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Is thickness in uterine lining a good sign for frozen embryo transfer?

DOCTOR OF THE MONTH - Mar 2013
Mar 2013
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Practicing since : 1998
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I am due to have a frozen embryo transfer shortly My scans so far are showing quiet ovaries and a uterus lining that is growing thicker everyday (currently 8.2mm) I have another scan tomorrow where I am hoping they tell me I am allowed to start on progesterone. My question is - once they think I am ready for transfer, how do they bring on ovulation?
Posted Wed, 5 Feb 2014 in Pregnancy
 
 
Answered by Dr. Aarti Abraham 2 hours later
Brief Answer: OVULATION IS INHIBITED IN FACT FOR THE TRANSFER Detailed Answer: Hello Thanks for writing to us with your health concern. Yes, I recollect our previous conversation threads. If I rightly recall, you were apprehensive the last time about why they did not downregulate you in the previous cycle . Am I correct ? Now for your present concern. So far, your ovaries are quiet, and your endometrium ( uterine lining ) is growing well enough. These are very good signs, since for the embryo transfer, the lining must be proliferated ( thick ) enough. Please let me know what cycle day you are on also. Now, you have asked, how would they bring on ovulation once you are ready for transfer. The answer is- they would NOT bring on ovulation. The purpose of the procedure is that an embryo would be directly transferred inside the uterine cavity. Hence, endogenous ovulation would be avoided entirely. Thus, they would not bring on ovulation, infact the high doses of estrogen that you have been taking ( Progynova ) would serve to inhibit intrinsic ovulation. They do not WANT ovulation to occur at all. I hope that clarifies things. Please do feel to discuss this further, am glad to assist you anytime 24 x 7. All the best.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 31 minutes later
Hi, I did not know that I won't ovulate at all during a frozen embryo transfer! That makes so much sense now. So the medication I am on mimics my hormones as if I would ovulate but I actually never release an egg at all? That really makes a lot more sense to me! On cycle day 4 I had my first scan and all looked good On cycle day 9 I had another scan and ovaries were quiet, no cysts and lining was 8.2mm I have a scan tomorrow which will be cycle day 12 Hopefully things are still looking quiet and my lining is thicker still. If things do look good, do you roughly know the time scale between now and transfer? Do they tend to transfer on a particular cycle day? Thanks
 
 
Answered by Dr. Aarti Abraham 10 hours later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hi again. Yes, endogenous ovulation is suppressed when a frozen embryo transfer is planned. The hormones will mimic the normal menstrual cycle, but you do not release your own egg during this month. Estrogen is given to grown the lining, and make it primed for reception of the embryo, and progesterone will be added in the coming days to further enhance the receptivity of the lining. Generally, looking at the time frame, transfer is done after 3 - 4 days of progesterone supplementation. Of course, it also depends at what stage your embryos were cryopreserved. If it is a 2 day embryo , it is transferred 2 days earlier compared to a day 4 embryo. I hope that makes sense to you. If you are having a cycle day 12 scan tomorrow, if all looks good, they should start you on progesterone, and then transfer after another 3 - 5 days, depending on the embryos which were preserved. Please keep me in the loop at every point, and feel free to discuss any doubts which should arise at any point. I wish you all the luck with the procedure. Fingers crossed ! take care.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 3 hours later
Thank you so much! We have 8 blastocysts frozen. So im not sure when we'd be having them implanted. I no doubt will be in touch soon!
 
 
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: DELAYED BELOW Detailed Answer: Hi A blastocyst is a day 5 embryo, so you would have it transferred slightly later. Wish you so much of luck !
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 44 minutes later
My scan today showed lining of 8.6mm I am to go in for another scan in two days and then after that they will start me on progesterone. Apparently my ovaries are still very quiet and my lining is looking good. So, if it is a blastocyst - could I roughly be looking at transfer for 10 days time? Or before then?
 
 
Answered by Dr. Aarti Abraham 6 hours later
Brief Answer: DETAILED BELOW Detailed Answer: Hello Yes, the lining is good enough. If they start you on progesterone after 2 days , they would transfer within the next week, yes.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 2 minutes later
Great. My scan today showed lining of 8.6mm I am to go back in 2 days for final scan and then they'll start me on progesterone. Fingers crossed!
 
 
Answered by Dr. Aarti Abraham 2 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: Yes, so far so good. Just do not stress out about it. Easier said than done, I know, but stress will only impact your body and mind negatively. Best take it as it comes. Prayers for you !
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 48 hours later
Hi My scan today was good. I am now on daily prontogest injections and baby aspirin. My transfer due in 6 days. Two days before transfer i start clexane injections. Can i ask why i am on aspirin and what clexane i jections do? Thanks
 
 
Answered by Dr. Aarti Abraham 20 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: Hi again. Good you are on track now, as D - day approaches ! Keep your moral up and think positive, that always matters. Now, for aspirin, it reduces the risk of thrombosis ( clots ) developing in the blood vessels , and thus increases blood supply to the uterine bed and the developing embryo after transfer. It increases chances of implantation. Also, clexane is heparin, which is a conventional blood thinner. It too increases perfusion to the uterine bed and to the embryo, thereby increasing chances of pregnancy resulting from the transfer. There are many scientific studies to support this, however, I will provide a link to a page that hopefully minimizes the technical jargon and is easy to comprehend . Please go though it - WWW.WWWW.WW It is not a scientific website, but explains the concept in easy to understand language. Keep me posted. Wish you luck in the coming days !
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 14 hours later
Do i really have to wait 16 days past my transfer to take a pregnancy test? That is what my clinic has said. I would have thought have a 5 day blastocyst transferred might have meant i didnt need to wait 16 days til testing day I will lose my mind!
 
 
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: DETAILED BELOW Detailed Answer: With a 5 day blastocyst transfer, it might be done earlier, say in 10 days. However, there is a lot of stress and ambiguity when one tests earlier. They would want you to have a conclusive answer, and hence are giving you a safe time zone of 16 days post transfer. It avoid unnecessary repeat testing, worry and serious stress. Go by the timeline prescribed, it is always better. Wish you luck.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 33 minutes later
Hi, Yes - you are probably right! I need to be patient. My lining measured 8mm at my last scan Is that an OK size for the transfer? And also - is there anything I can do in the run up to the transfer that will help? And is there anything I can do after the transfer as well?
 
 
Answered by Dr. Aarti Abraham 5 hours later
Brief Answer: DETAILED BELOW Detailed Answer: Hi, You already told me the lining was 8.6 once, right ? With progesterone it would only grow. Linings measuring 10 mm and above are associated with higher pregnancy rates. Am sure you will get there ! In the run up to the transfer - STAY CALM ,yes, all capitals ! It is most important. Involve your partner if possible, crack jokes, take a stroll, watch a movie, do whatever it takes to reduce stress and negative thinking. Stop alcohol, smoking ( even passive ) and cut back the tea and coffee. Take regular folic acid supplements. Avoid jerky travelling, late nights, erratic eating and sleeping schedules and prolonged standing or strenuous exercise. Walking is fine. Double check everything with your clinic, so that they do not make small mistakes that can cost you big. If possible, get in touch with the consultant who would be transferring the embryos, and ensure it is somebody XXXXXXX and with a good degree of expertise and experience. After the procedure, do not opt for bedrest. Do not exert too just carry on normal activity. Again a relaxing activity such as a movie, reading a good book, swinging in a hammock, or whatever it takes to soothe you ,is recommended. Gentle sexual intercourse can be continued. Take the medications rigorously. Do not read too much on the internet or engage in fretting or worrying, it is not going to alter the results ! Avoid very hot showers / sauna / jacuzzi. Wishing you good luck again.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 15 minutes later
It was 8.6mm but at the latest scan she said 8mm I said "it was 8.6mm before" she didnt seem concerned. (Well she didnt respond) Hopefully with the prontogest injections and crinone gel this will help me get to 10mm
 
 
Answered by Dr. Aarti Abraham 17 minutes later
Brief Answer: EXPLAINED BELOW Detailed Answer: See it must be a very cursory measurement. What I mean is she must have seen it was good enough, a difference of 1 - 2 mm is always subjective . So do not worry about it. If it was 8.6 mm, it CANNOT decrease. That is a fact, so it was her problem if she did was not specific enough. Yes, with progesterone, it would shoot up significantly. Dont worry on that score.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 41 hours later
Hi Ive been on prontogest injections for 4 days now. I am experiencing no side effects (swollen breast, bloated, mood swings etc) Does this mean it isnt working? In the past ive been on progesterone suppositories and felt all progesterone side effects but now, on the injections i feel nothing. I read on the internet sll these women feeling all these things on pronogest- but i feel normal still.
 
 
Answered by Dr. Aarti Abraham 3 hours later
Brief Answer: DETAILED BELOW Detailed Answer: See these are side effects perceived by a certain percentage of women, all women do not have to experience them all the time. SOmetimes, you do feel normal, that does not mean that the drug is not working. Just check the expiry date of the medications ( am sure you have ). If that is fine, the injections are fine, and they WILL work. The best evidence would be a thickening of the uterine lining. SO please dont worry. Take care.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 21 hours later
Hi! Transfer day tomorrow! What will they be looking for? Will they scan me beforehand? What would be reasons for it being cancelled?
 
 
Answered by Dr. Aarti Abraham 5 hours later
Brief Answer: DETAILED BELOW Detailed Answer: Hello All the luck for tomorrow. Yes, they should scan you tomorrow. IF they scanned you already today , they might not do so tomorrow. Generally, the procedure is done under ultrasound guidance, so real time scanning should be done. There is no reason for it being cancelled. If they have decided to go ahead with the transfer tomorrow, that means that the uterine lining is optimum, and the ovaries are quiet, and all is favourable for going ahead. The only hitch ( rare ) is that once the embryos are thawed, the quality might not be good enough for transfer ( that too is rare , mostly wont happen ). No anesthesia required, so even that side effect is ruled out. Short of you panicking and running off, nothing should stop you. WIsh you so much luck, dear.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 15 hours later
I keep reading conflicting things about what I can and can't drink during the two week wait. Are peppermint tea, chamomile tea and fruit teas ok?
 
 
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: DETAILED BELOW Detailed Answer: Herbal teas and fruit teas are quite safe if consumed in moderation.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 21 hours later
Hi I was meant to take a voltarol suppository 6 hours after transfer and i forgot and took it 20 hours after. Is this something to worry about- should i tell my clinic? Thanks
 
 
Answered by Dr. Aarti Abraham 2 hours later
Brief Answer: DETAILED BELOW Detailed Answer: So did it go smoothly ? Voltarol suppository is supposed to provide you pain relief after the procedure. If you took it later instead of after 6 hours, and were fine, then no issue. There is no need to report to the clinic. Take care, wish you luck.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 2 minutes later
Transfer went without a hitch. Doctor was very pleased. Embryologist said the embryo was great too. You dont happen to know success rates for first time frozen transfers do you? I suppose it depends on many factors.
 
 
Answered by Dr. Aarti Abraham 4 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: See, only so much is what is under human control. The embryos, the technique, the precautions that you can take. In the best of hands, success rates are hugely variable - right from 25 % to 50 %. Yes, it depends on many factors, most of which are under research. You have done what you could, the rest only time will tell. Stay positive.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 3 hours later
Hi, There was a tiny bit of brown coloured discharge when I wiped. Is this normal? I am on crinone - but that normally produces a very white milky discharge. This is the first time I have had spots of brown in it. Thanks
 
 
Answered by Dr. Aarti Abraham 4 hours later
Brief Answer: DETAILED BELOW Detailed Answer: Yes a bit of spotting is common and to be expected. Do not worry.
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Follow-up: Is thickness in uterine lining a good sign for frozen embryo transfer? 37 hours later
Hi, I am now three days past my blastocyst transfer. I feel normal. Nothing. No symptoms, no cramps, nothing to indicate that anything is happening. Is this normal? Does this mean it hasn't worked? I read online women who seem to have every symptom under the sun and feel things from transfer - and I suppose I am just wondering if the fact I don't feel any different could mean I am out?! Thanks
 
 
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: DETAILED BELOW Detailed Answer: Hi, Again the same reply as the one with the Prontogest injection question . Not feeling anything does not mean anything. Some women go through an entire pregnancy without any of the typical symptoms, so do not worry. It means nothing either ways, positive or negative. No news is good news , right . Take care.
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