Embryo Transfer Protocols: Which Protocol is Best? What Progesterone Is Best for an FET?

Double board certified OBGYN and REI, Dr. Natalie Crawford, discusses embryo transfer protocols and what progesterone is best for FET. The intramuscular progesterone shots can be painful but in some situations, it may be best. In this video, Dr. Crawford reviews a new study that came out and what the findings were when it comes to embryo transfer protocols.

Questions Answered:
What is an embryo transfer?
What is a fresh embryo transfer?
What does IVF look like now?
What are the types of progesterone supplementation?
What is a modified natural cycle?
What are the protocol options?
What do studies say?
In what situations should each type of progesterone be used?

Resources:
Wolfe et al. Modified natural and optimized programmed frozen embryo transfers have equivalent live birth rates: an analysis of 6,682 cycles. Fert Steril Vol 120, P80-88, July 2023.

#ivf #embryotransfer #progesterone
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Fertility doctor, Natalie Crawford, MD is a double board certified OBGYN and REI, and co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas.

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FORA FERTILITY:
715 W 34th Street, Austin, TX 78705

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Sharing fertility facts to educate women about trying to conceive, getting pregnant, ovulation, fertility treatments, IUI, IVF, becoming a doctor, life as a woman in medicine, and more.

[lw]

I cannot express how helpful and informative these videos are. Thank you so much for sharing ❤

[sbiemerful]

Great video! Thanks for breaking down the new research.

[tj]

Darn... I was really hoping I could skip PIO for my next transfer lol. I'm in the don't ovulate without a ton of meds camp so big ol needle in the backside it is. 😭 Grateful for all the science that gave me my son and hopefully a sibling for him someday. ♥️

[MJ]

This is so helpful! I lost my pregnancy at week 10 after a controlled FET. I was only on vaginal progesterone alone and I could tell it wasn’t enough which stunted the growth of the fetus.

[crunchyfrog]

My Endometrin only controlled FET that I did 16 years ago ended up working really well. I guess I got lucky. I'm not sure that I could have gotten through it if I'd had to do the PIO injections.

[SuadMohamed-wwhm]

Hi thank you for making these informative videos.
I want to know how to take both injections and suppositories together and dosage for a frozen thawed embryo transfer

[Cristina]

Can you talk about cycle synching and fertility. I’ve been researching and practicing it for over 6 months and It’s been working wonders for my cycle. I think it’s important to know that certain foods or restricting of foods can cause progesterone to tank. Anyway, would love your take ☺️

[halilimiac]

Out of curiosity, is there a “less invasive” protocol than the modified natural? Or is it the “least invasive” of the options?

[TheDotcotton]

For my upcoming FET I’m having days 1-10 oestrogen tablets 2mg x 4 per day then I go for a scan and they might adjust then I will start progesterone pessaries 200mg x 3 per day and lubion 0.25mg per day by subcutaneous injection not intramuscular? I wasn’t even told about different protocols I was just given this one.

[meghanblack_]

Would you do a natural implant if there was only two embryos? considering everything else is normal as far as the ovulation and periods are normal and no other problems?

[ginamv]

Have you ever had a patient that had intensely negative reactions to all IM progesterone (multiple types of oil)? I tried for almost a week twice - debilitating body aches, 102 degree fever, intense headaches, nausea, heart racing, couldn’t walk because injection site swelled. Am now on oral and suppository and doing well. Doc told me she had never seen this before. Would love to know if you have seen this.

[MsFlamingFlamer]

Thanks for this video! I went through 2 ERs and got 5 euploids. I then needed an open myomectomy to remove fibroids. I’m now waiting 6 months post op and my doctor wants a fully medicated FET.

[MRC]

My fet HRT emdometrium cycles are being cancelled because of leading follicle formation. My AMH is low. I have 2 PGT tested normal embryos. Could you educate or guide about the same

[jendesimone]

In the abstract, I didn't see any mention of age of the carrier. Does this mean that the parity between the 3 methods held true across all age groups?

[kzfingerprint]

Can Prometrium be used in place of Endometrin for FET with a natural or modified natural cycle?

[suzannemarie]

So for hx - I've had 4 egg retrievals and 4 failed embryo transfers and 1 additional transfer that resulted in a miscarriage during the 9th week. Previously told that I had unexplained infertility but recently underwent an exploratory lap and found extensive stage 3 endometriosis and adenomyosis which was removed by excision and then I underwent 3 months on Orlissia for estrogen down regulation. I'm prepping for a transfer of my last embryo which is a day 5, AB which has been tested normal. What transfer would you recommend? Is vaginal progesterone (Endometrin) in addition to IM progesterone better than IM progesterone alone? Is a modified natural cycle better so that less estrogen is used prior to transfer and therefore less inflammation hopefully?

[siyandamothibeli]

What about subcutaneous progesterone injections?

[kendallmcguire]

Day 5 or 6, but not 7? Aren't some slower growing?

[lanaa]

Hi doc, does multiple ivf cycles affect on liver function and increase liver enzymes? What’s the main side effects that we should be aware of when taking ivf stim medications? I’ve had 3 ivf cycles and now elevated liver enzymes، please advice. Thanks for your videos ❤

[LetsBeHealthy_]

For individuals who require progesterone supplementation, such as women undergoing fertility treatments or those with certain medical conditions, these shots can be crucial for supporting a healthy pregnancy. While the pain can be a downside, the benefits they offer in terms of hormonal balance and reproductive health can outweigh the temporary discomfort. Nicely summarized.