Course / Improving Your Live Birth Rate Per Transfer
The physician who performs the embryo transfer has a critical impact on the outcome.
Even with top-quality embryos and a receptive uterus, subtle technical variations can determine whether implantation occurs.
When selecting a fertility clinic or IVF physician — particularly in surrogacy cases — Surrogacy4All advises assessing the following:
1. Experience and Transfer Volume
Choose a doctor who performs a high volume of transfers annually.
Studies show physicians who conduct hundreds of transfers per year achieve higher implantation rates due to refined technique and familiarity with variable anatomy.
2. Transfer Success Metrics
Ask your clinic:
What is the live birth rate per embryo transfer under this physician’s care?
Are results broken down by age group, embryo stage (blastocyst), and PGT-A testing?
How do their success rates compare with the SART national averages?
3. Ultrasound-Guided Technique
Ensure the doctor consistently performs ultrasound-guided transfers — the current standard of care.
This allows precise visualization of catheter placement and minimizes uterine trauma.
Blind (non-guided) transfers are less accurate and may reduce success rates.
4. Handling of Difficult Transfers
A skilled doctor should know how to manage:
Tilted cervix or uterine angle
Cervical stenosis (narrow opening)
Embryo placement depth within the uterine cavity
Proper handling reduces the risk of mechanical injury or embryo displacement.
5. Gentle Catheter Technique
The best-performing clinicians use:
Soft, flexible catheters
Smooth, controlled movements
Minimal uterine manipulation
No uterine contractions triggered during the procedure
The goal is a quiet, atraumatic transfer, ensuring the embryo is placed precisely without disrupting the uterine lining.
While much of embryo transfer success relies on biology, the clinical environment and precision of the transfer itself play a key role.
1. Optimize Timing
Transfers should align with optimal endometrial receptivity, often assessed by endometrial receptivity array (ERA) or ultrasound monitoring.
In medicated cycles, start progesterone at the exact interval that mimics natural ovulation timing.
Even a 12–24-hour deviation in progesterone exposure can reduce implantation likelihood.
2. Control the Environment
The transfer room temperature and air quality must mimic laboratory standards.
Embryo handling outside the incubator should be under one minute.
Embryologists use pre-warmed transfer media and sterile, contamination-free conditions.
At Surrogacy4All’s partner clinics, these environmental controls are strictly standardized to maintain embryo viability from lab to uterus.
3. Uterine Mapping and Cervical Assessment
Understanding the patient’s anatomy is essential for a smooth transfer.
Techniques such as:
Cervical dilation if necessary (days prior)
Trial catheter insertion (mock transfer)
Pre-transfer ultrasound scan
can prevent last-minute complications and ensure ideal catheter navigation.
4. The “Soft Landing Zone”
Clinical studies show embryos implanted in the upper-middle uterine cavity (1–1.5 cm from fundus) have the highest chance of successful implantation.
Too shallow or deep a placement can compromise outcomes.
5. Reduce Uterine Contractions
Minimize patient stress before and during the procedure.
Avoid touching the fundus or overloading the catheter.
Use slow, steady catheter withdrawal to prevent contractions.
These small adjustments significantly improve implantation rates.
A mock transfer (also known as a trial or practice transfer) is a vital, often underappreciated step.
It allows the physician to map the uterine cavity and anticipate any technical issues before the real embryo transfer.
Why It’s Important:
Identifies uterine angle, cervical bends, or scar tissue.
Ensures smooth catheter passage and correct placement depth.
Prevents difficult transfers on the actual day of implantation, which can cause trauma or contractions.
Reduces procedure time and stress for both surrogate and team.
When It’s Recommended:
First IVF or surrogacy cycle.
History of failed transfers or difficult procedures.
Prior cervical surgery, fibroids, or uterine anomalies.
At Surrogacy4All’s partner clinics, mock transfers are performed routinely before the first real transfer, ensuring predictability and safety for both the surrogate and embryo.
Select experience over convenience. A physician’s steady, practiced technique can be the difference between implantation and failure.
Always confirm ultrasound-guided transfer — it’s non-negotiable in modern fertility care.
Request a mock transfer, especially for surrogacy or complex anatomy cases.
Keep the process calm and deliberate. Minimize uterine irritation and patient movement during transfer.
Evaluate lab-to-transfer workflow. The fewer seconds an embryo spends outside incubator conditions, the higher the survival and implantation probability.
Partner with clinics that have standard operating protocols (SOPs) aligning with ASRM and SART guidelines — these ensure consistency, safety, and reproducibility.
Our job is to listen, to connect the dots between your needs, and to determine how we can best help you have your baby. If you’re asking how much does it cost for a surrogate, we’ll walk you through every step of the process to ensure there are no surprises.
To make an appointment with one of our counselors or physicians, please call (212) 661-7673 or email info@surrogacy4all.com. We look forward to hearing from you.
Surrogacy4All is a unique international surrogacy service targeted at providing state of the art IVF and surrogacy services to Intended Parents irrespective of age, sex or color, at the lowest possible cost in the world.
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