Patient Education
Pre-Cycle Training
Patient Education: Preparing for Frozen Embryo Transfer (FET)
CHR's patient education for Frozen Embryo Transfer (FET) consists of the following components:
- 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.
Once you have read through all the materials relevant to FET, please complete the Completion/Question Form.
1. What is an 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 (see the medication list for more detail).
2. Timeline of Preparation for FET
| Frozen Embryo Transfer Cycles | ||
Click on the image for a larger version of the cycle card.  |
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| Step 1 | Day 21 of your period (10 days before your next cycle) |
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| Step 2 | After 2 weeks on Lupron or Day 1 of your next period |
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| Step 3a | Day 2 of your next period in the morning: |
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| Step 3b | Day 2 of your next period in the afternoon: |
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| Step 4 | 8-10 days after the start of Estrace |
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| Step 5 | 16 days after the embryo transfer |
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3. Pre-Cycle Checklist
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.
Download the Pre-Cycle Checklist. (A downloadable PDF will open in a new window or tab.)
4. Medications
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 usage instructions of the specific brand-name medication you will be using, click on the icons below(
& 
).
| Leuprolide Acetate | In FET cycles, Leuprolide Acetate (often called Lupron, even though it's a brand name--a bit like Band Aid and Hoover) is used to stop your own cycle so we can prepare your uterus for transfer. Leuprolide Acetate is taken as subcutaneous injections. If you start Lupron in mid cycle you may have a period one to two weeks later. | |||
| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Lupron | |
N/A | |
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| Progesterone | 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 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 Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Prometrium® | |
N/A | |
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| Progesterone | |
N/A | N/A | |
| Micronized Estradiol | Micronized estradiol helps maintain and build your uterine lining so that the transferred embryos will find a comfortable environment there.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Estrace | N/A | N/A | |
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| Baby Aspirin | Aspirin increases blood supply to your uterus and ovary. It also prevents clotting.
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| Prenatal Vitamins | Prenatal vitamins, such as Folate, will help prevent neural tube defects. Iron will build up your blood count. Calcium helps build your babies bones and will help maintain yours.
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| Prednisone | Prednisone suppresses male hormones and immune function.
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| Brand Name | Printable Instruction | Video Instructions | Prescribing Information | |
| Prednisone | N/A | N/A | |
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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.
- Download the Affirmation of Sexual Intimacy Form.
- Download the Comprehehsive Informed Consent for IVF, ICSI, AZH and Embryo Cryopreservation.
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.
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
For future reference, we recommend that you print out this pre-cycle training material (a printer-friendly version is located here). Please click here for the completion/question form where you will be asked to answer a few questions on this FET training material, as well as have an opportunity to ask additional questions, if you have any. After you have submitted the Completion/Question Form, you will be asked to print out a certificate, so that you can bring it in with you the next time you have an appointment with CHR.
Written by David Barad, MD
Last updated: April 9, 2013
