The Wide World of Frozen Embryo Transfers


Oooo, I know! I know the benefits of transferring a 5 day blastocyst!

A few months ago, some of you may have read my post, “IVF 101.” As my husband and I are getting ready to embark on a FET (or Frozen Embryo Transfer), the questions have again started to surface. 

So, what is a FET? Many people wonder if it is related to In Vitro Fertilization, how the embryos are frozen, and why anyone would do something so weird in the first place. So here is your answer – the fertilized eggs are kept in your freezer. I keep mine in an old popsicle box. When you are ready to use them, you thaw them for 24 hours and……yes, I am totally kidding. 

Frozen Embryo Transfer can be the result of a couple things. First, and in my case, you have gone through an IVF cycle but were unable to transfer the fertilized egg or blastocyst. This is usually due to ovarian overstimulation. If you cannot transfer right away, you need to freeze the eggs so you can use them at a later time when you have a better chance of success. You may also have to do a FET if your last transfer was unsuccessful, or you are using a donor egg. There are other reasons, but you get the picture. 

The Freezing 

When it comes time to freeze, you will have either fertilized eggs (embryos) or blastocysts. A blastocyst is a five-day or older embryo that has started to experience cell division. Should they need to be frozen, they are paired up in twos – like at the Ark – and placed in a little cryopreservation tube. This process will cost you a good amount of cash, so go ahead and ask to see the pictures of your embryos before freezing if possible. Also make sure you know how many you have and what each one is graded (meaning quality). It’s nothing weird like naming them or anything, it is just being an informed patient. You worked really hard to get these embryos, so make sure you are comfortable with what is happening. 

When it is time to freeze, the tubes are placed in cyclinders of liquid nitrogen, which keeps them in a static state. They remain alive, but the cells will not continue to divide until they are thawed. It does take some time to get used to the concept, because theorectically you could freeze some eggs tomorrow and thaw them out in ten years time to implant. 

This is NOT how you will freeze your embryos.

 Your mind will start to think about all sorts of philosophical, scientific, religious, spiritual, hypothetical circumstances and scenarios at this time. It’s normal. After all, you are most likely still pumped with drugs. So to clarify, these are embryos. Yes, they are amazing and beautiful, but they are not little humanoid creatures. Just saying. Some people are not sure. WE ARE NOT FREEZING BABIES HERE, PEOPLE. This is not that out there. 

OK. Moving on. 

The Transfer 

Once you are ready to attempt conception, you will begin preparing your body for implantation. For some people that mate normally this consists of a nice dinner at Ruth’s Chris and one too many cocktails. In your case, its time to dust off your trusty dusty needle kit. Yep – you are back to about 4 weeks of shots and pills and shots and pills and blood work and ultrasounds and shots. Oh yeah, and pills. Basically what you are doing is allowing your uterine lining to grow thick and healthy. Without this, and without sufficient progesterone, your embryo will be unable to implant and sustain itself after transfer. And that would just be sad. So you go through a much easier yet still needley version of what you did when you grew all the eggs in the first place. 

Once your uterine lining looks good and your blood work looks good, you are a go! By the way, the normal “compliments” that you used to revel in are not so coveted now. Instead of “cute shoes” (you will be living in flip flops and slippers) or “have you lost weight” (you are going to get some chunk, so just go with it), you now light up when you hear “Your lining looks great!”  

I love you, healthy uterine lining!

At this stage the embryologist will review the egg’s quality with you and choose which tube to thaw. I am actually not sure how they do this, I imagine they just set it out on the counter and head to Starbuck’s, but I have not asked. The morning that you come in for your transfer you will decide how many babies-t0-possibly-be you will transfer. Single Embryo Transfer is becoming quite popular, and if we have a very healthy one we may go this route. Regardless of how many you have decided to use, you will come in that day on valium. This is not so that you agree to go ahead and put 6 back because, hell, they’ll be adorable. This is so that when the embryo is being introduced into the womb you will not cramp. If you cramp, you may actually hurt the chances that the embryo can implant and begin to grow. Think about it – when you are settling down to go to sleep at night, exhausted, and then your spouse hugs you REAL TIGHT you cannot get comfy, right? He may even push you out of the bed. With valium, your body just responds better to a skinny straw being threaded into your itty bitty cervix. 

The Wait 

By this point, you have gone through a lot. In my case, it  took about 6 months to grow the eggs, get them out and fertilized, get them frozen, and prepare my body for our upcoming transfer. Once the embryo / embryos are in, you just have to chill out and take it easy for a couple weeks. I think that AVOIDING the home pregnancy tests would be wise in this case. Often times they take intially, but just as in nature, don’t last more than a few days. So it is better to just bite the bullet and wait for the blod test at the doctor’s office. You can avoid possible heartbreak this way. Either way, having it not work is hard regardless. Nothing about this process is emotionally easy. 

I hope that clarifies what FET is. There is no scary little man in a florescent, sterile lab. Oh wait, yes there is. Sorry. But he’s there to help your embryos grow, so if people ask you about this weird Frozen Embryo process, let them know the deal. 

Peace and Love, 

Sarah

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4 responses to this post.

  1. Posted by thecrazycatwoman on September 1, 2010 at 10:07 pm

    What a long wait you’ve had to get to this point! I’m curious (s’cuse my ignorance!) – why all the needles / pills etc for an FET? My FETs just involve one scan followed by a blood test to pinpoint ovulation, then transfer, followed by a series of HCG injections during the luteal phase. Much more straightforward than yours sounds.

    All the best for a sane 2WW! And I agree – don’t test.

    Reply

  2. I didn’t take any home tests with my IVF. We went into the blood test blind. Mainly because I didn’t want the dream to die before it had to. Luckily the blood test came back at 137 and we now have our son Henry.

    We are going to do an FET in the next few months to try for baby #2 with the embryos from the IVF. We have six high quality (Grade AA or AB) 5 day blasts. We put in two to have H, but can’t decide how many to put in this time around. Maybe just one, but time will tell!

    Reply

  3. LOL I love this post. Sorry I’ve been MIA but it’s been a little crazy lately with our little one and recuperating from the c-sec and all.
    I can’t wait to hear about your BFP!!

    Reply

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