Download Frozen Embryo Transfer - Center for Human Reproduction

This material is located online at www.CenterForHumanReprod.com/fet_training.html This material is located online at www.CenterForHumanReprod.com/fet_training.html 2. Timeline of Preparation for FET Frozen Embryo Transfer Cycles Patient Education: Frozen Embryo Transfer (FET) Go to http://www.centerforhumanreprod.com/images/fet.gif to see a larger image. CHR's patient education for Frozen Embryo Transfer (FET) consists of the following components: 1.
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What is an FET? ‐ a brief description of the procedure Timeline of FET at CHR ‐ what needs to be done and when Pre‐cycle checklist ‐ a list of pre‐cycle tests and preparations Medications ‐ pharmaceutical company's instructions and information on medications used Consent Forms FAQs Completion/Question Form ‐ let CHR know you've read it, and ask questions Please read each item carefully, and make a list of questions you might want to ask. This way, you will be more prepared when you meet with your nurse coordinator for your training session. When you are unsure about something along the way, you can always come back to this page to refresh your memory. Every cycle stimulation may have to be individualized and, therefore, may end up deviating from the here described routine. Please always follow the instructions, given by the CHR staff. When in doubt, call CHR at 212‐994‐4400, rather than taking the wrong step. Our staff is available for inquiries 24 hours a day, 7 days a week. 1. What is an FET? Visit CHR for blood test and ultrasound, to determine if you have ovulated. Start Lupron injections, as instructed by your nurse coordinator. Day 21 of your period (10 days before your next cycle) Step 2 After 2 weeks on Lupron or Day 1 of your next period 
Call 212‐994‐4400 to make an appointment for baseline tests (ultrasound and blood work) the next day. Step 3a Day 2 of your next period in the in the morning: 
Visit CHR for baseline ultrasound and blood work. Day 2 of your next period in the afternoon: 
Step 3b When your results of this testing are complete, your physician will determine the dosage of medications you will use. The nurse coordinator will call you to confirm the medication dose. Step 4 8‐10 days after the start of Estrace 
Visit CHR one or more times (as instructed) for ultrasound and blood work, to determine the state of your uterine lining. When your endometrium is ready, we will ask you to start Progesterone and other medications, and schedule your transfer for 5 to 8 days later. Step 5 16 days after the embryo transfer 
Visit CHR for pregnancy test. During FET (frozen embryo transfer), cryopreserved embryos from a previous IVF cycle will be thawed, and will be transferred into your uterus. You will probably find preparing for an FET less stressful than your IVF cycle. You will take hormones that build your uterine lining to prepare your uterus to receive the embryos. (Continued on next page) 
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Center for Human Reproduction 21 E. 69th Street, New York, NY 10021 Tel: 212‐994‐4400 Fax: 212‐994‐4499 Center for Human Reproduction 21 E. 69th Street, New York, NY 10021 Tel: 212‐994‐4400 Fax: 212‐994‐4499 This material is located online at www.CenterForHumanReprod.com/fet_training.html 3. Pre‐Cycle Checklist This material is located online at www.CenterForHumanReprod.com/fet_training.html Vitamins A series of tests may be required before an FET cycle can take place. If you have recently had an IVF cycle your checklist may be up to date. Please check with your nurse coordinator to be sure. Go to http://www.centerforhumanreprod.com/pdf/ivf_checklist.pdf to download the Pre‐Cycle Checklist. Prednisone suppresses male hormones and immune function. Prednisone Brand names for prednisone include Prednison. 4. Medications Take one 10mg pill daily until further instructions. For FET cycles, there are two main medications. Brand names of the medications you use will vary, so we've listed the generic name on the left‐hand column, with general information on each medication at the top of the right‐hand columns. For specific usage information, please revisit the FET training page at http://www.centerforhumanreprod.com/fet_training.html. In FET cycles, Leuprolide Acetate (often called Lupron, even though it's a brand name‐‐a bit like Band Aid and Hoover) is used Leuprolide to stop your own cycle so we can prepare your uterus for transfer. Leuprolide Acetate is taken as subcutaneous injections. If you start Acetate Lupron in mid cycle you may have a period one to two weeks later.
Brand names for Leuprolide Acetate include Lupron. Progesterone is used to thicken your endometrium (lining of the uterus) so that the implantation of fertilized egg(s) will be easier. Medications used in ovarian stimulation can suppress progesterone levels in your body, so it is important to supplement Progesterone it with exogenous progesterone. Progesterone is taken either vaginally (in the case of Prometrium) or as intramuscular injection (in the case of Progesterone in oil). Brand names for progesterone include Prometrium and Progesterone. Micronized estradiol helps maintain and build your uterine lining so that the transferred embryos will find a comfortable Micronized environment there. Estradiol Brand names for micronized estradiol include Estrace. 1 pill twice daily, orally. Aspirin increases blood supply to your uterus and ovary. It also Baby Aspirin prevents clotting. Take one 81mg pill daily. Prenatal your babies bones and will help maintain yours. Take one pill a day. Prenatal vitamins, such as Folate, will help prevent neural tube defects. Iron will build up your blood count. Calcium helps build Center for Human Reproduction 21 E. 69th Street, New York, NY 10021 Tel: 212‐994‐4400 Fax: 212‐994‐4499 5. Consent Forms Signing of the informed consent forms are required prior to any procedures performed at CHR. Please read through the appropriate informed consent forms according to your planned treatment(s) so that you are well informed by the time you meet with your nurse coordinator for further explanation and signing of the form(s). You should NOT sign the consent form(s) until you meet with your nurse coordinator. 
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Go to http://www.centerforhumanreprod.com/pdf/ivf_consent.pdf to download the Informed Consent for IVF. Go to http://www.centerforhumanreprod.com/pdf/ivf_consent_addendum.pdf to download the Addendum to IVF Informed Consent. Go to http://www.centerforhumanreprod.com/pdf/cryo_consent.pdf to download the Informed Consent for Cryopreservation of Embryos. Go to http://www.centerforhumanreprod.com/pdf/med_consent.pdf to download the Informed Consent for Fertility‐Enhancing Medications. Go to http://www.centerforhumanreprod.com/pdf/sperm_donor_consent.pdf to download the Informed Consent for Sperm Donor Inseminaton. Go to http://www.centerforhumanreprod.com/pdf/affirmation_consent.pdf to download the Affirmation of Sexual Intimacy Form (for unmarried couples). 6. FAQs What is FET? ‐‐ During FET (frozen embryo transfer), cryopreserved embryos from a previous IVF cycle will be thawed, and will be transferred into your uterus. You will probably find preparing for an FET less stressful than your IVF cycle. You will take hormones that build your uterine lining to prepare your uterus to receive the embryos. Is FET expensive? ‐‐ ‐‐ The average cost of a FET cycle can be between $4,000‐ $6,000. Please check with our billing department at 212‐
994‐4400 for the cost specific to your treatment protocol. How long does it take from the start to finish? ‐‐ It depends on the individual patients, but it can take up to 3‐4 weeks. How many visits should I expect to make? ‐‐ Approximately 4‐6 visits. How many embryos are going to be transferred? ‐‐ The number of embryos transferred will depend on several factors: your age, the embryo quality and how many have survived the thaw. Generally speaking, we will thaw one more embryo than were transferred in your fresh cycle. Center for Human Reproduction 21 E. 69th Street, New York, NY 10021 Tel: 212‐994‐4400 Fax: 212‐994‐4499 This material is located online at www.CenterForHumanReprod.com/fet_training.html How many embryos will be thawed? ‐‐ We can thaw embryos one at a time until we have enough to transfer. For instance, if you need to have three embryos transferred, we will first thaw three. If one has not survived, we will thaw another. Embryos will be allowed to grow out one or two days after thaw. Can thawed embryos be re‐frozen? ‐‐ Of course they can, but this would not be ideal, since thawing and freezing increases the chance of damage. How long can embryos remain frozen? ‐‐ The embryos could stay frozen as long as you want. However, there is an annual fee for maintenance. In general, couples use their frozen embryos within a few years, though we have had couples return after as long as ten years. What are the most common side effects of the hormone medications? ‐‐ Symptoms vary from patient to patient but some are swelling and possibly dizziness. It says on my progesterone prescription that I should not use progesterone if I am pregnant. Will this progesterone harm my pregnancy? ‐‐ No, progesterone will not harm your pregnancy. The progesterone that we give you is "natural" and is the same as the hormone you will produce during your pregnancy. Natural progesterone is "Pro‐gestational" (good for pregnancy). 7. Completion/Question Form If you need to complete the online pre‐cycle training, your last step is to go to http://www.CenterForHumanReprod.com/training_fet_quiz.php to fill out the Completion/Question Form and print it out. Please take the printout to your next appointment with your physician. Center for Human Reproduction 21 E. 69th Street, New York, NY 10021 Tel: 212‐994‐4400 Fax: 212‐994‐4499