Historically, Frozen Embryo Transfer (FET) cycles required taking birth control pills, followed by about 3 weeks of daily Lupron injections, and then taking the dreaded Progesterone in Oil injections for at least 2 weeks, and if you were pregnant for 2 additional weeks. Although a FET cycle was simple compared to a fresh IVF cycle, it still involved a number of injections.
Well those days are over! A new protocol for FET cycles eliminates, in most cases, any injections at all! With the new approach, patients just call with Day 1 of full flow and they are instructed to start taking natural estrogen (Estrace) tablets the same day. A monitoring appointment is then scheduled for Day 2, 3 or 4. After taking Estrace for about 9-11 days, patients return for another monitoring appointment to check the uterine lining thickness and to be sure that they have not ovulated. Most of our patients just continue this monitoring on a weekly basis until they are ready to start their progesterone support. A small percentage of patients (< 5%) do show signs that they might ovulate in which case a daily injection of Ganirelix (ganirelix acetate, a GnRH-antagonist) is required. This is a subcutaneous injection though (tiny needle), and it is only necessary for a short period of time.
Once a patient is ready to start the progesterone support (approximately 6 days before their transfer), they only have to use Crinone Gel twice a day instead of the Progesterone in Oil injections. Just imagine – no more shots in your bum! The cycle is also shortened from approximately 6 weeks with the old protocol to only about 4 weeks with the new one. And of course the most important thing is that the success rates remain the same. So the old saying -No Pain, No Gain– doesn’t apply to FET cycles anymore!
The success rates with this (relatively) new protocol are comparable to the old protocol. At InVia Fertility Specialists, the FET pregnancy rate approximates 40%. The number will vary based on the patients age and the number of embryos transferred.
Janet Chiaramonte joined the staff of Invia Fertility as a registered nurse in 2005. Years ago (too many to count), she received her Bachelor's Degree in Psychology, and then worked for a decade at Children's Memorial Hospital in an administrative position. She always wanted to be part of the patient care side of medicine though, so she went back to school and received an Associate's Degree in Nursing.