The procedure for embryo transfer after cryopreservation. Cryoprotocol Cryo protocols in the natural cycle reviews

On the day of replanting, there may still be several viable embryos left. Since the result of perfect implantation is known, the remaining “spare” ones are frozen (cryopreserved) so that they can be reused. The same is done in case of unexpected cancellation of the transplant due to a sharp deterioration in the patient’s health, threatening the termination of a future pregnancy. When the next attempt comes, the embryos are transferred after cryopreservation in a natural cycle or in a cycle using two types of replacement therapy.

Procedure

The process of freezing fertilized eggs at extremely low temperatures using a cryoprotectant in liquid nitrogen is called cryopreservation. Cells undergoing the procedure suspend their development, but retain the ability to further cell division after thawing. Embryological work “freezes.” In practice, freezing occurs at any stage of development.

Cryopreservation is carried out in two ways - fast and slow. The first means that complete freezing will occur in 15 minutes, the second - in several hours. The slow freezing route is considered less effective and is rarely used. The cryopreservation process is very complex. It is necessary to comply with the requirements so that during freezing there is no liquid left that will turn into ice and be able to rupture the fruit.

How are embryos thawed before cryotransfer? Before the implantation procedure begins, cryoembryos must thaw. This is done at room temperature, the flasks with the material are placed in a special environment. If the method of ultra-fast freezing (vitrification) was used, then revival also occurs in a few minutes.

Thawing of embryos during cryotransfer is carried out at least several hours before transfer. At this stage, a decision is made either on their immediate transplantation into the uterus, or their viability is still monitored. In the second option, subsequent cultivation and transfer of thawed embryos takes place. In some cases, thawed embryos grow to a blastocyst.

Specifics of the event

As described above, cryopreservation is resorted to in cases of pregnancy failure or failure in the IVF protocol.

Factors influencing the deposition of replanting, with mandatory freezing of the morula or blastocyst, include:

1. ovarian hyperstimulation syndrome that occurs during preparation;
2. the endometrium is not ready to accept the embryo, the implantation window is delayed;
3. detection of pathologies or exacerbation of the patient’s chronic diseases during the period of preparation for transplantation.

Cryopreservation is also used in matters of surrogacy. The transfer of donor thawed embryos is carried out at a suitable period for implantation in the expectant mother. It is difficult to synchronize the cycles of two women; here cryopreservation is the optimal solution.

How is cryopreserved embryos transferred? When frozen, the blastocyst membrane often becomes denser. Therefore, before transplantation, doctors usually open it to make it easier for the embryo to attach to the uterus. Hatching of embryos during cryotransfer is carried out using a laser, microneedle or acid. It has been proven that it significantly increases the chances of successful transfer of thawed embryos.

If the blastocysts were frozen, then replanting is possible within several hours after thawing; if cryopreservation was carried out at earlier stages of embryo development, then its cultivation is usually carried out for another 1 day. And then, everything is as in a standard procedure - ward, catheter, transplantation, waiting.

Preparation for the transfer of cryopreserved embryos includes collecting the necessary tests from the patient, assessing the readiness of the endometrium and the success of thawing. Sometimes, after defrosting, all the embryos die, and cryotransfer is canceled. If the mucous layer of the uterus is at an insufficient level or reasons that interfere with replantation have again emerged, transplantation of the embryos in the next cycle with re-freezing is possible. Usually, in cryoprotocols, 1 element is transplanted, but sometimes, by agreement with the patient, cryotransfer of two embryos is carried out.

Transplantation in different cycles

The transfer of cryopreserved embryos is carried out in several ways. The success of the procedure often depends on correctly selected eco tactics.

A distinctive feature of the cryoprotocol is the chance to transfer frozen embryos in a woman’s natural cycle. This is the closest process to natural conception. The egg has already been fertilized and its development has occurred; no additional hormones should be taken to stimulate endometrial growth.

From the first day of menstruation, the doctor monitors the patient’s condition, how the endometrium develops and whether the follicles are growing. Hormonal blood tests are constantly analyzed. The most suitable day in the cycle for replanting is determined - the ovulation peak and then, on average, on the 14th day it is performed. This may be followed by light luteal phase support. This version of the protocol requires the doctor to have sufficient experience to clearly determine the implantation window. In most cases, it is practiced in young women who have a constant regular cycle.

The next option is a cryoprotocol for MHT (hormone replacement therapy). It is performed both with and without pituitary gland blockade. This method allows you to control the patient’s cycle as accurately as possible, literally creating the right one.

If the protocol is carried out with a blockade, then on the 20th day of the woman’s cycle (beginning of the protocol), she is given an injection with a drug that turns off the pituitary gland. Then, with the onset of the next menstruation, estrogen is started for endometrial growth under constant monitoring using ultrasound until ovulation.

The next step is the introduction of another hormone into the body - progesterone, to maintain the luteal phase. A few days after this it is produced. The cryoprotocol without blockade differs only in that it does not contain an injection on the 20th day of the cycle of drugs that block the functioning of the pituitary gland. It starts right away with taking estrogen at the beginning of the cycle.

The cryoprotocol with ovarian stimulation is used in rare cases. If in previous IVF attempts there was no ovarian response to hormone replacement therapy, the egg did not mature and ovulation did not begin. After injections of drugs that stimulate the ovaries, at the moment when the egg has already formed, the woman is given a dose of hCG in order for ovulation to begin. After this, the embryos are transplanted after 2-3 days.

Important points

Before transferring embryos in a cryoprotocol, it is necessary to exclude such a reason for unsuccessful previous attempts as “difficult transfer”. If earlier during the transplantation process there were injuries to the cervix, bends or stenoses of the cervical canal, or there was discharge immediately after the procedure, then this could cause an unsuccessful IVF.

What is a trial transfer? If the situations described above exist in the medical history, it is recommended to undergo the so-called trial transfer. This is a procedure that imitates the entire process of real transplantation without introducing the embryo itself. It allows you to assess the degree of patency of the cervical canal, determine how the actual transfer will take place - live or under anesthesia, and outline a plan for further actions.

If there are restrictions on the patency of the catheter, hysteroscopy and bougienage (dilation of the canal and examination of the uterus) may be required.

Some clinics conduct a trial attempt directly on the day of replantation. If everything goes smoothly, then it’s a small matter.

If we talk about a woman’s feelings during a cryoprotocol, they are no different from usual. There are no additional feelings like it’s freezing or cold inside. This is all unfounded. The slightest discomfort in the abdominal area, slightly aching pain is possible. Everything as usual.

Cryopreservation has a number of advantages in further stages of the IVF protocol. If it is necessary to re-transplant, there is no need to undergo a full course of standard IVF - take enormous hormone therapy to stimulate the ovary, there is no need to perform another puncture. Accordingly, the cost of embryo transfer after cryopreservation will be lower, even taking into account the cost of freezing/thawing and storing the material.

The cryoprotocol is a successful stage in the development of embryology and reproductive science. Failures are possible here too. The embryos do not take root or do not all come to life after defrosting. The main thing remains the goal. If the cryo procedure is chosen, the transfer of 2 embryos or 1, it doesn’t matter, it is important that all future cryo embryos take root, are carried and are born healthy!

In vitro fertilization is a complementary self-reproducing technology that is used when it is impossible to get pregnant.

In common parlance, IVF is carried out in case of infertility of a woman.

To do this, an egg is removed from the female body and artificially fertilized with embryos (usually only 1-2 eggs take root), after which they remain in a test tube and are kept in it for 3-6 days.

This procedure is additional and is performed if more eggs mature and are fertilized than needed (from 4 to 6).

Most often, out of 6 healthy eggs, only 1 or 2 engraft. But sometimes 4 engraft, but this happens very rarely; the remaining embryos are frozen.

In the case of an unsuccessful cryoprotocol, cryotransfer is used after IVF in order for the biomaterial to be used in the future.

Cryotransfer after unsuccessful IVF

There are also opposite cases that were not successful. IVF may not work out the first time.

There are the following reasons for this:

1. Woman's age. The older the patient is, the less likely it is that the cryoprotocol will be successful;
2. Product quality. The embryo may be of unsatisfactory quality, which may have a negative impact on IVF with cryoembryos, and the procedure will be unsuccessful;
3. Diseases. Diseases, especially in the acute stage, can negatively affect the course of the procedure;
4. Poorly selected stimulation. You need to choose the right drug and dose;
5. Increased physical activity. After cryotransfer, you should never overexert yourself. Light walks in the fresh air will have a positive effect.

If these rules are followed, the IVF cryo protocol will be successful. Otherwise, the procedure will need to be repeated, but after some time, so that the body is not stressed.

Cryo transfer after IVF is impossible without one of the main components of the procedure – sperm. Sperm cryopreservation is carried out in almost all reproductive centers.

After the sperm cryopreservation procedure, the frozen product is left in the sperm bank.

There it can be stored for a long time, preserving all the vital qualities of the sperm.

Sperm cryopreservation is carried out with the aim of informing the population that it is currently possible to freeze male reproductive cells for a long time without causing harm.

Sperm cryopreservation is performed in the following cases:

1. Treatment of any organ. The procedure is carried out because thirty percent of men remain infertile after cancer treatment;
2. A type of human activity that involves heavy physical exertion. When playing various sports, the genital organs of athletes may be damaged, after which they may remain infertile, which is why sperm cryopreservation is recommended;
3. Operations on the genital organs. Men with diseases that can only be cured by surgery often remain infertile after surgery, so sperm cryopreservation is necessary for them;
4. For spinal cord injuries. The reason is the same as in the second case.

Cryo in a natural cycle

This is the most popular type of treatment. IVF natural cryo cycle is the best among other types of IVF cryo embryos for the female body, since the preparation of the uterine cavity for implantation of embryos into it occurs in a natural and measured rhythm.

In this cryoprotocol, drugs are prescribed only in small quantities and in only one of the phases than in other IVF cryo-embryos.

The cryoprotocol in a natural cycle is performed only by a highly qualified specialist who has extensive experience behind him.

The most common difficulty that arises with this type of cryoprotocol is a mistake in establishing the timing of ovulation.

If a specialist makes a mistake in this, then the results and the procedure may be reduced to zero. This type of cryoprotocol is most often prescribed only to women with a regular menstrual cycle and normalized ovulation.

Pregnancy after cryotransfer

Signs of pregnancy after cryotransfer:

• Bleeding. This seems to be a normal consequence of embryos being implanted in a woman's uterine cavity, so there is no need to worry about it. This is a normal reaction of the body;
• Nausea and pain in the abdomen and lower back. These symptoms are also common reactions of the body to embryo transfer;
• Dizziness. They can be caused by hormonal therapy or psychological stress that a woman may experience at first;
• Breast enlargement or swelling. This is also a common reflex to estrogen and progesterone, which can cause swelling and enlargement by retaining fluid in the body;
• Emotional discomfort. It includes stress, anxiety, and feelings of uncertainty. These signs are common in the first days after a woman undergoes cryo transfer after IVF.

These symptoms are the most common consequences of in vitro fertilization and should not be alarmed. But if the patient is very concerned about these signs, then she should consult a specialist in order to avoid negative consequences.

Also, you should rest as much as possible in the first two to three weeks, since the body needs it.

All the above-mentioned signs are mediocre symptoms of pregnancy after cryotransfer, they are primary, occurring in the first fourteen days after cryotransfer. If these symptoms remain the same after fifteen days, then, presumably, the cryoprotocol was successful.

But to be one hundred percent sure of this, it is imperative to take a test for human chorionic gonadotropin (hCG).

It determines the human hormone protein produced by chorionic cells during pregnancy. With a positive IVF cryotransfer, the hCG level is 100 mU/ml higher than usual.

But the result of IVF cryotransfer is positive only in half of the cases. Then the next question arises: “When is cryotransfer done after unsuccessful IVF?”

It is necessary to wait several months, in some cases a year, so that the woman’s body can recover properly.

After these several months, you should make an appointment with a specialist again and undergo an examination and pass all the necessary tests.

If the doctor announces that the body has returned to normal, only then will it be possible to sign up for repeat IVF. Otherwise you will have to wait some more time.

Also, patients may have a question: “On what day is embryo cryopreservation performed?” and “On what day of the cycle is cryopreservation performed?”

Answers to these two questions can only be given to a woman by a specialist who has undertaken the procedure, based on the results of tests taken from the patient.

Video: Cryotransfer after IVF

Conclusion

In vitro fertilization is a long-term and promising procedure through which couples who are infertile can have children. Although in half of the cases the procedure is unsuccessful, you should not admit defeat. The main thing is to be patient and not give up halfway, then the dream of a happy family with children will turn into reality!

There are several methods to combat female infertility, including cryotransfer. On what day of the monthly cycle is the procedure performed, what it is and what the features of the in vitro fertilization process depend on must be considered in its entirety. The article will give a detailed answer to all these questions based on women’s experience and medical data.

Description of the method

Cryopreservation is the process of freezing biological material with the subsequent possibility of restoring its functions after thawing.

Embryologists distinguish two methods for carrying out this procedure:

• slow freezing program;
• vitrification (almost instantly).

In the first case, the temperature decrease occurs gradually. But most clinics offer their clients the fast method due to the higher chance of maintaining cell quality at the original level.

When to resort to the procedure

Cryo or cryotransfer is an additional procedure within IVF, which is carried out:

• in case of a large number of excellent embryos after the first replanting;
• when parents plan to have a child in a few years;
• if there are contraindications for embryo transfer this month;
• if the patient has already had cases of unsuccessful fertilization;
• if specialists decide to accumulate eggs over several months;
• when there is a risk of frozen pregnancy.

If a woman received one or two blastocysts during IVF, then it makes sense to freeze the rest, so as not to resort to puncture later, and also after an unsuccessful procedure.

How to choose a day for cryotransfer

On what day of the cycle the frozen embryos are transferred depends on the chosen cryoprotocol:

• use of hormone replacement therapy;
• upon stimulation.

The best option is transfer in the first case, but sometimes it is necessary to resort to drugs and additional techniques so that the female body is as ready as possible for embryo transfer.

For each woman, the date of the transfer is determined individually and depends on age, the onset of ovulation and the condition of the uterine mucosa.

Doctors' opinion

In the medical field, there is the concept of an implantation window. It is by this method that experts determine on what day of the cycle the embryo is transferred in a cryoprotocol.

This is a unique period of time when there is a chance for successful implantation of cryoembryos into the endometrium of the uterus. With a normal menstrual schedule, this period falls 6-8 days after the start of female ovulation. Next, the body launches certain processes of interaction between the cells of the fertilized egg and endometrial receptors.

The longest duration of the implantation window for transfer is observed in EC.

With stimulation, the situation is the opposite. The most unexpected things happen during hormone replacement therapy:

• bias;
• inferiority of the AI;
• unpreparedness of the endometrium (low sensitivity of receptors).

That is why only a doctor can determine the most appropriate period for blastocyst transfer. If the clinic chooses the wrong time, the chance of successful implantation of the fertilized egg is significantly reduced.

Transfer without HRT

On what day of the female cycle is cryopreservation performed in a natural cycle depends on the age of the fertilized eggs:

• three-day period - 3 days after a positive ovulation test;
• five-day period (blastocytes) – 5 days after ovulation.

The transfer of cryoembryos is carried out under the most natural conditions possible. There is no need to use hormonal drugs. From drug support, a slight effect on the luteal phase can be identified.
The protocol has the following features:

Start

The reproductive specialist prescribes an ultrasound scan for the patient (1 day) to study the condition of the endometrium and the activity of the ovaries.

Before ovulation

A woman donates blood and urine for tests. If the test does not confirm the maturation of the follicle, then minor stimulation is performed.

After ovulation

A few days after ovulation is confirmed, the transfer procedure is carried out. Sometimes light luteal phase support is prescribed.

The main problem with this method is the difficulty of determining the exact period of readiness of the follicle. Therefore, eggs are implanted using this protocol only in healthy patients who have virtually no problems with phases or the endometrium. Otherwise, there is a possibility of incorrectly determining the transfer date.

Procedure using hormones

The cryoprotocol for HRT is used for embryo transfer when there is a need not only to control, but also to create the necessary conditions in the patient’s body.

Before determining on what day of the menstrual cycle cryoembryos are transferred in this case, it is necessary to find out the type of procedure. This transfer is made in the following situations:

• irregular menstruation;
• there is no natural ovulation;
• lack of follicles (low ovular reserve);
• ovaries removed.

Can be carried out in two options:

• with blockade of the pituitary gland;
• only hormonal support.

In the first case, the onset of ovulation occurs in the first 24 hours of taking progesterone.

With conventional HRT without blockade, everything happens as follows:

1. Monitoring endometrial growth and taking estrogen from the first day.
2. When the endometrium acquires the desired structure and thickness, the doctor prescribes progesterones.
3. Next, the embryos are transferred to the uterine cavity, depending on the stage of development at which cryopreservation took place (third or fifth day).
4. After embryo transfer, the doctor prescribes an individual course of maintenance therapy for fetal development.

Stimulation

During this protocol, the transfer procedure is possible only after ovulation has been stimulated with a small amount of gonadotropins.

It is prescribed immediately in the following situations:

• immature endometrium with EC;
• poor structure and thickness of the uterine mucosa due to hormones.

It happens according to the following scheme:

• the doctor is observing the patient;
• Ultrasound examines the follicle and endometrium;
• if the follicle size is 18 mm or more, an injection of hCG is prescribed.

In this case, on what day of the cycle the embryo cryopreservation is performed is determined by the doctor. Most often, 4-5 days after the injection, thawed blastocysts are already transferred.

For the procedure to be successful, girls should adhere to the following recommendations:

• complete refusal of sex until the permission of the attending physician;
• sufficient fluid intake, especially in the morning;
• complete physical and psycho-emotional peace;
• enriching the diet with plant and animal protein;
• full compliance with the instructions of the reproductologist.

A woman who is faced with the problem of conception needs to listen to her doctor. Only a specialist can accurately determine the date for transplantation. You cannot be equal to other patients who leave comments on a website or forum. It is much more important to find an embryologist with sufficient experience and knowledge.

A successful cryoprotocol: reviews and questions about embryo cryotransfer

The IVF (in vitro fertilization) procedure has been used for decades. During this time, more than a million children were born in this way, and according to some estimates there are five million of them. There are two known variants of this procedure: “fresh” transfer and cryopreservation of embryos. The second option is often prescribed for repeated attempts, with thin endometrium. And here the question arises, how often is a successful cryoprotocol obtained?

A little about embryo cryotransfer: advantages and disadvantages

There are successful cryoprotocols in all three options. The main thing is that the best one for a particular woman is chosen.

Reviews about the cryoprotocol

There are quite a lot of successful cryoprotocols. This is evidenced by the reviews of women who have completed them.

Women who come for IVF cryoprocedures are called “snowflakes.” Not all of them survive after defrosting. This reduces the effectiveness of the procedure itself. But there are many cases where this is exactly the case, and not after a “fresh” protocol, a positive result is obtained.

Here are the stories of women who have had successful cryoprotocols.

Maria:“I didn’t have a fresh transfer, just cryo. And it worked the first time. Luck is now lying in the crib and tormenting the rattles.”

Larisa:“My hell lasted six years. And over these many years, my timid and timid “I want a child!” became a cry from the soul and turned into the leitmotif of my whole life, radically changing me and my consciousness...

The appendicitis that I suffered as a child was complicated by peritonitis. Because of it, adhesions arose, including in both pipes. Neither traditional nor non-traditional treatment yielded results... Only IVF remained as the only chance... And although this is not yet a complete success, there is a 30-40 percent chance of it.

... My husband and I went to one of the best clinics we found in Ukraine. There were only good reviews about her. ...Then, 17 embryos were successfully obtained, three of which were implanted in me... I really felt that they were in me, I talked to them, sang lullabies. There was such a strong desire!.. But, alas, it didn’t work out. There were tears, disappointments, and then we went to the clinic again. And again they implanted 3 embryos, already cryopreserved, and again it misfired.

… For the third time I was already driving pessimistically, with my hands down and almost absolutely sure that nothing would come of it, but I still wanted to take another chance. They implanted 4 embryos in me, then there were difficult two weeks... But those moments when I first saw two stripes were more trembling than, probably, the first kiss!.. I went (ran) for an ultrasound and there was confirmation: “Yes, you pregnant, one embryo, favorably located.”

Our son was born. I look at him and it’s as if all this didn’t happen to me, and continues to happen...”

As you can see, there are successful IVF cryo protocols, although there are often cases when everything does not work out the first or even the second time. Some women undergo the procedure three, four, or more times.

Some questions that arise

Effectiveness of cryotransfer

Women who are offered a cryoprotocol have many questions. And the first of them is how effective it is. There are two opinions on this matter among doctors and in the literature. One opinion is that the effectiveness of the “fresh” procedure is the same. The second opinion is that cryoprocedure is less effective. If you look at the reviews about cryo IVF, there are quite a lot of positive ones. And sometimes it is after cryotransfer that a long-awaited pregnancy occurs. Statistics of cryoprotocols say that their effectiveness is about 70% of conventional ones. But this is also very good.

For a woman’s body, cryotransfer is more gentle, since the procedure is no longer carried out, although hormonal support is required here.

Health of children born after cryoprotocol

The second question that arises is: how healthy and healthy will children be conceived from embryos that have been cryofrozen?

These studies exist. Statistics after cryoprotocols say that, in principle, these children are practically no different from those conceived naturally. In addition, they are examined more often and their health is monitored more closely. This applies to everyone. And sometimes this is precisely what explains the statistics of detection of a greater number of certain diseases in them. As for cryo IVF, reviews say that the children sometimes turn out even healthier and more talented. After all, an embryo that has undergone freezing and thawing turns out to be stronger.

The only thing you need to understand is that children born through in vitro fertilization, including after successful cryo IVF protocols, are like any other, and may have problems with childbearing and a predisposition to certain diseases. It’s difficult to get away from this, but there are diagnostic methods that allow you to avoid troubles in the future.

...Many women have taken advantage of the possibilities of modern technologies to become mothers, and there are quite a few of them who have had a successful cryoprotocol. Their reviews and memories of how everything worked out for them are inspiring.

Here's a review Nellie from Israel, who has already given birth to several children using IVF: “Many of my close friends. And, you know, they are all the same, in terms of development, there is no particular difference between them. And all the pregnancies, all the times, were good, and our babies were born healthy.”

In Israel, there is a free government program that allows couples to use the IVF procedure. In Russia, quotas from the state are now issued for this.

In the reviews of women who have undergone a successful cryoprotocol, as well as those who have not yet become pregnant, one can read joy and disappointment, as well as an even greater will to win and an unbridled desire to experience the happiness of motherhood. And no matter what they say about IVF, this is a chance, even if sometimes small, for those who cannot conceive a child naturally, but really want their little miracle child, his blood and continuation to become a reality.

It is important for women who are preparing to transfer frozen embryos, as well as for patients who want to prepare genetic material in advance, to know how the cryoprotocol works and what it is. Cryoprotocol is a type of IVF that allows a childless couple to become parents. The procedure is recognized as the most modern and progressive tactics for treating female and male infertility.

The cryoprotocol is essentially the same in vitro fertilization, which involves the transfer of finished embryos into the uterine cavity. The only difference is the preliminary freezing of the embryos. It is performed after all points of the artificial insemination algorithm have been completed.

The IVF cryoprotocol is a unique procedure that allows a woman to become pregnant and give birth to a child even after the decline of reproductive function. The procedure is carried out only in those clinics that have conditions for storing frozen embryos. Moreover, the “shelf life” of cells is not limited by time. Only the best and highest quality cells are selected for processing, and this allows for the preservation of 70% of the genetic material after defrosting.

A couple can enter into a cryoprotocol and become biological parents of their child only with prior advance donation of genetic material.

Pros and cons of the cryoprotocol

Like any medical procedure, cryo during IVF has its advantages and disadvantages. If you do not delve into the specifics of the procedure, you can assume that the likelihood of success of in vitro fertilization with preliminary freezing of embryos is lower, because not all cells survive after such treatment. However, this opinion is erroneous. The only disadvantages of this ART method are the high cost and risks, because the survival rate of embryos during IVF with preliminary freezing and thawing is lower.

The advantages of the cryoprotocol include the following points:

According to the statistics of IVF cryoprotocols, this technique is more effective than the standard procedure. Embryos are transferred on the day of the cycle intended for implantation, when the endometrium is most mature. The highest quality embryos are selected for freezing. The procedure of cooling and subsequent recovery itself is a kind of natural selection in which only the strongest cells survive.

Types of cryoprotocols

In accordance with the individual characteristics of the female body and her state of health, the type of cryoprotocol is determined. An individual technique using medications is developed for each patient. There are no absolutely identical protocols, but they can all be classified into two forms:

1. cryoprotocol for HRT (assumes complete control over the functioning of the gonads with blocking of the pituitary gland);
2. cryoprotocol in a natural cycle (requires careful monitoring of the behavior of the ovaries so as not to miss the right moment for embryo transfer).

In a natural cycle

The cryoprotocol in the natural cycle (NC) is intended only for women with normal hormonal levels, regular ovulation and stable menstruation. Otherwise, it will be impossible to predict how the reproductive system will behave in the in vitro fertilization protocol. Even a stressful situation, which is normally experienced by every woman who decides to use ART methods, can affect the stability of hormonal levels.

Cryotransfer in the natural cycle involves preliminary observation of the behavior of the follicles and endometrium from the moment of completion of menstruation. In accordance with the growth rate of Graaf's vesicle, the patient is prescribed a dynamic pelvic ultrasound. When the follicle is ready to ovulate, the woman performs an ovulation test. Progesterone support begins 1-2 days after receiving a positive result. Embryo transfer is carried out 3-5 days after ovulation in the EC.

On HRT

The cryoprotocol for HRT (hormone replacement therapy) involves preliminary preparation for the patient. When compared with a procedure in a natural cycle, this type of technique will be more expensive in monetary terms and more difficult in a physical sense. However, the chances are higher in such a protocol. Cryotransfer with preliminary hormonal correction is recommended for women with an unstable menstrual cycle, hormone-dependent diseases (fibroids, PCOS, endometriosis), as well as patients with declining reproductive function.

The long cryoprotocol starts on days 20-22 of the menstrual cycle with the introduction of an injection of hormonal blockade of the pituitary gland. In the future, all processes that will occur in the pelvic cavity with the ovaries and uterus become controlled by reproductive specialists and embryologists. A woman is prescribed an individual regimen that involves stimulation of ovulation and maturation of the functional layer of the uterus (endometrium).

When the follicles reach the required size and are ready to open, drugs are used to promote this process. As a rule, puncture is not performed in the cryoprotocol. Hormone replacement therapy after ovulation involves the use of drugs to maintain proper progesterone levels. The transfer of cryopreserved embryos is carried out over the next 5 days.

Stages of cryotransfer

The algorithm for performing the cryoprotocol completely depends on the chosen form of manipulation. The final decision always remains with the fertility specialist, despite the fact that the woman’s wishes are also taken into account. Differentiation of forms of IVF protocols occurs in the process of preparation for the procedure.

Preparation

Before entering the protocol, a woman undergoes a detailed examination and undergoes a lot of tests. Preparation for the cryoprotocol in a cycle with stimulation involves the administration of an agonist drug in the period from 20 to 22 days from the onset of menstruation.

Read a detailed article about.

From this point on, any manipulations inherent in the reproductive system can be controlled and regulated with the help of medications. The patient is prescribed drugs that stimulate superovulation. There is no close monitoring of the condition of the endometrium, since its thickness does not play a special role in the case of subsequent freezing of the resulting embryos. To obtain eggs, the Shanghai and Japanese protocols are often followed.

How they differ from each other, read the detailed article.

Follicle puncture

The collection of eggs in the cryoprotocol provides standard rules:

• 1-2.5 days before an injection of hCG is administered;
• anesthesia is used during the manipulation process;
• puncture of the follicles is carried out under ultrasound control;
• the woman can go home 2-3 hours after the procedure.

In vitro fertilization

After obtaining the genetic material of a man and a woman, it is placed in a comfortable environment where fertilization occurs. If necessary, additional manipulations are performed, for example, intracytoplasmic injection (ICSI). Hatching after cryopreservation significantly increases the chances of successful attachment, since when temperatures change, the membrane of the embryo can become denser.

Read about IVF.

Cryopreservation and thawing

Cells can be frozen at any stage of development and division: egg, embryo during cleavage, blastocyst. Most often, a cryoprotocol is performed on 5-day-old embryos. That is, the cell is allowed to develop and divide for 5 days before freezing, to the state of a blastocyst.

When undergoing vitrification, the genetic material does not crystallize, but passes from a liquid to a glassy state. If frozen embryos were stored in a regular freezer, they would turn to ice, causing all the material to be destroyed. Cryogenic storage creates different conditions. Here, a set of cells is stored at temperatures approaching 200 degrees below zero. The cryopreservation procedure for embryos occurs very quickly, which prevents distortion of the genetic material.

The embryos are defrosted before the cells are transferred into the uterine cavity. Storage of vitrified cells can last for several decades.

Cryotransfer: on what day is it done and how?

Embryo placement after cryopreservation is carried out with their preliminary diagnosis. Preparation for cryotransfer requires an assessment of the available embryos. Cells are differentiated into 4 classes, where 1 is the best, and 4 is not suitable for transferring frozen embryos.

Using a catheter, thawed cells are delivered to the uterine cavity. Cryotransfer of embryos does not involve the use of anesthesia, as with conventional in vitro fertilization.

How to behave after embryo cryotransfer

After cryotransfer, the patient is given individual recommendations, which differ little from the requirements for a conventional IVF protocol. In the first few days, it is advisable to remain calm, and if possible, bed rest. It is necessary to eat well and consume sufficient fluid levels. It is necessary to take the hormone progesterone. If the protocol is successfully completed, maintenance medications will need to be taken for a long time.

Feelings after embryo cryotransfer

Almost all women look for signs of pregnancy after cell replantation, but most symptoms during this period turn out to be far-fetched and not real. For several days after the procedure, women felt pain in the lower back, but if the stomach feels tight after a week, they should inform the doctor about it. Feelings of nausea can be caused by the hormones used. A basal temperature of 37 degrees may be an indirect sign of a successful result. It will be possible to confirm pregnancy after cryotransfer only after 5-7 days by donating blood for hCG.

Price

The cost of cryopreservation of embryos in different regions of Russia will differ. The price includes stimulation (if it is intended) and subsequent cell freezing. According to various sources, the cost of such a procedure is 150-200 thousand rubles. If IVF was performed under compulsory medical insurance, but the couple still has embryos, they can be frozen.

How to do it, read the detailed article.

Storage time is paid for independently, and the price of the service is about 20-40 thousand rubles for six months. The price for defrosting and transferring cryopreserved embryos is 30-70 thousand.

The cost of services at private reproductive clinics may vary depending on the list of drugs used and the range of preliminary preparation.