Endometrial Preparation with Substituted Cycle

 

 

 

 

 

Endometrial preparation is an essential process in assisted reproduction treatments, which aims at preparing the endometrium (the inner layer of the uterus) to receive an embryo and favour its implantation. 

It is used in cases where the embryo has already been generated in a previous cycle (cryopreserved embryo transfer), in the reception of donated embryos, or in the generation of embryos from a synchronous egg donation cycle.

This procedure can be performed using different approaches, depending on the individual needs of each patient.

In case of Substitute Cycle preparation, external hormones are used to prepare the endometrium.

This method is ideal for women with irregular cycles, who do not ovulate, or require a more precise treatment schedule.

STAGES OF THE PROCEDURE
01 Previous Tests

Medical consultation: Assessment of the patient’s clinical history and organisation of treatment.

Initial Diagnostic Tests: A general blood test is performed to assess the patient’s state of health, including relevant parameters for embryo implantation. In addition, a transvaginal ultrasound is performed to assess the uterus and uterine cavity.

02 Procedure

Medication: Oestrogens are administered to stimulate endometrial growth, followed by progesterone to stabilise the endometrium and prepare it for embryo implantation.

Monitoring: Regular ultrasound scans and, if necessary, hormone tests are carried out to ensure that the endometrium has reached the right thickness and is in optimal condition to receive the embryo.

Embryo Transfer: Once the endometrium is prepared, the embryo transfer is performed. This is a simple and generally painless procedure in which the embryo is introduced into the uterus using a catheter. It is performed in an eco-guided manner to establish the most suitable place for the transfer.

 

Procedure
03 Post-transfer

Relaxation Time: After the transfer, the woman has time to relax and process the moment.

Pregnancy Test: Approximately 10-12 days after the transfer, a pregnancy test is performed to determine if the procedure has been successful. If positive, an ultrasound is scheduled two weeks later to confirm the pregnancy.

Endometrial preparation is an essential process in assisted reproduction treatments, the aim of which is to prepare the endometrium (the inner layer of the uterus) to receive an embryo and promote its implantation.

 

WHO IS IT FOR?

It is a treatment used in cases where the embryo has already been generated in a previous cycle (cryopreserved embryo transfer), in the reception of donated embryos, or in the generation of embryos from a synchronous egg donation cycle.

Endometrial preparation in a substituted cycle allows the timing of endometrial checks and transfer to be planned in advance. Unlike the natural cycle, the substituted cycle can be used in patients with regular or irregular cycles, or non-menstrual patients.

SUCCESS RATES

The effectiveness of endometrial preparation is directly related to the quality of the embryos transferred. Success rates may vary according to individual factors (age at the time the embryos were generated, seminal quality…), but an adequate endometrial preparation maximises the chances of implantation and pregnancy.

 

FAQs

In natural cycle, the preparation follows the rhythm of the woman’s menstrual cycle. It usually takes about 4 weeks between the period and the pregnancy test.

If the endometrium does not develop properly, the doctor may adjust or change the medication or change the cycle approach (from natural to substituted or vice versa). 

Maintaining a healthy lifestyle, a balanced diet and following medical recommendations can help optimise endometrial readiness. It is important to attend all follow-up appointments and communicate any symptoms or concerns to the medical team.

Doses are not very high. The most common symptoms of taking exogenous oestrogens are gastrointestinal discomfort and headache.

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