk pregnancies with multiple fetuses, you can choose to freeze the extra embryos for future use or donate them to other families for adoption. When several embryos are available, your doctor will guide you on choosing one that's most likely to implant and survive the early stages of pregnancy.

How is embryo transfer done?

The ideal stage for transferring a fertilized egg is somewhat up for debate among scientists in the fertility research field. Typically, implantation occurs approximately 72 hours after egg retrieval (the cleavage stage) or five days after (the blastocyst stage). Ask your fertility clinic about the plan in advance, along with its rationale for the chosen timing.

For accuracy, an ultrasound-guided placement is usually recommended. The experience is similar to what you would feel during a routine Pap smear. Sedation isn't required because this should be a relatively pain-free procedure. A special device, called an embryo transfer catheter carries the embryo through the cervical opening to a specific depth. The embryo is then released, and the catheter is carefully removed.

You may be advised to rest at the clinic for an hour after your transfer procedure before heading home. To avoid disrupting this delicate process, your doctor may require you to take it easy during the first few days after the transfer, laying off exercise until the embryo has had an opportunity to attach fully.

You also may experience some effects from the procedure. Since the cervix is swabbed before the embryo transfer, some women may pass a small amount of clear or bloody fluid from the vagina shortly after the procedure; this is normal and not a sign that the embryos are being expelled.

Breast tenderness and engorgement, bloating, and constipation are not uncommon; they are due to the elevated hormone levels associated with ovarian stimulation and, to a lesser extent, the supplemental hormones used for luteal phase support.

Cramping during an embryo transfer may be caused by touching the inside of the uterus with the transfer catheter.

Hormone prescriptions in the days leading up to and for some time following the transfer help control the process and ensure a better likelihood of success. Be sure to talk to your doctor about any questions you have along the way.

When you'll get your results

A fertilized egg at the cleavage stage takes two to five days to implant, while a blastocyst takes one to three days. Your fertility doctor will order a blood test to check for pregnancy around day 12 after the transfer. Home pregnancy tests are not recommended after IVF. Blood tests are more accurate in this very early stage of conception, so avoid the temptation to take a test at home before the time is right.

It's normal to get your hopes up in anticipation of a positive pregnancy test. Try to keep in mind that IVF often requires multiple attempts. It's critical to maintain realistic expectations as you wait for your blood test after the transfer procedure. Having at least one supportive person with whom you can share the news can help you feel grounded throughout this emotional journey.​