Embryo transfer- how delicate is it??

[Saya85]

Hi ladies,

Need your wonderful advice.

It is now 10 days since my BFN after my first fresh cycle of IVF 😞 my embryo transfer was very difficult! And I'm now wondering how much did this impact on the embryos chances??

The first insertion of the speculum was so painful! She then said it wasn't in right position (cervix had been pushed to the side? She wasn't sure if it was due to ovarian swelling)

Second speculum was smaller/softer but couldn't open cervix wide enough.

Third try she put the original speculum back in and it went in far more easily and thankfully it was correct.

She then had to change the catheter twice to a softer one? To get through the cervix and deposit the embryo in the lining- she even went back to 'push' the embryo further back ( I saw this on the ultrasound) as she was talking to us.

We had embryo glue also (not sure if it helped or hindered things)

She was an older nurse but seemed a little nervous- not sure if this was inexperience or just worried that it wasn't going as straightforward as she had hoped.

I was also the one to ask if I had OHsS as my stomach was massive on the day!! (This was actually mainly due to drinking lots of water to have a full bladder for the appt) and then she agreed and was concerned and did some scans. The registrar who did my EC was then called in but be didn't do the ET- he just held the ultrasound in place...

Just for some background - We have been ttc for 7years - I am 32, have PCOS and am hypothyroid, with anovulation previously.

The actual IVF short cycle went amazingly and I had 25 eggs at EC, 15 fertilised, and 11 reached blastocyst.

(2 grade A, rest c+\-) ☺️

1 was transferred even though I had mild OHsS (they gave me option to freeze or continue)

But I started bleeding 5dp5dt heavily and continued for 10 days this way.

I have always bled irregularly with menstruation and usually have very heavy and prolonged periods since my teens years. So it may have nothing to do with ET. I'm actually going to put up a separate post with regards to my bleeding as its a whole can of worms in itself)

🙋🏼 My Q for this thread is: how delicate a procedure is ET?

It was only after that I researched and found some consultants saying it is vital for good chances- and that a lot of places do mock transfers esp with difficult 'routes'.

I only had the tiniest bit of spotting the day after ET and then nothing until 5dp5dt.

Should I insist on having a consultant next time? I don't think my clinic does mock transfers and the FET will be self funded now.

My post IVF chat has been brought forward to tomorrow so I wanted to ask you ladies so I go in prepared

Thanks in advance for you advice xx

[emmab178]

Can't comment on the delicate question but on my ET they struggled to get to my cervix. I'm 5ft 11 and for some reason they started with the shorter speculum which resulted in routing around and then changing to the longer one where it was no problem.

The consultant said afterwards "make sure for smears you tell them to use the longer speculum" I thought to myself "the nurses usually do that assessment without any announcement as it's common sense and get on with it" but just mumbled "thanks will do"

Wishing you all the best with FET x

[Saya85 in reply to emmab178]

Thanks Emma! Oh gosh you just reminded me-

All my smears went smoothly without any hiccups with speculums! And not nearly as painful.

So that's why I was confused about cervix to the side- maybe it was the swelling...

I'm only 5'3 btw.

Thanks for your response ☺️ I'm glad I'm not the only one... It's worrying when they come across such problems and seem completely dumbfounded. They're the experts right?? Surely they have dealt with these complications ?!

I actually left the EC and ET to them thinking I could trust them to do their part. 😞

[emmab178 in reply to Saya85]

Well you would think it was the easy bit! I also have endo and my uterus is attached to the bowel so it pulls it back making me retroverted. This probably doesn't help. Unless stuck like mine i think the lady bits can be quite mobile and things like a full bowel can move them about a bit.

It was funny though as my husband was holding my hand at the time of the dr messing about with the smaller one and i squeezed his hand. The dr apologised and said "sorry if you felt that" which is when my husband piped up "I bloody felt the squeeze on my hand"! Yes dear, he was apologising to you not me.

[Saya85 in reply to emmab178]

Lol ahh don't you just love our OHs... The struggles they go through

[Music1]

Hi, I haven't had any luck with any of my transfers - well, one which ended in miscarriage. I have however, had all of them done under anaesthetic as my cervix is narrow and i've been told bent over at a 90 degree angle and difficult to reach. I'd recommend you ask them to do it under anaesthetic next time if possible. I guess it costs more, but if they are more relaxed and not so worried about how long it takes and whether they are hurting you etc? I think it helps when you're muscles and everything else are relaxed as well - including the cervix. I'm only guessing?

I would imagine it's very delicate. Have heard good things re: the glue so wouldn't imagine it's that. My old clinic used to give you a scan showing where they had placed them as well. Almost showing little white glowing blobs, but this did give me more confidence they had placed them back with no problems. Sorry, I can't answer your question from a medical opinion. x

[Saya85 in reply to Music1]

Thankyou x

Yes I'm def going to query it... I didn't think much of it at time but want to know any particular thing that could help next time!

[Hayleigh86]

Hello, i had my transfer done yesterday. It was done by the same consultant who did my egg collection. He did a mock transfer first. I had no issues and felt no pain - unlike egg collection which was awful. Hope this helps. Best of luck with FET x

[stephanienissim in reply to Hayleigh86]

Had my transfer yesterday as well. Worried though and hoping that I am doing things right. Good luck xx

[Hayleigh86 in reply to stephanienissim]

Me too - so worried and so desperate for it to work. I feel really positive though and keep getting a little bit giddy at the thought of what may be. Is you testing day the 10th? X

[stephanienissim in reply to Hayleigh86]

My testing day is the 5th of July. Why is yours the 10th of July? I think because my embryos were out for 7 or 6 days as doctors stated they wanted the best blastocysts. How long did you wait before you were implanted with your embryo? xx

[Hayleigh86 in reply to stephanienissim]

Oh i dont know? Mine was a five day transfer, just double checked my paperwork and it definitely says 10th july, i thouggt it was usually two weeks after transfer but im not 100%? Xx

[Fredaflintstone]

My consultant also seemed to swap the speculum and instruments around and said my cervix was curved. I also wonder whether that may have impacted on the transfer. It all seemed a bit panicked. I'll ask when we have our follow up though I expect they'll say it didn't make any difference. x

[bluewanderlust]

Hi, I had my ET on Saturday.I will try and give as much info as possible and hope it helps. I too was concerned that I may have OHSS, I was mostly fine through stimms but my stomach was really swollen after EC, and I put on around 5 lbs. On the day of transfer I told the consultant about this and she said she would scan me first and then make a decision. The scan was very thorough as she said if I did have OHSS it would have a negative effect on the transfer and she would then advise freezing our emby. She said I was ok and although swollen just recovering from EC and it was fluid retention, but I had not had any other symptoms of OHSS. The actual ET was relatively straightforward. It honestly felt the same as a smear test and probably more comfortable than most if I am honest. The only discomfort was from the fact that I had a really full bladder. There was a nurse holding the scanner on my tummy and a consultant doing the transfer. She let me watch the screen and I saw the catheter and the moment of emby being transferred was recorded and we were given a photo to take away. xxxx

[Saya85 in reply to bluewanderlust]

Hi thanks for replying.

I had swollen ovaries and fluid in abdomen but overall was quite mild. I asked if it would affect the transfer (doesn't affect the baby if u do get pregnant) and they said no- it was just dangerous for me if I did overstimulate further.... Hence I went ahead.

They gave me option of continuing or not.

My transfer was done by the nurse ! And the consultant was holding the scanner!

I'm sure I've read that nurses do transfer in some clinics but I'm wondering if this is something I should query.

Oh well tomorrow I will hopefully have enough time to go through it all with the consultant (!)

[Fredaflintstone]

I think it's worth querying - in our clinic it's the consultant that does the transfer. Hope your appointment goes well xx

[Persian40]

I always have very difficult transfers due to tight and mobile cervix. Last time the embryos were sent back to the lab while she changed the catheter! All the evidence does say that difficult transfers reduce chance but I did get pregnant last time, although I have since miscarried. All the best for future x

[Saya85]

Thanks for your messages ladies....

Thought I would update you

I did ask my consultant who works at the fertility clinics satellite clinic (and was my NHS consultant too)

She said it def could affect things with a difficult transfer and that she performs mock transfers - so I will have that done at my FET.

She also said it's mostly consultants who do the transfers but my clinic trains it's nurses to do it.... I feel a bit let down because I think they should have treated me as an awkward case rather than thinking I would be straight forward just because I was young. I've had a few issues during the cycle but the FET will be done at a diff clinic and with my usual consultant so I feel in better hands!