Following normal fertilization, embryo quality is checked in the morning of Day 2 (2 days after OPU). At our center, we near exclusively perform Day 5 embryo transfer (ET), both in fresh and frozen embryo replacement (FER) cycles. For fresh ETs, there is good available evidence that Day 5 ET is associated with much better live birth rates compared to Day 3 ET while minimizing the multiple pregnancy rates, since single embryo is transferred in the majority of Day 5 ETs. If the couple has only 1-2 embryos, we may then plan Day 3 ET.
As a policy, we transfer 1 embryo in women less than 35-yr old for the first or second IVF treatment cycles. For rare patients failing to conceive with the first 2 IVF attempts, we may consider transferring two embryos. In women greater than 35-yr old, we transfer 1 or 2 embryos, following frank discussion with the couple. In pre-implantation genetic screening (PGS) cycles, female age and the number of previous failed cycles lose their importance; hence, in such cases with highly filtrated embryos, we also transfer 1 embryo. Given the high maternal and neonatal risks associated with multiple pregnancies, we are very proud of our embryo transfer policy! Good and respectful clinics transfer single embryo with high live birth rates!     
We have a very successful cryopreservation program for surplus embryos. We, currently, only freeze on Day 5 or 6 (5-6 days after OPU). Following thawing, the survival rate is around 98% and our pregnancy rates in FER cycles is comparable to fresh Day 5 ET cycles, around 64%. 
The procedure of ET is done under ultrasonographic guidance will full bladder and it takes about 3-4 minutes. The two main reasons for full bladder is motorization of the entire process with trans-abdominal ultrasonography as well as the easiness of the transfer procedure due to the positioning of the entrance way to the uterus. To perform ET, a speculum, an examination tool during routine vaginal examination, is introduced into the vagina and cervix is cleaned with sterile medium. A trial test is performed to map the entrance to the cavity. Thereafter, once the trial test is complete, the embryologist brings the embryo-loaded catheter and the embryos are deposited into the middle of the uterine cavity under ultrasonographic guidance. ET is totally a painless and very quick procedure.
Following ET, our patients rest for around 1-hr at our Center. Although not based on scientific evidence, we tell our patients to take it easy and have some bed rest for 2-3 days following ET. For those patients that are coming abroad, they may fly back home 1-2 days after ET.

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