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Patient Education

Medically reviewed by Dr. David H. Barad - Written by CHR Staff - Updated on Oct 04, 2018

Pre-Cycle Training for Frozen Embryo Transfer (FET)

Preparing for Frozen Embryo Transfer (FET)

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 relevant material according to the type of IUI you will be going through, print this page for future reference, then please complete the Completion/Question Form.

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.

1. 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 (see the medication list for more detail).

2. Pre-Cycle Checklist

A series of tests are required before an IVF cycle can take place, on both female and male partners. You should discuss your specific checklist requirements with your clinical-coordinator who will be responsible for guiding through this process.

Download the Pre-Cycle Checklist.

3. Informed Consents

Typically, your initial consultation with a physician determines the type of treatment you will be undergoing. (Some patients may not have a formal treatment plan until they have their follow-up consultation to review some information that was unavailable at the time of the initial consulstation.). Once you and your physician determine the type of treatment for you, you will receive a packet of informed consent forms from your clinical coordinator. CHR's comprehensive informed consent for IVF is also posted below.

All signed informed consent documents are required prior to any procedures performed at CHR. Please read through the informed consent forms you receive 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 to go over the consent forms.

If applicable, your partner will also have to sign the consent forms. If you are siging the forms outside of CHR without a CHR employee to witness your signature, consent forms need to be notarized.

Download the Comprehensive Informed Consent for IVF, ICSI, AZH and Embryo Cryopreservation.

4. Billing Clearance

A full payment for your treatment cycle is also due at this time. Our front desk staff can help you with cost questions and payment. With pre-cycle checklist completed (or waivers signed), informed consent forms executed and billing clearance in place, you are ready to start your cycle.

5. Timeline of Preparation for FET

Frozen Embryo Transfer Cycles

fet  2

STEPS
1Day 21 of your period (10 days before your next cycle)
  • Visit CHR for blood test and ultrasound, to determine if you have ovulated.
  • Start Lupron injections, as instructed by your nurse coordinator (see the medication list for more detail).
2After 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.
3aDay 2 of your next period in the morning:
  • Visit CHR for baseline ultrasound and blood work.
3bDay 2 of your next period in the afternoon:
  • 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.
48-10 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 (see the medication list for more detail), and schedule your transfer for 5 to 8 days later.
516 days after the embryo transfer
  • Visit CHR for pregnancy test.

6. 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 links below.

Leuprolide AcetateIn 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 NamePrintable InstructionVideo InstructionsPrescribing Information
LupronPDFN/APDF
ProgesteroneProgesterone 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 NamePrintable InstructionVideo InstructionsPrescribing Information
Prometrium®PDFN/APDF
ProgesteronePDFN/AN/A
Micronized EstradiolMicronized estradiol helps maintain and build your uterine lining so that the transferred embryos will find a comfortable environment there.
  • 1 pill twice daily, orally.
Brand NamePrintable InstructionVideo InstructionsPrescribing Information
EstraceN/AN/APDF
Baby AspirinAspirin increases blood supply to your uterus and ovary. It also prevents clotting.
  • Take one 81mg pill daily.
Prenatal VitaminsPrenatal 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.
  • Take one pill a day.
PrednisonePrednisone suppresses male hormones and immune function.
  • Take one 10mg pill daily until further instructions.
Brand NamePrintable InstructionVideo InstructionsPrescribing Information
PrednisoneN/AN/APDF

7. FAQs

Is FET expensive?

The average cost of a FET cycle can be around $8,000. 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 that.

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).

8. Completion/Question Form

For future reference, we recommend that you print out this pre-cycle training material. 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.

Dr. David H. Barad

Dr. David H. Barad

David H. Barad, MD, MS, is an expert reproductive endocrinologist with decades of experience in treating women with aging ovaries and patients with multiple failed IVF cycles. Dr. Barad is Director of Assisted Reproductive Technology and Senior Scientist at CHR.