The natural cycle in embryo transfer

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One of the most frequent activities in any fertility clinic or reproduction unit is the transfer of cryopreserved embryos, which represents about 20% of the work done in these centers.

Below you have an index with all the points that we will discuss in this article.

Index

The natural cycle in embryo transfer

Factors to transfer an embryo

At the moment of transferring an embryo to the maternal uterus, it is necessary to take into account a series of parameters that must be controlled to optimize the reproductive process and ultimately guarantee a correct pregnancy at term:

  • Maternal age at the time of embryo cryopreservation
  • Cause of infertility
  • Embryonic quality
  • Embryo freeze-thaw technique used
  • Optimization of the endometrium at the moment of transferring the embryo to the uterus
Transfer of vitrified embryos

Natural cycle vs substituted cycle

For this last factor there are different strategies that can be classified into two large groups or cycles:

In the natural cycle, the normal endometrial cycle is used due to the effect of endogenous estrogens and progesterone secreted by the follicle, synthesized by the spontaneous ovarian cycle in cases where it remains preserved.

The other option is the substituted cycle, in which the endometrium is prepared by exogenous estrogen administration to better control growth and optimize its conditions for transfer.

How to prepare the endometrium

Some researchers favor the use of natural cycles to achieve an "adequate and receptive" endometrium since, a priori, a higher proportion of pregnancies is achieved compared to those achieved as a result of the replaced cycles, even with low levels of estradiol (estrogen predominant in the woman's reproductive years) and equal or even greater endometrial thicknesses. Even so, there is controversy about which procedure is better to prepare the endometrium once the embryo of cryopreserved or donated origin has been transferred, a fact that has led to the consideration of techniques such as the measurement of the endometrial ultrasound thickness, in order to achieve a greater reproductive success.

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