What to do right before and after an FET

You’re getting ready for your frozen embryo transfer (FET) so you probably have a mix of emotions. It was probably a significant journey to get to this point (is that the understatement of the year?). Now you want to know what to expect and how to make your FET a success. Here’s what it could look like and what you could do, but it’s dependent on your clinic and your unique needs.

Unless you’re doing a natural cycle, you’re probably taking medication that should increase your estrogen and progesterone. It might be injections such as Progesterone In Oil (PIO), vaginal suppositories and oral medication (check out tips for doing these injections). With the flare protocol you might be on the Lupron depot shot for a couple of months leading up to it. Other protocols may include nose sprays, patches, baby aspirin and too many others to name here. You’ll be setting alarms and systems for taking and tracking the medication, similar to the lead up to egg retrieval, if you harvested yours or your partner’s own eggs.

Closer to the day you’ll probably be having your estrogen, LH and progesterone levels monitored through blood tests. Your progesterone levels, might indicate that you need daily PIO shots or every 3 days, but not necessarily. Your medical team will be checking your lining is thick enough too, which is partly what your medication is meant to do. Every clinic is different but they often aim for a minimum of 7 to 8mm thickness and a maximum around 14mm. The day of transfer will depend on a few factors but often it’s the fifth, sixth or seventh day after you start progesterone based on the age of your blastocyst or cleavage. As always follow the medical advice of your clinic and doctor.

Then, finally the day arrives!

Before and during a Frozen Embryo Transfer

• You might want to eat a big, wholesome breakfast the morning of FET Day. Pop a snack in your bag too. Choose something that’s nourishing like a homemade bar or Lara or Kashi bar or fruit and nuts.
• Dress in layers and wear warm socks. The temperature might be unpredictable and your comfort is important when your bottom half is hanging out!
• Keep valuables at home but consider something small to keep with you that has meaning that gives you hope or trust in your body.
• You may want to snap pictures or a video of the embryo(s), but ask your clinic beforehand. Not every clinic allows this. Some clinics provide a photo of the embryos for you.
• You’ll probably be asked to come in with a full bladder but if you’re too uncomfortable when you get there ask the clinic staff if you can release a bit. You don’t need to be in agony.
• Before going in the main room you might get blood pressure taken and even have an ultrasound to check how full your bladder is.
• Once in the main room, you should have the doctor or embryologist go over the embryo (e.g. grading), your name, and potentially sign documents.
• Then it’s go-time. It should be a quick procedure, similar to a Pap test where you lie down with a cloth or paper gown on and booties, then lie down on the chair with your in legs in stirrups. They may disinfect and wipe your vagina and pelvic area. Then a speculum is inserted through your vagina and then a catheter is strung up and through your cervix. It might be slightly uncomfortable but it usually isn’t painful unless you have pelvic pain, which hopefully you’ve addressed with your care team ahead of time. If you can relax the muscles all around your pelvic area as much as possible that’s ideal. It’s not uncommon for doctors to have a bit of trouble finding the cervix or have trouble getting it in or other little delays. Sometimes it can take a little longer than expected. Chances are very much in in your favour that they are doing everything possible to make this a success.
• In the room you may have a monitor for you to watch the embryo actually inserted. It’s pretty cool if you see it or them inserted. It’s a sort of sparkle of light!
• Additional options:
  1. Acupuncture right before is an option. Many clinics offer it on site so you can relax and have your mind and body ready.
  2. Consider a guided meditation of some kind like the Mindful IVF app to have your muscles and mind relaxed, your heart rate down, and so you can hopefully enjoy the potential for what’s happening.

After a Frozen Embryo Transfer

• You’ll go back to a waiting area or more likely be able to leave right away. In most cases you should be able to drive home.
• Many people take the day off of work but most clinics will tell you that you don’t need to.
• Light exercise after and no bed rest after. This is probably what your clinic will advise but make sure to follow their medical advice.
• You can expect a bit of cramping but again, talk to your clinic.
• The embryo hopefully starts hatching around 1 to 3 days after the transfer.
• Additional options:
  1. Celebrate in some way! This a milestone no matter what happens. It’s also OK if you need to ignore what’s actually happening in order to cope with this. Everyone deals differently.
  2. Acupuncture after is an option and many clinics offer it in in-house in partnership with an acupuncturist or Naturopath.
  3. Consider some kind of relaxing activity with a coach or hypnotherapist that afternoon.
  4. Check out these considerations for the two week wait .

That’s what to expect with an FET in a nutshell! I hope it’s a success and that you find ways to manage your expectations and to trust that your body is working with you in the best way it can.