Embryo Transfer Vs. Artificial Insemination

Every year, thousands of couple struggle with infertility. This can be crushing as most people don't expect to have trouble with something so seemingly natural. Other women are choosing to start their families without a male partner, and same-sex couples are having their biological children. All of these people will need to go through infertility treatment in one form or another.

Infertility Treatment Basics

• Infertility treatment can take a number of different forms. The first step should be to visit an infertility specialist, or reproductive endocrinologist, to have a full evaluation done. Once a diagnosis is reached, you will meet with your doctor to discuss his or her recommendations. Usually, treatment falls into one of two categories: ovulation induction with or without artificial insemination, and in vitro fertilization. In both situations, medications will be prescribed to induce ovulation beforethe selected procedure.

Artificial Insemination

• Artificial insemination is a procedure where your partner's sperm (or donor sperm, if you are using it) will be injected into the uterus during or right after ovulation. There are a number of ways to determine when you are ready for the insemination. If you are taking medication, the doctor will most likely be monitoring you through blood testing and ultrasound, and will instruct you when to come in for the insemination. If you are not taking medication, the doctor may ask that you check for ovulation using an ovulation predictor kit, and call to schedule the insemination once you get a surge.

  Insemination is a fairly simple procedure, done in your doctor's office. Either the doctor or a specially trained nurse will perform the insemination. A speculum will be inserted into the vagina so the doctor/nurse can visualize the cervix. The cervix will be cleaned and then a small catheter will be passed through the cervix and into the uterus. You may feel a slight cramp while this is happening but it should pass quickly. Once the catheter is in place, the sperm will be injected into the uterus. The catheter and speculum will be removed and you may be asked to lie still for a short period of time. Please talk to your doctor about any post-insemination instructions that you will need to follow.

Fresh Embryo Transfer

• Having a fresh embryo transfer is the one of the last steps of IVF. You will need to take a series of injections designed to stimulate your body to grow multiple egg follicles on your ovaries. Once you have reached a pre-determined criterion, set by your doctor, you will have a surgical procedure known as egg retrieval to remove the eggs from the ovary. The eggs will be combined with your partner's (or donor's) sperm in the laboratory. The resulting embryos will continue to grow in the lab for a few days and will later be transferred back into the uterus.

  The embryo transfer will also take place in the physician's office. You will be fully awake during the procedure, though the doctor may give you medication, such as Valium, before the procedure. This is to relax the smooth muscles of the uterus. You should speak with your doctor before the transfer about what your embryos look like, and how many (and which) she recommends transferring. Usually only two, sometimes three, embryos are transferred during a given cycle. If many embryos have survived, freezing extra ones is often an option.

Frozen Embryo Transfer

• If you have frozen embryos, and have not become pregnant with your fresh cycle, the doctor may recommend having a frozen embryo transfer. You will need to take supplements of estrogen and progesterone to build up your uterine lining. Once the lining is sufficiently thickened and developed, the doctor will make arrangements for the selected embryos to be thawed and transferred.

The Embryo Transfer Procedure

• Using ultrasonography, the doctor can see your uterus and pass a special catheter through the cervix to a particular point in the uterus. The embryologist will load the embryos into a special syringe that fits into the catheter and hand the loaded syringe to the physician. The doctor will fit the syringe into the catheter and slowly inject the embryos. Once the catheter and syringe are removed, they will both be checked to ensure that the embryos have in fact been transferred.

  Please check with your doctor regarding post-transfer instructions, but a period of bed rest and abstinence from sexual intercourse are common.