The Frozen Embryo Transfer Timeline: A Guide to Navigating Your FET Journey

Navigating the frozen embryo transfer (FET) timeline can feel daunting, especially with the precise timing of medications, ultrasounds, appointments and those oh-so-painful injections! At the end of the day, most of you just want to know “so when is my embryo transfer going to happen?”. To help you answer that, I’m thrilled to introduce my Frozen Embryo Transfer Date Calculator, a tool that helps you get a sense of the timeline involved in a FET cycle. This calculator simplifies the planning process, allowing you to focus on what truly matters—staying calm and confident during this exciting step in your fertility journey.

My name is Dr. Lucky Sekhon, I am an REI based in New York City. When I am not busy helping people get pregnant, I use my platform on Instagram and on this blog to help demystify the fertility journey that so many of you are on. If you find this blog helpful, I encourage you to follow me on Instagram or sign up for my free monthly mailing list.

In this blog post, to go along with my new calculator, I’ll shed some light on where the dates in the calculator come from and what the frozen embryo transfer timeline looks like. Note, in this blog post I am only going to focus on medicated frozen embryo transfer cycles and not cryonatural cycles.

The Frozen Embryo Transfer Process: A Step-by-Step Guide

An FET cycle typically involves 3-4 office visits. Each step is carefully timed to ensure your body is prepared for the embryo transfer, increasing the likelihood of a successful implantation. Here’s an overview of the timeline:

1. Baseline Visit

At the start of your cycle, usually on day 2-3 or about 4 days after stopping birth control pills, we’ll schedule a baseline visit. This visit includes a transvaginal ultrasound and bloodwork to confirm that your ovaries are in a quiet, resting state and your uterine lining is thin. These are ideal conditions to proceed with the next steps. If everything looks good, you’ll start estrogen supplementation on the same day. Estrogen is essential for thickening the uterine lining to prepare it for implantation, and starting it right away ensures no delay in moving forward. This step is the foundation of the FET cycle, helping us confirm your body is ready to respond to the medications.

2. Mid-Cycle Ultrasound

About 1.5 to 2 weeks after starting estrogen, we’ll perform a mid-cycle ultrasound to check the thickness of your uterine lining. Ideally, the lining should measure at least 7-8 mm, which is considered optimal for embryo implantation. If your lining meets this goal, we’ll provide instructions to begin progesterone supplementation, which can come in the form of patches, pills or as an injection. (Injections aren’t fun, here are some tips on how to make Progesterone injections a bit more bearable!) The timing of this is critical, as the number of days you’re on progesterone must match the age of the embryo being transferred. This visit ensures your uterine lining is ready to support the embryo and allows us to move forward with confidence. With the progesterone protocol tailored to your needs, you’re one step closer to transfer day.

3. Pre-Transfer Check

A day or two before the embryo transfer, we’ll perform one final ultrasound and bloodwork to confirm your uterine lining is still optimal and your hormone levels, especially progesterone, are where they need to be. Occasionally, we may discover an issue, such as fluid in the uterine lining or low progesterone levels, which could require delaying the transfer. While it’s rare, this final check is crucial to ensure all conditions are ideal. Taking the time to address any last-minute issues, even if it means postponing, maximizes the chances of a successful implantation and a healthy pregnancy.

4. The Embryo Transfer

The embryo transfer is the most exciting part of the process, happening after 5-7 days of progesterone supplementation. It’s a quick, outpatient procedure performed without anesthesia. You’ll come in with a full bladder, which helps us visualize the uterus clearly on ultrasound. Using a thin catheter, we carefully place the thawed embryo into the uterus under ultrasound guidance. This step is the culmination of all the preparation, and precision is key to depositing the embryo in the optimal location for implantation. The procedure is generally painless, and you’ll be able to go home and resume most of your normal activities right after. It’s a brief but meaningful moment, marking the start of a new chapter in your journey.

5. Post-Transfer Follow-Up

Approximately 8-10 days after the transfer, we’ll do bloodwork to measure the pregnancy hormone hCG and determine whether the transfer was successful. If the result is positive, we’ll schedule another blood test 2-3 days later to ensure hCG levels are rising appropriately, followed by a pregnancy ultrasound a week later. From there, you’ll have weekly ultrasounds until 8-9 weeks of pregnancy before transitioning to your OB. If the transfer isn’t successful, we’ll stop the medications, and you can expect a withdrawal bleed within a few days. We’ll then meet to review the cycle and discuss next steps, whether that means additional testing or planning for another transfer. This follow-up phase ensures that regardless of the outcome, you’re fully supported and have a clear plan moving forward.

The FET process can feel like a mix of science and art, with precise timing and careful planning at its core. Now that you have a better sense of whats involved and how the dates are derived, take your own cycle information and give the calculator a try to see your approximate timeline:

With that, I hope you have found my calculator and this blog post useful in your FET journey. If you just stumbled onto this blog, my name is Dr. Lucky Sekhon and I am an REI in New York City.  For more insights, tips, and support, follow me on Instagram and sign up for my free monthly newsletter to stay informed on important topics and developments in fertility and reproductive health. If you are in the NYC area and would like to schedule an in-person consultation with me, you can request an appointment here.