No. All transfer and biopsy dates are tentative. Transfer dates are determined by how your endometrial lining responds to medications during monitoring checks and when your CD1 arrives.

If your transfer date shifts due to lining development or CD1 timing, another clinic provider will perform the transfer. Your overall cycle management and treatment plan remain under your provider’s direction.

If having your primary doctor perform the transfer is mandatory for you, contact the FET coordinators to see if an adjusted cycle timeline is possible.

PGT-A results take approximately 3 weeks from retrieval. If results are not available when PIO is scheduled to start, your transfer calendar may be delayed or canceled.

Moving a transfer date back simply means your uterine lining requires a few additional days of estrogen exposure to reach optimal thickness and triple-line (trilaminar) structure. All subsequent milestones (PIO start, antibiotics, transfer appointment) shift back by the exact same number of days.

*Depending on provider availability, your transfer may be covered by another provider at our clinic.

Depending on when this happens during the transfer calendar, next steps include, but are not limited to:

• Estrace is reduced to 2 tablets twice daily (any other forms of estrogen supplementation will be given specific instructions) with oral Provera or Prometrium nightly with dinner for 10 days to induce a withdrawal bleed.
  OR
• Switched to birth control to realign with our transfer calendar.

Full menstrual flow will arrive 3 to 5 days after the last Provera dose, allowing you to restart a fresh cycle (often utilizing transdermal patches or alternative protocols).

In accordance with American Society for Reproductive Medicine (ASRM) guidelines, the clinic practices Single Embryo Transfer (SET) to ensure optimal success rates while avoiding the high maternal and fetal risks associated with twin or multiple pregnancies.

Under the most current ASRM guidance (which you are welcome to read here), a single embryo is the standard of care in almost every situation (even with patients who have previously completed a DET), except for when:

• Embryos have not been genetically tested (PGS).
• Embryos were found to be lower quality (less chance of implantation).
• Embryos were created over the age of 38.
• The patient has a history of repeated Failed FET attempts using this specific batch of embryos.

If you feel that you have met the above criteria, you can submit your request to the Medical Board here: Double Embryo Transfer Request Form.
The link will start with eligibility questions — please answer these honestly. When you click ‘Check Eligibility,’ the system will clarify whether or not you meet the criteria outlined here. Patients who are eligible to request a Double Embryo Transfer will have the ability to add additional commentary and officially submit their request to the Medical Board.

Transferring a mosaic embryo requires formal genetic counseling (e.g. via Progenesis). You must submit written proof of your counseling session before the clinic will thaw or transfer a mosaic embryo.

A serial thaw occurs if your primary selected euploid embryo fails to survive the thawing process, requiring the lab to immediately thaw your next available embryo.

If your backup embryo is mosaic (containing mixed normal and abnormal cells), clinic safety policy requires documented Genetic Counseling (e.g., via Progenesis or Igenomix) prior to cycle start to ensure full informed consent regarding potential chromosomal risks. Without proof of counseling, the lab will not thaw a mosaic backup embryo.

While preferences (such as gender selection or embryo grade) are noted, the embryology team evaluates the embryo for the highest quality for transfer. The embryologist will confirm the specific embryo details with you in person during your procedure.

The West Valley clinic (10750 West McDowell Rd, Avondale, AZ) provides SHGs, monitoring ultrasounds, and blood draws which are sent to Labcorp (blood draws are not processed onsite and will take longer for results to return). Procedures such as embryo transfers or surgical interventions are performed at the main facilities (Gilbert/Scottsdale).

No. Arizona remains on Mountain Standard Time (MST) year-round. Out-of-state patients must adjust their injection schedules for time zone changes when traveling to Arizona for procedures to maintain consistent dosing intervals. Please see the MST Timezone Converter tool on this page.

Completed consent forms must be received by the clinic at least TWO (2) business days prior to your scheduled transfer date so embryology can verify authorization before warming the embryo.

Both you and your partner must complete and submit the emailed form at least TWO (2) business days before transfer. Both partners must upload a clear image of a government-issued ID (driver's license or passport) and double-check that the birth date entered is accurate.

All uploaded files or screenshots MUST display your full legal name and date of birth to be legally placed in your medical record.

If results are missing near close-of-business:

1. Verify that your local clinic faxed reports to 480-351-8221.
2. If you have patient portal access, download the report or screenshot it (ensuring your full legal name and DOB are clearly visible) and upload it to your secure chat or via the DrChrono patient portal link.
3. Continue taking your current medication doses as scheduled until explicit instructions are delivered by your care team.

*If your clinic uses a photo-sharing system for ultrasounds, please let us know.

The clinic closes at NOON on Fridays. If you must schedule a Friday lining check ultrasound out of state, schedule it as early as possible. It is highly recommended to have it on a Thursday or a Monday if your calendar allows leeway. If results are not received by close of business on Friday, continue your CURRENT estrogen dose until the team reviews your reports and reaches out.

These labs are required to be updated every 6 months, as they can impact transfer outcomes. These include TSH/T4, Prolactin, and Vitamin D.

While standard lab reference ranges consider a TSH under 4.0–4.5 µU/mL normal for general health, reproductive endocrinology guidelines recommend a TSH below 2.5 µU/mL to optimize transfer outcomes.

*Instructions (if needed): Take Levothyroxine every morning on an empty stomach with a sip of water only, 45 to 60 minutes before eating food or drinking caffeine/coffee.

Do not self-adjust your dose. Notify your coordinator of your exact current daily dosage and confirm whether you take it consistently on an empty stomach. Your provider will increase your daily prescription, if necessary, and schedule a lab draw to recheck TSH in 4-6 weeks.

Prolactin levels above 30 ng/mL can interfere with endometrial receptivity and uterine vascularization. However, Prolactin is highly sensitive and can transiently spike due to stress, eating, physical exercise, sexual activity, or tight clothing.

Fasting Recheck Rules: Fast (nothing but water and medications) for 8 hours prior to the draw, wear loose-fitting clothing, avoid nipple stimulation/intercourse the night before, and skip any morning workout.

Spotting is common, but heavy bleeding (equal to a normal period) while on active birth control usually indicates your progesterone levels may have dropped or your lining shed early. Do not stop taking your active pills.

Contact your FET coordinator immediately; the provider may order a serum progesterone/estradiol blood draw or adjust your birth control end date.

Prescriptions are re-ordered to guarantee you have sufficient refills and active supplies to last through 12 weeks of gestation. Inform your pharmacist if you already have enough supply on hand.

Take the missed dose as soon as you remember. If it is over halfway to your next scheduled dose, skip the missed pill and stay on your normal routine. A single missed dose will not ruin your cycle.

• Contact the clinic if more than one dose is missed.
• Setting an alarm for your medication is highly recommended.

Your provider will increase your total estrogen intake to encourage further growth. This may include:

• Increasing oral Estrace to 2 - 3 tablets, 3 times daily (breakfast, lunch, dinner).
• OR adding 2 Estrace tablets inserted vaginally at bedtime.
• OR adding/increasing Estradiol patches to 3 patches changed every other day.

AND scheduling a follow-up lining check ultrasound a few days later before approving Progesterone in Oil (PIO) start and/or pushing transfer date back to give your lining more time.

The exact hour of your first PIO injection opens your uterine "window of receptivity." If this initial dose is missed or delayed, the timing between your lining maturity and embryo age will be misaligned, requiring immediate intervention from your care team.

After your initial timed dose, subsequent injections can be given at a consistent evening time (e.g., 9:00 PM).

Timing can be moved, but must be taken earlier, not later. Reach out to FET coordinators for how to move injection times.

⚠️ You must never go more than 25 hours between progesterone injections.

Valium (10 mg oral) can be administered 1 hour before SHG/biopsy/transfer at provider discretion.

• A driver is required if Valium is taken.
• Must be requested at least 3 days prior to procedure to allow for provider approval time.
• This is NOT for breastfeeding patients.

All prescribed support medications (Estrace, PIO, suppositories, antihistamine protocol) must be continued through 12 weeks, 0 days gestation (your official Med Stop Day) unless instructed otherwise by an NDFC provider or your OB/GYN.

Please see the Timeline Calculator on this page to compute your exact date.

One option a lot of FET patients elect to use for transfer is Embryo Glue. The cost of embryo glue is $400 (cash pay) — it is NOT included as part of any prepaid FET Package and will NOT be covered by any insurance plans.

If you plan to move forward with this option, you MUST confirm by your final lining check so that our Billing team can collect payment prior to your transfer appointment, and our Embryology team can confirm that we have enough on hand to prepare for transfer.

**You will NOT be able to add this on the day before transfer, or on transfer day.

This protocol helps reduce inflammation and immune reactivity:

• Dietary Restriction (Immediate Start): Eliminate ALL caffeine and chocolate.
• Medications (Started 2 days pre-transfer through 12 weeks):
  • Prednisone 10 mg (once daily in the morning).
  • Claritin 10 mg daily (or Benadryl 25 mg three times daily).
  • Pepcid 20 mg twice daily.

• Caffeine: Can trigger certain immune cells to release histamine, which may increase inflammation throughout the body and in specific areas.
• Chocolate: Contains natural stimulants that can cause your body to release stored histamine from its tissues, potentially worsening symptoms.

Yes. FET medications are safe while breastfeeding. However, supplemental estrogen can diminish milk supply or alter taste, which may lead to natural weaning.

Select a high-quality prenatal vitamin containing methylfolate and iron (note: most gummy prenatals lack iron).

Recommended brands include Theralogix (PR code: 108901) and Thorne. Unverified non-essential supplements should be discontinued.

• Fragrances: NO perfumes, scented lotions, body sprays, or aftershaves for you or your partner (fragrance chemicals harm delicate embryos in the embryology lab).
• Bladder Prep: 1 hour prior to transfer, completely empty your bladder, then drink 32 oz of water and hold it. A full bladder straightens the uterine angle for smooth catheter insertion.
• Arrival: Arrive 30 minutes prior to transfer (or 1 hour prior if receiving Valium or acupuncture).
• Diet & Meds: Eat and drink as normal. Take all medications as scheduled (including suppositories).

You may have multiple family members or support people in the recovery room before and after the procedure, but only ONE adult guest is permitted inside the procedure transfer room.

Children/toddlers must always be supervised by an adult in the waiting area and may only enter the recovery room after the transfer is complete.

The Embryology team uploads post-thaw embryo images directly to your chart once procedure tasks are complete. This upload process can take up to 7 to 10 days following your transfer. You will receive an alert via your OnPatient portal when the image is available for viewing and download.

Schedule directly with Amie Guerrera:

• 📱 Phone: 480-877-0222
• 📩 Email: azfertilityacu@gmail.com
• 🖥️ Online: azfertilityacupuncture.janeapp.com

Plan to check in at the clinic 1 hour prior to transfer to complete pre- and post-transfer sessions.

On the day of transfer, you are approximately 2 weeks and 5 days pregnant (no matter whether your embryo was frozen on day 5, day 6, or day 7).

• Day After Transfer: You may resume 80% of normal daily activity, returning to 100% normal non-strenuous activity thereafter. Bed rest is not required or recommended.
• Exercise: Aerobic, high-impact workouts are discouraged. Low-impact exercise (such as light walking or gentle stretching) is allowed.
• Vibration/Impact: Avoid activities causing whole-body vibration (e.g., riding ATVs, operating heavy machinery, or using percussive body massagers).
• Pelvic Rest: Strictly NO sexual intercourse until explicitly cleared by your provider.
• Water Submersion: Strictly NO swimming, hot tubs, or baths until transfer restrictions are formally lifted by your provider (typically after a fetal heartbeat is confirmed on your initial OB scan).

Yes. Do not feel guilty about caring for your child during this window.

Tylenol (Acetaminophen) or Extra Strength Tylenol is the ONLY approved pain medication.

⚠️ Do NOT take NSAIDs (Ibuprofen, Motrin, Advil, Aleve, or Aspirin) after transfer.

Unless you are on the Antihistamine Protocol (which mandates 100% elimination of all caffeine and chocolate), you may consume up to 200 mg of caffeine per day.

Progressive serum hCG blood tests are conducted on Post-Transfer Days 10, 12, and 14, scheduled at the front desk before leaving the office on the day of transfer.

• Out-of-state patients must obtain printed lab orders from the front desk on transfer day before departing the clinic.
• Home urine pregnancy tests are strongly discouraged prior to Day 10 due to high rates of false-negative stress.

Do not stop taking your medications.

Light bleeding or brown spotting occurs in up to 30% of successful FET pregnancies and is often caused by cervical sensitivity or minor subchorionic hematomas (small pockets of blood behind the gestational sac).

Notify your FET team immediately to check your serum progesterone levels and schedule a scan.

No, absolutely not. It is completely normal to have zero physical symptoms during the 10-day post-transfer window. Many patients experience full, healthy pregnancies without ever having morning sickness, breast tenderness, or fatigue. Symptom severity is not an indicator of transfer success or failure.

• Vitamin B6: 10–25 mg (3 to 4 times daily).
• Unisom (Doxylamine): 25 mg (½ tablet up to 3 times daily).

Fever must be addressed promptly. Take Tylenol (Acetaminophen) every 6 to 8 hours as needed to keep your body temperature down, and see your primary care provider (PCP) or visit urgent care immediately to identify and treat the underlying cause (e.g., flu or bacterial infection).

• First-Line Medical Relief: Tylenol (Acetaminophen). If migraines persist, consult your primary care doctor for pregnancy-safe prescription triptans.
• Preventative/Natural Remedies: Topical peppermint oil on temples, Ginger supplements, Magnesium, Riboflavin (Vitamin B2), and daily Omega-3 fatty acids.