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Is there a chance that the embryo won’t implant after transfer? What do you do if that happens?

The answer is unequivocally - yes. Even in clinics with high success rates there is always a chance that the embryo won’t implant in the first embryo transfer. Even in the most exclusive clinics, with success rates of 75% and higher - there is still a likelihood of more than 20% that you will need another attempt.

When you transfer two embryos, there is a higher chance that at least one of them will implant (90% in the good clinics). I’m sure that your next question is: So why don’t they always transfer two embryos and worst-case scenario only one implants? The answer is not simple. Since there is a 70% chance that twins will implant, and a twin pregnancy requires the right surrogate, a lot of risks, disadvantages, fears (and advantages) need to be considered ahead of time, which most parents nowadays prefer not to take.

There are a few possible reasons why an embryo doesn’t implant. Perhaps it didn’t implant immediately (negative beta pregnancy result after around 10 days from the transfer), there’s a chemical pregnancy (where the test values increase but are still low, even though the body initially reacted as if implantation occurred), and of course there are various pregnancy terminations (miscarriages) that generally occur during the first trimester of the pregnancy.

The more advanced the pregnancy is around the time of its termination, the more medical procedures the surrogate will have to undergo (like an abortion, lowering the beta level to zero, D&C and conducting additional tests before planning a second embryo transfer). Sometimes the clinic’s decision or medical recommendation will be to use another surrogate for the rest of the process, out of a mutual concern for the surrogate’s welfare, and of that of the pregnancy as well.

The success rates of the clinic you chose are important for this very reason. Even if you chose an excellent clinic there’s a chance that the transfer won’t work, which will require a subsequent second transfer. Additional transfers may be included in most clinics’ financial plans, but it’s important to remember that there are always additional costs like the surrogate’s travel to and from each transfer, lost workdays, costs of tests and local screening, ongoing medical insurance, and so on. And of course, the more transfers there are, the fewer embryos you’ll have left.

It’s important to read the small print and ensure that you are protected in the plan you selected in case you need to do additional transfers, and to choose a clinic with good success rates in advance, which will make the most out of your embryos.

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