Synthetic Frozen Embryo Transfer (FET) Cycle: Procedure and Instructions

1. Introduction QUICK START: Synthetic Frozen Embryo Transfer (FET) Cycle

2. Cryopreservation Cryopreservation During a fresh IVF cycle, embryos that are frozen or cryopreserved through a process called VITRIFICATION. These frozen embryos can be stored in liquid nitrogen indefinitely until you are ready to use them.

3. Important Info before Cycle Start Prior to beginning your cycle, you must have: • Completed your checklist • Signed all consents • Confirmed your specific embryo thaw and transfer plan with your physician and nurse • Obtained all of your medication for your cycle • Checked with your financial coordinator that you are financially cleared for your cycle. You will not be allowed to start any medication if you are not financially cleared. ImportantInfo

4. Cycle Prep • Typically, it takes to two to three weeks to prepare the uterus for embryo transfer. • In some cases, patients need to take medications such as oral contraceptives or Lupron prior to their cycle start. Your nurse will discuss a pre cycle treatment plan with you if these medications are to be used. • In most cases, patients simply start medications on day three of their menstrual cycle after ultrasound and blood work are performed. Cycle Prep

5. Estrogen Estrogen For most patients, the process of thickening the uterine lining takes 10 to 14 days. During this time, blood work and ultrasound are needed every 4 or 5 days to watch the lining thicken.

6. Estrogen • Estrogen (Estrace/Estradiol) can be taken orally or vaginally. • Estrogen patches (Vivelle/Estraderm) are applied to the skin and changed every other day. • Estrogen injections (Delestrogen/Estradiol Valerate) are administered intramuscularly. Estrogen Click here to view our Injectable Medication Training Videos

7. Progesterone Embryo Transfer Progesterone Once a physician determines that your uterine lining is appropriate for transfer, your embryo transfer will be scheduled.

8. Progesterone • Approximately 5-6 days prior to the embryo transfer, progesterone injections are started. Progesterone injections are administered intramuscularly into the upper outer quadrant of the gluteal muscle, which is found in the buttocks. • Please watch the progesterone injection training video. Click here to view our Injectable Medication Training Videos

9. Embryo Transfer You will receive a phone call the day prior to your embryo transfer with what time to arrive in Basking Ridge the next day. Embryo Transfer

10. Embryo Transfer • Since there is no anesthesia needed for an embryo transfer, you can eat or drink that day. Once again, we ask that you or your significant other please do not wear any makeup or use scented fragrances when visiting our Basking Ridge IVF Retrieval and Transfer Facility. • Pre-embryo transfer instructions are fairly simple. Patients are instructed to insert a progesterone suppository into their vagina at approximately 1-2 hours prior to transfer.

11. Embryo Transfer • The transfer is quite simple. The physician places a speculum into the vagina and inserts a soft, flexible catheter containing the embryos into the uterine cavity. The procedure is similar to a pap smear. • After the transfer, we will ask you to get up and empty your bladder and prepare to be discharged home. • Your Pregnancy test will be approximately 9 days later