My husband and I started our IVF journey almost exactly one year ago, and while it took longer than we had hoped, we are finally pregnant! We did one egg retrieval (you can read my post on that here) and 3 frozen embryo transfers. I learned SO much throughout this process and wanted to share some thoughts, tips, and what we did differently the round that was successful.

Please Note: I am not a medical professional; this post is a reflection of my own personal experience and is not intended to be taken as medical advice. Always consult with your doctor or medical professionals with any questions, or before implementing any changes.

Frozen Embryo Transfer Prep:

At my fertility clinic, the “prep” time for each FET is about 8 weeks. I didn’t make any crazy lifestyle changes, but during this time (just like my egg retrieval prep) I focused on maintaining a healthy lifestyle.

• Having a well balanced, nutrient dense diet: Lots of eggs, avocado, berries, greek yogurt, leafy greens, vegetables, wild caught salmon, whole grains, nuts, and all the other “fertility foods.” I mostly cut out alcohol (I did have a glass of red wine on occasion) and limited caffeine to one cup of coffee a day. I also tried to have plenty of warm food and drinks like soup, bone broth, and hot tea. Apparently warm food = warm uterus which (supposedly) helps with implantation. I also read that red raspberry leaf tea helps with thickening the uterine lining, so I had a cup of that here or there (stopping after my transfer.)
• Exercise: I focused on low impact movement, like walking and yoga. Both are great for blood circulation, and won’t spike your cortisol. I tried to walk 1-3 miles per day!
• Prioritizing sleep: Sleep is incredibly important – one of the best things you can do for your health is getting enough sleep!! I make sure to prioritize my night time “wind down” routine which helps me relax and fall asleep without tossing and turning. Getting into bed earlier also helps ensure I go to sleep earlier, and I really try to sleep in when I am able to. I used to have the mindset of “waking up earlier will make you more productive” and I have learned that (for me at least) that is not at all true. Not only is my focus and productivity so much better when I’m well rested, but I feel better mentally and physically.
• Reducing stress: Life is stressful enough to begin with, and IVF is incredibly stressful on top of that. I really tried to focus on keeping my stress levels low while prepping for my FET. I learned from a podcast (I wish I could remember which one – sorry) that stress has a huge impact on your hormones, and can even increase inflammation (and high inflammation = not good for implantation.) So do what you need to do to keep stress levels low! Take on less work projects, avoid being around toxic people or situations that make you feel anxious. Do more things that make you happy, and try not to stress over things that you have no control over!
• Reducing toxin exposure: This is something I really started to focus on when prepping for my egg retrieval last year, but it’s worth mentioning again! There is a lot of info out there on how environmental toxins affect fertility, so I try to reduce them as much as I can. As I run out of beauty or household products, I look for “clean” / non toxic alternatives to purchase next. Fragrances are known for being hormone disrupters, so instead of burning candles (which I love) I diffuse lavender oil. I quit using perfume, and swapped any plastic items around the house to glass (tupperware for example.) 
• Medication: During this prep phase, you will likely start taking hormone medication for your upcoming transfer. This will be different for everyone depending on your protocol! I started with birth control pills to suppress my hormones, and went off the birth control about 4 weeks before my transfer. A couple days after going off birth control, I started taking estrace (a pill) and slowly increased my dosage over a couple weeks. About a week before transfer, I added in progesterone in oil (injection) and you continue to take those medications until your blood pregnancy test, which is usually 9-12 days after the transfer. If the transfer is unsuccessful, you will stop all medications. If the transfer is successful, you will likely be told to continue those medications through 10 weeks of pregnancy.

PIO Tips:

FET medication will be different for everyone, but a lot of us have to do the dreaded progesterone in oil (PIO) shots in the butt. The needles are huge and intimidating, but I promise you, the shots were not bad at all. With my routine, I barely felt them. Here are my tips:

• Have someone else administer the shot if possible. It’s in an awkward spot to reach, and much easier to not look at it. If you have to do it yourself, I’ve heard that an auto injector is super helpful! My husband was happy to help with my shots each night which I am extremely thankful for, but I would have bought an auto injector if I’d had to do them myself.
• Use a lidocaine patch!! My clinic prescribed them to me, but I think you can buy them over the counter. I applied a patch to the injection site 1-2 hours before shot time, and it helped a ton. *Always check with your doctor or clinic first to make sure this is approved for you!
• Use a heating pad. Heat is your friend when it comes to PIO! The oil is thick, so warming both the shot and your muscle will help it to inject smoothly and absorb. I sat on a heating pad for 5-10 minutes before the shot, and layed the shot itself on the heating pad for a few minutes too. You don’t want it to get hot (that would hurt going in) just a little warm!
• Inject slowly! It’s a thick liquid so it will take a good 20 seconds to fully inject. Go slow and steady, don’t try to rush it.
• Keep yourself distracted during the injection. I would scroll TikTok or something on my phone to get my mind off the shot, and it was over before I knew it!
• Warm compress and massage the injection area after the shot. This helps the oil to absorb and prevent knots from forming in the muscle. The knots are worse than the shot itself, so trust me you don’t want to skip this step! Get a warm wash cloth and massage the injection area for a good 5 minutes after each shot.

Day of Transfer:

A frozen embryo transfer is a quick and painless procedure! I’m sure the process is different for each clinic, but this is my experience.

The clinic will tell you to show up with a full bladder. Having a full bladder helps to position your uterus so that the doctor can place the embryo where they want to. So drink up! They also told me to bring (or wear) socks. Not sure why, and for some reason I never thought to ask!

I was brought back to the OR section of my clinic, where I changed into a hospital gown and a lovely hair net. My husband was given a hair net and nets to cover his shoes. While we waited, the nurses had me sign some paperwork and reviewed my medications and instructions for after transfer.

Then I was brought back into a room with a typical bed with stirrups, and ultrasound machine. They used the ultrasound to make sure my bladder was full enough, and then the embryologist came out to meet with us and tell us about the embryo. They told us the grade the embryo was frozen at, and the grade it was upon thawing. They printed out a picture of the embryo, and explained what we were looking at – this was really cool! Since we did PGT (genetic) testing on our embryos, they asked if we wanted to know the gender (which we did!) So you get to find out the gender of your baby right then and there, if you want to 🙂

Then the doctor came in, and it was transfer time!! I layed back on the bed, and a nurse held the ultrasound stick on my uterus so the doctor could watch where he was transferring the embryo. He used a device to crank open my cervix (just like when you’re getting a pap smear) and then inserted a small catheter up into my uterus. This was not painful at all – actually my bladder being so full (with an ultrasound stick pressing on it) was the most uncomfortable part! Once we were in position, the embryologist (who was in a separate, but conjoined room) called out my name and birthday to verify that they had the correct embryo in hand. Once confirmed, they brought the embryo over and loaded it into the catheter. The doctor then pushed the embryo up through the catheter and into my uterus. We could watch on the ultrasound screen and see exactly where the embryo was placed, which was really cool!! I couldn’t feel anything. After the embryo was placed, the embryologist double checks the dish to make sure that it is empty, and once that is confirmed, the doctor removes the catheter and clamp, and that is it! The whole process takes only a few minutes – it is very quick!

After Transfer:

Immediately after the transfer, my clinic had me get up and get dressed/go to the bathroom. From what I’ve heard, some clinics will have you lay down for a few minutes, but my doctor said that there is no evidence of that making a difference. It is not possible for the embryo to fall out or anything like that.

Your clinic will likely give you instructions for what to do and not to do after your transfer. My instructions were:

• Take it easy the day of transfer, and back to normal activity the next day.
• No alcohol. Limit caffeine to 2 cups per day
• No hot tubs, hot baths, or anything that will affect your body temperature
• No intense workouts or anything that involves jumping or bending
• No lifting anything heavier than 10-15 lbs
• Pelvic rest (no sex) until after pregnancy test
• Continue all medications

And that’s about it! My clinic did not recommend bed rest, but I still took it easy for a few days. Luckily I was able to work from the sofa, so I spent most of the day sitting/laying. I still did chores around the house, ran errands, cooked dinner and all that – you want to keep the blood circulation going! I did not exercise for about a week after my transfer, and then I just started to take some slow walks around the neighborhood.

I read somewhere that laughing after a transfer can help increase the chance of implantation, so I made sure to have some funny movies/videos lined up to watch the day of. Not sure if that actually helps, but it can’t hurt! I was also told to eat/drink warm foods (like I mentioned earlier) to keep the uterus warm. And also to wear fuzzy socks and just keep myself warm in general.

At the end of the day I don’t think there is much you can really do that will make a difference, the embryo is either going to stick or it isn’t. But it doesn’t hurt to stay warm and laugh, so why not give it a try! I think it helped me mentally to feel like I was doing everything I could to help my chances.

What We Did Differently Our Successful Transfer

Like I mentioned earlier, we did 3 total frozen embryo transfers. The first was unsuccessful. The second was successful, but ended in an early miscarriage. The third was successful, and is my current pregnancy (now almost 18 weeks.) All transfers were with PGT normal embryos, by the way!

After my 2nd transfer, we decided to do some testing. Since this was my 2nd miscarriage I did a recurrent pregnancy loss blood panel, tested for clotting disorders, and my husband and I both had genetic testing done to see if we were carriers for any genetic conditions. I’m sure there were more tests in there that I don’t remember – it was a lot of blood work. All of that came back normal.

I also did a hysteroscopy and BCL6 testing, which is the test for endometriosis. These are minor surgeries. In addition, I did the 3 endomtrio tests (ERA, EMMA, ALICE.) This involves taking a biopsy of your uterus and testing the environment and receptivity for implantation.

For the biopsy tests, you basically do a “mock transfer.” This means that you go through the same 8 weeks (or however long) of prep and medication as you would do for an embryo transfer, but on “transfer day” you have this testing done instead of an actual transfer. Normally you are awake for this procedure, and I’ve heard it’s pretty uncomfortable. Since I was also having a hysteroscopy done (which you are under anesthesia for) they did my biopsy tests at the same time, so I was asleep. I was very thankful for that!

Not going to lie, it sucks having to spend so much time taking medication for just a test (not to mention paying for more meds) but in my case, I really do think it helped. My BCL6 test came back negative for endometriosis, but my biopsy tests were a little out of whack. We discovered that my uterus was missing some “good bacteria” so we added a probiotic to my protocol. And based on the test results, we added one extra day of PIO injections before my transfer. I also had to do my shots at a very specific time each night (9:15pm) instead of having a 2 hour window like my previous transfers. Seems like pretty small changes to make, but I guess they worked!

The other thing we did different this time was adding in intralipid infusions. This is an IV infusion, and it takes about 90 minutes. My IVF nurse brought it up as something to consider, although I’m not a typical candidate for it. Typically, intralipid infusions are used for IVF patients with diagnosed autoimmune diseases (which to my knowledge I don’t have.) My clinic had recently seen success with a couple other non-candidate patients who had tried everything else, so I decided to give it a try. The only downside was the cost (it is not covered by insurance) and the time it takes. I did my first infusion the day before my FET, and then every 4 weeks for my first trimester. So I believe there were 3 total.

There is really no way to tell what helped my 3rd transfer to stick – maybe I just got lucky on the 3rd try. But I’m very thankful that my clinic offered these tests, and was willing to give the intralipids a try. Lifestyle wise I did not do anything differently, so I do believe that these things helped to make a difference.

I have to mention McDonald’s french fries. There is an IVF superstition that eating McDonald’s french fries after an embryo transfer will help with implantation. There is zero medical reason for this, but some people swear by it. So I picked up McDonald’s fries after transfers 1 and 2, because why not.. their fries are delicious! Well that obviously didn’t work for me. After transfer 3, I picked up Chick Fil A (nuggets and fries) and that was the one that worked 🙂 I guess Chick Fil A is my lucky meal!

My heart goes out to anyone who is going through (or about to) go through IVF. It’s not easy, but it will be worth it one day. Take care of yourself throughout this process, and try to stay positive! When I get into a negative headspace, I try to remind myself that I’m so fortunate to have IVF as an option. It’s amazing what these doctors can do. You’ll learn so much, and be so grateful for every second of pregnancy when the time comes. Feel free to leave a comment below if you have any questions, or send me a DM over on Instagram 🙂