Editing Embryo transfer (section)

== Adjunctive procedures ==
It is uncertain whether the use of mechanical closure of the cervical canal following embryo transfer has any effect.<ref name="Farquhar_2018">{{cite journal |last1=Farquhar |first1=C |last2=Marjoribanks |first2=J |title=Assisted reproductive technology: an overview of Cochrane Reviews. |journal=The Cochrane Database of Systematic Reviews |date=17 August 2018 |volume=2018 |issue=8 |pages=CD010537 |doi=10.1002/14651858.CD010537.pub5 |pmid=30117155|pmc=6953328 }}</ref>

There is considerable evidence that prolonges bed rest (more than 20 minutes) after embryo transfer is associated with reduced chances of clinical pregnancy.<ref>{{cite journal |last=Tyler |first=Bede |title=Interventions to optimize embryo transfer in women undergoing assisted conception: a comprehensive systematic review and meta-analyses |journal=Human Reproduction Update |year=2022 |volume=28 |issue=4 |pages=480–500 |doi=10.1093/humupd/dmac009|pmid=35325124 |pmc=9631462 }}</ref>

Using [[hyaluronic acid]] as an adherence medium for the embryo may increase live birth rates.<ref name="Farquhar_2018" /> There may be little or no benefit in having a full bladder, removal of cervical mucus, or flushing of the endometrial or endocervical cavity at the time of embryo transfer.<ref name="Farquhar_2018" /> Adjunctive antibiotics in the form of [[amoxicillin]] plus [[clavulanic acid]] probably does not increase the clinical pregnancy rate compared with no antibiotics.<ref name="Farquhar_2018" /> The use of Atosiban, G-CSF and hCG around the time of embryo transfer showed a trend towards increased clinical pregnancy rate.<ref>{{cite journal |last=Tyler |first=Bede |title=Interventions to optimize embryo transfer in women undergoing assisted conception: a comprehensive systematic review and meta-analyses |journal=Human Reproduction Update |year=2022 |volume=28 |issue=4 |pages=480–500 |doi=10.1093/humupd/dmac009 |pmid=35325124 |pmc=9631462 }}</ref>

For frozen-thawed embryo transfer or transfer of embryo from [[egg donation]], no previous [[Controlled ovarian hyperstimulation|ovarian hyperstimulation]] is required for the recipient before transfer, which can be performed in spontaneous ovulatory cycles. Still, various protocols exist for frozen-thawed embryo transfers as well, such as protocols with [[Controlled ovarian hyperstimulation|ovarian hyperstimulation]], protocols in which the endometrium is artificially prepared by [[estrogen]] and/or [[progesterone]]. There is some evidence that in cycles where the endometrium is artificially prepared by estrogen or progesterone, it may be beneficial to administer an additional drug that suppresses hormone production by the ovaries such as continuous administration of a [[gonadotropin releasing hormone agonist]] (GnRHa).<ref>{{cite journal |last1=Ghobara |first1=T |last2=Gelbaya |first2=TA |last3=Ayeleke |first3=RO |title=Cycle regimens for frozen-thawed embryo transfer. |journal=The Cochrane Database of Systematic Reviews |date=5 July 2017 |volume=2017 |issue=7 |pages=CD003414 |doi=10.1002/14651858.CD003414.pub3 |pmid=28675921|pmc=6483463 }}</ref> For [[egg donation]], there is evidence of a lower pregnancy rate and a higher cycle cancellation rate when the progesterone supplementation in the recipient is commenced ''prior'' to [[oocyte retrieval]] from the donor, as compared to commenced day of oocyte retrieval or the day after.<ref name=Farquhar2014 />

[[Semen|Seminal fluid]] contains several proteins that interact with epithelial cells of the [[cervix]] and [[uterus]], inducing active [[gestational immune tolerance]]. There are significantly improved outcomes when women are exposed to seminal plasma around the time of embryo transfer, with statistical significance for [[clinical pregnancy]], but not for ongoing pregnancy or [[live birth rate]]s with the limited data available.<ref name="CrawfordRay2014">{{cite journal | vauthors = Crawford G, Ray A, Gudi A, Shah A, Homburg R | title = The role of seminal plasma for improved outcomes during in vitro fertilization treatment: review of the literature and meta-analysis | journal = Human Reproduction Update | volume = 21 | issue = 2 | pages = 275–84 | date = 2014 | pmid = 25281684 | doi = 10.1093/humupd/dmu052 | doi-access = free }}</ref>