Preparing for our first Frozen Embryo Transfer (FET)
It has been a wild journey for my husband and I to get to this point but here we are, preparing for our first Frozen Embryo Transfer (FET). If you’d like to learn more about why we are doing IVF, check out our first IVF story. This has been an unexpected and emotional journey for us but we have tried to maintain a positive outlook on where life has taken us. When things get too hard for positivity, we turn to gratitude to help stabilize us through this journey. Read more about how we took some very hard situations and found things to be grateful for. From Lemons to Love >
What is a frozen embryo transfer (FET)?
A frozen embryo transfer, commonly called a FET cycle in the fertility world, is when a previously frozen embryo is transferred back into a woman’s uterus. Whether the frozen embryo came from the mother or a donor, plenty of prep work has already taken place to get to this point. The mother or donor has undergone an Egg Retrieval, and the egg was fertilized with the father’s or a donor’s sperm. Although every clinic and cycle are a bit different, typically a fertilized egg will be allowed to grow in vitro medium in the laboratory (hence, in vitro fertilization, IVF), for 3-5 days. The embryo has reached cleavage stage at 3 days and blastocyst stage at day 5. If you are freezing embryos, this is the stage at which they will be frozen for transfer at a later date. Some people choose to freeze embryos to help reduce the risk of OHSS after egg retrieval, or to perform genetic testing on the embryos. At some point, the mother is ready for the embryo to be thawed and transferred back to the uterus. This is called a Frozen Embryo Transfer, and is the last step before pregnancy for some families.
Our First FET Cycle
My husband and I are doing our first FET cycle tomorrow. It has been 5 months to the day since I had my life-saving surgery for a fallopian tube rupture, which set us on an IVF journey. We froze our embryos for both reasons listed above - I was marked as a high-risk patient for OHSS and we also wanted to do genetic testing on our embryos. Since my husband and I will be having all our children through IVF, we wanted to make sure we weren’t paying to freeze and store embryos that didn’t have the right genetics to achieve live birth. This was a personal decision based on our preferences and is not required. Read about our PGT-A testing decision. Choosing to do a frozen embryo transfer instead of a fresh transfer also gave me a few weeks of recovery time from the egg retrieval, which was much needed. The retrieval was an experience of its own - if you’re getting ready for your egg retrieval then check out my overview on egg retrieval.
My husband and I tried to have some fun with our preparation. We both ordered shirts we liked, and wore them on the day of the transfer!
Preparing Emotionally for our FET
Although my husband and I have maintained a very positive attitude towards our IVF experience, and overall a feeling of gratitude, this upcoming transfer has been a little different. I think I should be excited but am mostly fighting off anxiety and stress. Over the past week I’ve noticed that I’m avoiding the topic, even in my own head. I feel that some of the avoidance is coming from the anticipation of the dreaded two week wait (TWW), because I know I will not get any news of any sort on our transfer day. According to my thoughts leading up to this transfer, if I am not getting news then I don’t want to make it a big deal. If I get too excited, it’ll only be harder to wait for the real news. I know that we as don’t have to think and act as our emotions dictate, but this has been hard to separate.
Plenty of concentrated effort has gone into this part of our journey. I am spending time every day trying to minimize stress and anxiety by breathing slowly throughout the day, slowing down my eating, and going to yoga. The only thing that my clinic really told me is that after the transfer, I needed to minimize stress. Since it was the only guidance I really had, I ran with it! This week is our transfer week and I requested 3 of the 5 days to be work-from-home days, so that I am not exposed to unnecessary stress at the office. I took my lunch break by the pool, and made sure I was caught up at work. I spent quite a bit of time with friends over the past week which helped me stay distracted and positive. It was also nice for my husband that we went and did so many things last week because we’ve been tied to our IVF routine for a few months now. The break was needed and helped us both quite a bit.
All these things have helped us, but our big secret to lowering stress and anxiety before our first frozen embryo transfer was a two-week technology cleanse leading up to the transfer. We completely eliminated T.V., Instagram, and TikTok during those two weeks. This helped my brain really settle into a slower pace where I had less anxiety because my new after-work hobbies became reading, gardening and puzzles. I could literally feel the anxiety diminishing over those few weeks as I became less worried about what was happening next, and more focused on what was currently happening. We have all heard at some point that technology contributes to stress anxiety but separating from it really made a difference. I would not hesitate to do this same practice for our next frozen embryo transfer!
Preparing Physically for our FET
Shots! This is the first thing that most people think of when they think of IVF, and this is the part of IVF where the injections become more challenging. Many women, myself included, have to take the Progesterone in Oil injection (PIO shot), daily. This injection has a much longer needle than the needle for the egg retrieval stimulation medication, and it’s an intramuscular injection that goes in the upper part of your buttocks. Since this is my first FET, having a partner available to give the injection daily is a must. Shout out to the women out there administering these shots to themselves! You’re really out there doing it and I see you! Shout out to my husband as well - he doesn’t like needles and had to overcome that for this part of our journey. It meant a lot to me that he was willing to sacrifice a little and do something that made him uncomfortable since so much of the IVF procedure is about what the Mama has to do. Watching my husband step up to do something that he doesn’t like, every day, helped me deal with my own struggle.
Back to the shots - there are many great resources online to help with the muscle aching that comes with the PIO injection, just browse around YouTube. Personally, I’m a big fan of Dr. Lora Shahine, her resources have been so helpful for me. When it’s time to give yourself the injection, there are a lot of little tips and tricks that people use to make the shot easier. What works best for me (and was recommended by my neighbor, a seasoned IVF warrior), is to remove the weight from the leg on the side of the injection and bend over the counter to tighten the skin. After that, just breathe it out. If these injections seem to take forever - it’s because they do! My husband and I timed our injection, and it takes about 1 minute and 45 seconds to administer the shot. That seems like forever when you’re impatiently waiting for it to be over. When the needle is removed, deeply massage the injection site for 5 minutes to help spread the oil. My fourth injection burst a little blood vessel - be ready for it. It was painful and I didn’t realize it could happen even when there is no blood in the syringe initially. Both my husband and I were caught off guard and it took the day to recover. They really aren’t kidding when they say these shots are a pain in the butt!
Hormones & Side Effects
For my FET, I was given Progesterone in oil (PIO), as well as estradiol valerate. These are injections that raise your Progesterone and Estrogen levels in the body. These hormones are both produced naturally during your menstrual cycle and during pregnancy, so your symptoms should be similar to what you may experience if your having a menstrual period or are pregnant. Just like with pregnancy, I’ve read that the symptoms of these medications can vary wildly and not all women will share the same experiences. I was one of the lucky ones and have only had mild side effects from the injections so far. I can’t offer much good perspective here since everybody is different - but I will say that the cleaner I ate and better I slept - the easier the days were. I experienced mild fatigue, bloating, mild nausea, and muscle aches at the injection sites. Frequent urination also picked up for me around the time of transfer. This is not related to your pregnancy outcome - it’s the progesterone. Around this time I also increased my water intake because the clinic told me that a hydrated uterus is a sticky one. For me, increased urination was probably a combination of increased water intake and the PIO injection. Overall, it’s all survivable and if you’re looking to be prepared for your frozen embryo transfer, just know that you’ve got this.
Lifestyle Changes for my FET
This is an underrated category. So much time is spent preparing for the medication and doctor’s visits that it’s hard to make impactful changes in your life as well. Sleeping on a schedule is important to your overall health, and an embryo transfer is no different. Although I did stay out late with friends a few times in the weeks leading up to my transfer, I did make sure that most nights I was in bed at a consistent time. Sleep has the most impact on my attitude during the day, and I have more mental capacity to deal with difficult things when I get better sleep. I also cut caffeine and alcohol during the preparation for our first frozen embryo transfer. Cutting caffeine caught me off guard with the egg retrieval and I suffered through days of migraines after quitting my morning coffee cold-turkey. For the transfer I weaned off my coffee habit, reducing to every other day, then every 3-4 days, then once a week. It took me 4 weeks to slowly remove coffee from my routine and I feel very prepared for our transfer to be caffeine-free. I know that people give mixed advice on coffee and caffeine during pregnancy, and cutting caffeine was my personal choice. I can’t say that I don’t miss my morning latte!
Your First FET - You’ve Got This!
I am writing this today as much for you as I am for myself. I don’t know exactly what I think or feel going into this transfer, but I am doing my best to control variables where I can. This likely won’t be the last step in our IVF journey, but somehow I feel like we’re there. All the things we’ve gone through have already been worth what the future could hold for us, and I’m excited to see where our journey goes. If you’re headed down your own IVF path, I wish you the best of luck. WE’VE GOT THIS.
