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Continue hormone support while traveling; pregnancy test usually done after return."},"follow_up_visits":[{"purpose":"result_review","requirement":"routine","after":{"min":9,"max":14,"unit":"days","qualifier":"After Frozen donated embryo transfer: Blood hCG pregnancy test; timing depends on embryo stage and clinic protocol."}},{"purpose":"assessment","requirement":"conditional","after":{"min":28,"max":42,"unit":"days","qualifier":"After Frozen donated embryo transfer: Early pregnancy ultrasound, only if the pregnancy test is positive."}}],"indications":["Own eggs or embryos unusable (e.g., poor ovarian reserve, age)","Repeated IVF failure with own embryos","Risk of transmitting a genetic disease through own gametes","Both partners without usable eggs or sperm"],"main_risks":["Early miscarriage","Multiple pregnancy if more than one embryo is transferred","Ectopic pregnancy, including rare heterotopic pregnancy","Mild cramping, spotting, or rarely pelvic infection after transfer","Hormone side effects (bloating, mood changes, headache); rare thromboembolism","Pregnancy complications such as hypertensive disorders of pregnancy"],"pain":"Usually minimal. The transfer feels like a Pap smear, with mild cramping or pressure, and is done without anesthesia. Hormone injections or vaginal products can cause mild local discomfort.","preparation":["Recipient evaluation: history, uterine assessment, infectious disease screening","Counseling and legal consent as required by local regulations","Estrogen then progesterone preparation, with ultrasound and sometimes blood monitoring","Embryo allocation and thaw timing planned by the embryology team","Comfortably full bladder if requested for ultrasound-guided transfer"],"recovery_timeline":[{"phase":"Day of transfer","description":"Short rest after transfer, then discharge home the same day. Walking and ordinary daily activity can continue.","restrictions":["Avoid heavy lifting and strenuous exercise"]},{"phase":"Days 1-14 after transfer","description":"Continue estrogen and progesterone support as prescribed. Mild cramping, spotting, bloating or breast tenderness can occur while waiting for the pregnancy test.","restrictions":["Avoid strenuous exercise","Follow clinic advice on intercourse, baths and swimming","Do not stop hormone medication unless the clinic advises"]},{"phase":"After the pregnancy test","description":"If positive, continue hormones as directed and plan early ultrasound. If negative, the clinic advises on stopping medication and next steps.","restrictions":["Return to strenuous exercise as guided by the clinic"]},{"phase":"At any time","description":"Seek prompt care for heavy bleeding, severe or one-sided pelvic pain, fever, fainting, shoulder-tip pain, leg swelling, chest pain or breathlessness.","restrictions":[]}],"rehabilitation_days":{"min":0,"max":0,"unit":"days","qualifier":"No formal rehabilitation needed; ordinary activity continues, with temporary strenuous-exercise precautions."},"result_longevity":"A successful transfer results in a pregnancy and a permanent outcome: the birth of a child. Unused frozen donated embryos can remain viable in storage for years, subject to local storage limits.","revision_rate_pct":{"min":50,"max":70,"unit":"percent","qualifier":"Share of recipients needing repeat transfer cycle after non-ongoing pregnancy; falls with embryo quality and good lining."},"scars":"No scars: the embryo is placed through the cervix with a catheter, with no incision.","sessions_or_stages":{"sessions":{"min":3,"max":4,"unit":"visits","qualifier":"Treatment visits per cycle: baseline scan, one or two lining checks, transfer. Excludes initial screening and pregnancy checks."},"stages":[{"code":"baseline_scan","label":"Baseline scan and start of estrogen preparation","after":{"min":0,"max":7,"unit":"days","qualifier":"After first consultation; timed to menstrual cycle start, with screening and consent completed."}},{"code":"lining_monitoring","label":"Ultrasound check of endometrial lining","after":{"min":10,"max":21,"unit":"days","qualifier":"After first consultation, typically after 10-14 days of estrogen; extra checks if lining is thin."}},{"code":"embryo_transfer","label":"Thawed donated embryo transfer","after":{"min":14,"max":35,"unit":"days","qualifier":"After first consultation; depends on lining readiness and progesterone start. Delayed or cancelled if lining is inadequate."}},{"code":"pregnancy_test","label":"Blood hCG pregnancy test","after":{"min":9,"max":14,"unit":"days","qualifier":"After transfer; timing depends on embryo stage and clinic protocol."}},{"code":"early_ultrasound","label":"Early pregnancy ultrasound, only if the test is positive","after":{"min":28,"max":42,"unit":"days","qualifier":"After transfer, if pregnant; usually about 2-4 weeks after a positive test."}}],"qualifier":"One frozen-thaw donated embryo transfer in a hormone-replacement cycle. Further cycles may be needed if no pregnancy results."},"success":{"metric":"Live birth per transfer","value":35,"unit":"percent","horizon":"Delivery after one transfer cycle, about 9 months","population":"Recipients with prepared lining receiving one frozen donated embryo; varies with embryo quality.","evidence_status":"limited"},"techniques":[{"name":"Single frozen-thawed donated embryo transfer after hormone-replacement endometrial preparation, ultrasound-guided","suits_whom":"Most recipients, especially with irregular cycles or no ovulation; the clinic controls timing.","recovery":"No recovery period; normal daily activity can resume the same day."},{"name":"Transfer in a natural or modified natural cycle","suits_whom":"Recipients with regular ovulatory cycles who prefer fewer hormones; requires closer timing of ovulation.","recovery":"No recovery period; normal daily activity can resume the same day."},{"name":"Double embryo transfer","suits_whom":"Selected cases after counseling about multiple pregnancy risk; single transfer is generally preferred.","recovery":"No recovery period; higher multiple pregnancy risk requires closer obstetric follow-up."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.25,"max":0.5,"unit":"hours","qualifier":"For the transfer procedure itself, including a short rest; excludes the weeks of preparation and monitoring."},"initial_assessment_documents":["Pelvic ultrasound report with uterine assessment","Hysteroscopy or saline sonogram report (if available)","Infectious disease screening results","Recent hormone panel results","Previous IVF or embryo transfer records (if available)","Recent cervical smear result"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Stay 2-5 weeks for monitoring and transfer, or a short trip if monitored at home. Test after return."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team who will treat you abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Make sure you understand the possible complications and side effects before the treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check whether follow-up care is scheduled at the same facility as the procedure","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C4","text":"Check that you have been able to ask the team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check that you are satisfied with the facilities and standards where you will be treated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C6","text":"Check how your aftercare will be coordinated before you agree to treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Heavy vaginal bleeding","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/22457-ivf","host":"my.clevelandclinic.org","quote":"There is heavy bleeding from your vagina.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Severe pelvic 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summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You prefer a less invasive option than 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placed into the womb by ultrasound-guided catheter","source":{"url":"https://www.salisbury.nhs.uk/wards-departments/departments/fertility-centre/treatments/frozen-embryo-transfer-fet/","host":"salisbury.nhs.uk","quote":"Transvaginal ultrasound is used to guide the placement of the catheter through the cervix and into the uterus.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":0,"max":0,"unit":"days","label":"Same day","source":{"url":"https://my.clevelandclinic.org/health/treatments/22457-ivf","host":"my.clevelandclinic.org","quote":"After the transfer of your embryo, you should be able to resume normal activities.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"transfer-natural","name":"Transfer in a natural or modified natural cycle","how_it_works":{"text":"Transfer follows your own cycle, which is hard to 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