All of your appointments, injections, procedures, and tests have brought us to this moment: Transfer Day! The entire process, from your first appointment to the pregnancy test takes about 4 weeks. Here’s a step-by-step guide to help you understand what’s ahead and how to prepare.

Preparing for Transfer

Preparation is key, ensuring all labs, procedures, and tests are completed beforehand. Here’s what you need to do, along with our medical team’s action items, to keep everything on track.

If you are planning for a Frozen Embryo Transfer outside of an IVF cycle, consider budgeting $10,200 plus medication costs.

What YOU’LL Do

Here are your action items:

Tell Us When Your Period Starts

As soon as your period begins, email Dr. Aimee with the subject line, “Transfer: My period started today!”

Confirm Your Transfer Calendar

Dr. Aimee will email you a personalized calendar with key dates for your transfer. Keep in mind that your Transfer Day is tentative and might change based on observations during appointments and your body’s response to medication, so please keep your schedule flexible.

Sample Calendar:

Note: This is a sample timeline and may vary based on individual treatment plans and monitoring results.

Order Your Medications

Dr. Aimee will give you a list of meds to order, customized to your cycle type: Modified Natural Cycle FET, Controlled Cycle FET, or Fresh Transfer. Here’s what you might need based on each cycle type:

We recommend Alto Pharmacy if you’re within their courier delivery zone. Other specialty pharmacies that ship nationwide are MDR, Freedom Fertility, and VFP. Please note that we can’t send IVF prescriptions to local pharmacies like CVS or Walgreens.

For at-home concierge services, such as daily injection assistance, contact BayPLS.

What WE’LL Do

Our medical team handles the following to ensure you’re ready for transfer:

Labs Results

We’ll check to ensure your ID Labs have been completed within the past two years, and Preconception Labs within the past 12 months. If not, we’ll schedule them for you. Here’s what we need:

• Infectious Diseases (ID): Tests for Hepatitis B surface antigen (HBsAg), Hepatitis C virus antibody (HCV Ab), Human Immunodeficiency Virus antibody (HIV Ab), Human T-lymphotropic virus antibody (HTLV), and Treponema antibody to identify any existing infections in both partners.

• Preconception Health: Tests for Thyroid-stimulating hormone (TSH), Vitamin D levels, Prolactin levels, Complete Blood Count (CBC), Rh factor, ABO blood type, Measles, Mumps, and Rubella titer (MMR titer), Varicella titer, and Antibody Screen to evaluate overall health and fertility in both partners.

Genetic Testing

If you haven’t completed genetic testing, we’ll ensure that you do carrier screening and chromosome analysis. Partners will also need to complete these tests.

• Carrier Screening: Identifies genetic mutations that could be passed on to your baby, such as cystic fibrosis, spinal muscular atrophy, or fragile X syndrome.

• Chromosome Analysis: Detects chromosomal abnormalities such as translocations, inversions, or aneuploidies. (e.g., Down syndrome).

ExEm Foam  / HSG / SIS Procedure

We’ll check to see that you’ve completed one of these procedures within the past six months. If not, Dr. Aimee will determine which one is best for you. These are typically done during Cycle Days 8-10, unless you’re on birth control, in which they can be done anytime.

• ExEm Foam: A less invasive and effective tubal patency assessment performed at Dr. Aimee’s office.
• HSG (Hysterosalpingogram): An X-ray test that outlines the internal shape of the uterus and checks if the fallopian tubes are blocked.
• SIS (Saline Infusion Sonography): A procedure to evaluate the lining of the uterus and the shape of the uterine cavity.

Carrier Screening 

If you’ve previously done IVF with another doctor, we’ll review your carrier screening report, as well as your partner’s. We want to ensure the number of genes screened matches the latest expanded panels, like the Invitae Comprehensive Carrier Screen 569. If it doesn’t, we’ll arrange for you to complete the additional testing.

We’ll also check if you and your partner have any common mutations. If you do, we’ll ask that you speak to a genetic counselor to help you understand the implications.

PGT + Embryology Reports

We’ll gather all of your PGT + Embryology Reports in order for Dr. Aimee to recommend the best embryo for transfer.

Surrogate or Gestational Carrier (if applicable)

If you’re using a surrogate or gestational carrier, we’ll prepare the required FDA Report and Summary of Records (SOR) and send it to the designated lab.

Pre-Scan Appointment

Held 3 weeks before the transfer date, this is an important appointment where we’ll not only perform an ultrasound and blood work, but coordinate the details of your transfer with you.

• Ultrasound and Blood Work: You’ll visit our central office for an ultrasound and blood draw to measure Estradiol (E2) and Progesterone (P4) to capture your baseline hormone levels. If you’re missing ID, Precon Labs, or carrier screening tests, we’ll do them during this appointment. 

• Embryo Selection: Dr. Aimee will discuss the embryo selection criteria with you.
  • How many embryos would you like to transfer? Dr. Aimee recommends one at a time.
  • Do you have a gender preference, or would you rather not know?
  • Based on the quality of embryos, which specific embryo should we transfer?

• Embryo Move (if applicable): If the embryo is at another facility or egg bank, we’ll work with you to coordinate its move to the facility where your transfer will take place.

• Lab Order Consent Form: You’ll verify the completed order form and sign it. We’ll send it to our partnering clinic to schedule your transfer.

Start Medication

• Follow your personalized calendar for the medication protocol. If you have questions, ask Dr. Aimee or your assigned nurse.

Follicle Check Appointment

Held a week before your transfer date, this appointment determines whether your transfer date remains the same or requires adjustment.

• Ultrasound and Blood Work: We’ll do an ultrasound and blood draw to assess your current hormone levels. 

• Transfer Medication Table: Using the ultrasound results, Dr. Aimee will personalize your medication dosages and review your Medication Table with you.

Sample Medication Table:

Note: This is a sample medication table and may vary based on individual treatment plans and monitoring results.

• Trigger Shot: You might take your trigger shot in the evening, depending on the results. Dr. Aimee will send you detailed instructions, so be on the lookout for an email from her!

Transfer Date Confirmed

• Transfer Date. The evening of or the next day after your Follicle Check Appointment, we’ll confirm if the transfer date stays the same or needs to be changed. Dr. Aimee will email you with the final transfer date. If it changes, we’ll update your medication table and give you new instructions.

• Transfer Time. Two days before your Transfer Date, you’ll receive an email from Dr. Aimee confirming the transfer time with instructions. Transfers generally take place in the mornings.

Transfer Day!

It’s here! Transfer usually takes place in the mornings at our clinic in San Ramon, Ca. To make the most of Transfer Day, follow the instructions below. The instructions are also in Dr. Aimee’s email to you.

• Have a Driver. Arrange for someone to drive you to and from the clinic.

• Stay Hydrated. Two hours before your appointment, drink three 8-ounce glasses of water. You want to have a full bladder, but not so full you can’t hold it for 45 minutes. You can eat or drink whatever you like.

• Take a Valium. 30 minutes before the appointment, take one Valium (aka Diazepam) to relax your uterus. This is why you need a driver.

• The Procedure. The transfer is quick and gentle. Afterward, rest for 5 minutes, and then you can empty your bladder.

• Progesterone. If you’re using vaginal progesterone, bring an extra insert to use after the transfer.

• Consider Acupuncture. Acupuncture can be beneficial before and after the transfer, though not required.

Continue Taking Your Medications

• It’s extremely important to follow the prescribed dosing and timing of your progesterone. Progesterone is crucial to the continuation of a pregnancy. Completely missing a dose (being a little late is okay) can result in unexpected bleeding and miscarriage.

Want even more tips? Read Dr. Aimee’s post-transfer checklist!

Pregnancy Test

The wait between your embryo transfer and the pregnancy test is often the hardest part of the process. On the 8th Day Post Transfer (8DP) you’ll do your blood pregnancy test, also known as a Beta test, to measure your hCG and progesterone levels.

• Read Dr. Aimee tips for keeping your sanity during this time! 

• When you’re ready for your pregnancy test, here are your options:
  • Visit your nearest Quest or Labcorp lab. For insurance billing, download this Lab Form, fill it out, and take it with you. Be sure to book an appointment online, as they might not accept walk-ins.
  • If you’re a Kaiser patient or prefer to pay cash, let us know.
  • You can also come to our San Ramon office for the blood draw .

After your test, email us so we can follow up on your results, which typically comes back within one day. We’ll contact you with your results and discuss the next steps.

Regardless of the outcome, Dr. Aimee and our team are here to support you on the next step of your journey!