Frozen embryo transfer in Greece: the protocol, the timetable and what to expect

Most fertility journeys in Greece involve a frozen embryo transfer: following PGT-A, following IVF where all embryos were vitrified to avoid hyperstimulation, or simply as a second attempt using the remaining embryos from a first cycle. FET is now just as effective as a fresh transfer, and sometimes even more so, because the endometrium has not undergone stimulation.

Two ways to prepare the endometrium

Choosing the protocol is the first decision, and it has direct practical implications for your schedule.

The substituted (or artificial) cycle: you take oestrogen from the start of the cycle, then progesterone from a set date. Ovulation is suppressed, and the transfer is scheduled to the day, often three to four weeks in advance. This is the most convenient protocol for a stay abroad, as the date remains fixed. Its drawback is a heavier course of hormone treatment, which must be continued until the tenth or twelfth week of pregnancy.

The natural or modified natural cycle: your ovulation is monitored via ultrasound scans and blood tests, and the transfer takes place five to six days later. Fewer medicines are required, and recent studies suggest a slightly lower obstetric risk. The downside is that the exact date is only known a few days in advance, which makes booking flights more difficult. Many Greek clinics offer a compromise, using ovulation induction to make the date predictable to within two or three days.

Follow-up from France

Everything is done remotely up until the transfer. You will need a gynaecologist or an ultrasound clinic near you for one to three ultrasound scans to monitor the endometrium, and sometimes blood tests. The results are sent to the Greek clinic the same day, and the doctor makes any necessary adjustments. I take care of forwarding the results and translating them if needed; this is one of the points where the process most often runs into difficulties when there is no one to coordinate it.

The stay

For a TEC, two to three days on site are sufficient: arrival the day before, the procedure the following morning, rest, and return the day after that. The transfer itself takes ten minutes, without anaesthesia, with a full bladder, and under ultrasound guidance. You can walk, take a taxi or fly the following day. Strict bed rest does not improve outcomes, and studies confirm this. Details of stays by protocol can be found here.

How many embryos should be transferred?

The recommendation from professional bodies, followed by reputable Greek clinics, is to transfer a single embryo at the blastocyst stage, particularly after PGT-A or with donated eggs. Transferring two embryos increases the pregnancy rate per transfer, but above all the rate of twin pregnancies, with the associated obstetric risks. Some clinics will agree to transfer two embryos on request in specific situations (age, previous failures); this is a decision to be made with your doctor, not by default.

After the transfer

In France, the blood pregnancy test is carried out ten to twelve days later. The Greek clinic will advise you on the next steps depending on the result: continuation of hormone treatment if pregnant, a first ultrasound scan at seven weeks, followed by referral to your gynaecologist. If the treatment is unsuccessful, stopping the treatment will trigger your period within a few days, and a new IVF cycle can be scheduled as early as the next cycle if you wish.

Cost

As a guide, the IVF treatment itself costs between 900 and 1,800 euros at a licensed clinic, plus 150 to 400 euros for medication depending on the protocol, plus travel costs. This is by far the least expensive stage of the process. Full pricing details are available here.

Remaining embryos

Storage generally costs between 300 and 600 euros per year. The consent form signed at the outset specifies what happens to the embryos in the event of separation, death or cessation of payment: donation to research, donation to another couple or destruction, in accordance with Greek law. The maximum storage period is set by law, with the possibility of an extension. Please review this document before each transfer; it can be amended.

Frequently asked questions

Source: https://fertilitegrece.com/en/blog/frozen-embryo-transfer-greece/ — Triada Baloukoudis, IVF patient coordination in Greece. General information, not medical or legal advice. Printed on