The Final Step Before Pregnancy
Embryo transfer is the moment your IVF cycle comes together — a carefully selected embryo is placed into your uterus to establish a pregnancy. It is a simple, painless procedure that takes only 5–10 minutes, requires no anaesthesia, and is often described by patients as easier than a routine cervical screening. No needles, no incisions, no sedation — just a brief, gentle procedure with potentially life-changing results.
Fresh vs. Frozen Embryo Transfer
Fresh Transfer
In a fresh transfer, the embryo is transferred during the same cycle as the egg retrieval — typically on Day 5 after retrieval. This approach is suitable when the patient’s hormonal levels and endometrial lining are optimal, and there is no risk of OHSS. Fresh transfers offer the advantage of completing the cycle without an additional waiting period.
Frozen Embryo Transfer (FET)
In a frozen embryo transfer, embryos are cryopreserved (vitrified) after the retrieval cycle and transferred in a subsequent cycle. FET is recommended when the endometrial lining is not optimally prepared during the stimulation cycle, when OHSS risk is elevated, when PGT results are pending, or when the patient prefers to separate the stimulation and transfer phases.
Modern vitrification techniques achieve embryo survival rates exceeding 95%, and FET success rates are now comparable to — and in some clinical scenarios, superior to — fresh transfer. FET allows endometrial preparation to be optimised independently, often using a simple oral or transdermal estrogen and progesterone protocol.
Endometrial Preparation for Transfer
Natural Cycle FET
For patients with regular ovulatory cycles, the transfer can be timed to the natural luteal phase — after confirmed ovulation via ultrasound and blood work. This approach requires no additional hormonal medication beyond luteal phase progesterone support.
Medicated (Programmed) Cycle FET
Estrogen tablets or patches are used to build the endometrial lining over 10–14 days, followed by progesterone supplementation (vaginal pessaries, intramuscular injection, or oral formulation) to prepare the lining for implantation. Ultrasound monitoring confirms endometrial thickness (target ≥ 7 mm with a trilaminar pattern) before scheduling the transfer date.
The Transfer Procedure
Before the Transfer
You will be asked to attend with a comfortably full bladder, as this helps with ultrasound visualisation of the uterus. Your embryologist will confirm the identity of your embryo(s) and show you the embryo image on screen. Your specialist will discuss the recommended number of embryos to transfer — in most cases, single embryo transfer (SET) is advised to minimise the risk of multiple pregnancy.
During the Transfer
A thin, soft catheter is gently passed through the cervix into the uterine cavity under abdominal ultrasound guidance. The embryo, loaded in a tiny droplet of culture medium, is deposited at the optimal location within the uterus. The entire process is painless and typically takes less than 5 minutes. You will be able to watch the procedure on the ultrasound screen in real time.
After the Transfer
You will rest for 10–15 minutes before being discharged. There is no medical need for prolonged bed rest — large-scale studies confirm that normal activity after transfer does not reduce pregnancy rates. You may return to work the same day or the following day. Your specialist will prescribe luteal phase support (progesterone supplementation) to be continued until your pregnancy test, and if positive, for approximately 8–10 weeks thereafter.
How Many Embryos Should Be Transferred?
Current international guidelines strongly recommend single embryo transfer (SET) for most patients — particularly for women under 38 with good-quality blastocysts. SET achieves pregnancy rates comparable to double embryo transfer while dramatically reducing the risks associated with twin or higher-order pregnancies, including preterm birth, low birth weight, pre-eclampsia, and neonatal complications. In specific cases — such as older patients or those with repeated implantation failure — transferring two embryos may be considered after careful discussion of the risks and benefits.
Frequently Asked Questions
No. The vast majority of patients describe the procedure as completely painless — similar to a Pap smear or pelvic examination. No anaesthesia or sedation is required. Mild cramping or a sensation of pressure may occur briefly as the catheter passes through the cervix.
Brief rest (10–15 minutes) at the clinic is standard practice. Beyond that, bed rest is not recommended. Multiple large studies have shown that prolonged bed rest does not improve implantation rates and may increase stress and anxiety. Normal daily activities, light walking, and non-strenuous work are all appropriate.
A blood pregnancy test (serum beta-hCG) is scheduled approximately 10–14 days after the embryo transfer. Home urine tests before this date are unreliable and can produce false negatives due to the low hCG levels in early pregnancy. We strongly advise waiting for the scheduled blood test.
Avoid strenuous exercise, heavy lifting, hot baths or saunas, swimming, and sexual intercourse until your pregnancy test. Light walking, office work, and normal household activities are all fine. Avoid smoking, alcohol, and excessive caffeine.
Success rates depend on multiple factors including patient age, embryo quality, endometrial preparation, and underlying diagnosis. For patients under 35 with a good-quality blastocyst, implantation rates per transfer are typically 50–60%. Your specialist will provide individualised success estimates based on your clinical profile.
Any good-quality embryos not transferred can be cryopreserved (frozen) for future use. Vitrified embryos can be stored for many years and used for subsequent frozen embryo transfer cycles, eliminating the need to repeat the stimulation and retrieval process. You will be counselled on storage options, duration, and associated costs.
Both approaches yield excellent results. Frozen transfers are increasingly preferred in many clinical scenarios because they allow endometrial preparation to be optimised independently of the stimulation cycle. Your specialist will recommend the best approach based on your hormonal profile, OHSS risk, and whether PGT is being performed.