What to do after your Embryo Transfer?

The two-week wait period between the embryo transfer and your pregnancy test can be very tense. It is normal to have your mind flooded with questions regarding what to do after your embryo transfer?

Should you travel or do any physical activities during this time? What are the positive signs of a successful embryo transfer?

All this overthinking during this period of uncertainty after IVF can build up a lot of stress, and that is not good for conceiving. To help ease your anxiety, let’s discuss some common dos and don’ts after an embryo transfer.

What happens after an embryo transfer day by day?

Once the embryos have been transferred to your uterus, it takes the below journey:

Hatching (Day 1 and 2)

• Day 1 & 2 – Inside your uterus, the blastocyst starts to hatch from its shell and moves closer to the uterine lining.

Implantation (Day 3 to 5)

• Day 3 – The blastocyst attaches deeper into the endometrium.
• Day 4 – Implantation continues.
• Day 5 – Implantation completes and the cells that eventually become the placenta and the fetus start developing.

hCG production & fetal development (Day 6 to 9)

• Day 6 – Production of Human Chorionic Gonadotropin (hCG) – the hormone that signals a developing baby.
• Day 7 & 8 – Fetal development continues and more hCG is secreted into the bloodstream.
• Day 9 – High levels of hCG. Time for a pregnancy test!

What to do after embryo transfer?

Your physical activity, the food you eat, stress, and other environmental factors can impact the embryo implantation and overall IVF’s success. Below are the things to consider after embryo transfer:

1.    Have a balanced meal

During the entire process, it is important to maintain a balanced diet with IVF treatment. Foods that are rich in vitamins and minerals, magnesium, zinc, and folic acid, cruciferous vegetables, fiber, and omega fatty acids, lean meat like poultry, and low-fat dairy products are great for you. Make sure to drink enough water and take a low-carb diet.

Some good additions to your diet would be: bananas, beet, berries, broccoli, sweet potatoes, sprouts, green leafy vegetables, dates, eggs, salmon, yogurt, nuts, sardines, beans, etc. 

2.    Rest

Ensure that you are resting enough. Most doctors recommend at least 24 hours of rest after embryo transfer. After this, some mild activities may be started to ensure that there is continued blood flow in your uterus, which may further help the embryo implantation.

3.    Stay Calm

Staying calm through IVF is essential as it can have a great effect on not only the embryo implantation but also the fetal growth. If you’re too anxious about something, it is best to ask questions directly to your fertility doctor and get the most genuine answers. Other proven ways to relax include exercise, sleep, a healthy diet, deep breathing, and perhaps a little pampering.

If your doctor allows, you may even consider acupuncture for improving chances of conceiving,

4.    Medications

Fertility drugs are prescribed keep the uterine environment optimal for healthy fetal growth. Your fertility doctor will personalize and prescribe estrogen, progesterone, or other pills or injections, perhaps 1-2 times a day to optimize the levels of hormones in your body.  Place a reminder and try taking these medications at the same time every day. 

5.    Sleeping position after embryo transfer

You can sleep in any position you like without any risk after an embryo transfer. But getting into the habit of sleeping on your side is always advantageous.

In a pilot study in the Journal of Sleep Medicine, sleep disturbances are thought to be frequent in patients undergoing IVF due to a variety of physical and psychological reasons (1).

Try to get into a better sleep routine ahead of your IVF cycle by meditating or listening to some relaxing music or reading a book for better sleep.

Also, it is important to sleep on time. A hormone called melatonin is naturally produced by our body soon after the darkness that helps promote sleep. In a study among 60 patients, it was found that melatonin improves the eggs and embryos in IVF patients with sleep disturbances (2).

So, try to turn the lights off to establish harmony with the circadian rhythm of your body.

What not to do after embryo transfer?

1.    Disturbed or inadequate sleep

Try not to sleep on your stomach. This is to ensure a good supply of blood and oxygen to the growing embryo.

Avoid exposure to blue light or accessing your mobile or laptop before going to bed.

Avoid having tea, coffee, or soda, especially during the evening as it may affect your sleep cycle.

2.    Bumpy car ride after embryo transfer

Pregnancy through IVF is a delicate process. If you are traveling by road, avoid taking bumpy rides which could cause jerky movements. This is especially important to consider if you have a weak endometrium or are diagnosed with endometriosis.

3.    Traveling after embryo transfer

You should consider the guidelines from ASRM on traveling for IVF if you have to travel immediately after an embryo transfer. For those who are planning to travel abroad, especially to rough destinations or taking long-haul flights, it is advisable to wait for a few days or until your doctor allows you to travel.

4.    Foods to avoid after embryo transfer

Some of the foods to avoid consuming after your embryo transfer are:

• Fruits like pineapple and papaya
• Alcohol, tobacco, or cigarettes
• Caffeine
• Fish and seafood (may contain mercury)
• Sugary items like soda. However, if you have cravings, it’s okay to have some chocolate or other sweets as long as your sugar levels are controlled.
• Junk food, processed meat, and soft cheese

5.    Aggressive physical activities after embryo transfer

After a 24-hour rest period of embryo transfer, you can use the stairs, walk, or do a little bending but you must avoid anything that might be too exerting.

Don’t do any strenuous exercise. Instead, if you already practice yoga, you can do some light fertility yoga exercises like bhramari pranayam (bee breathe pose), nadi shodhan pranayam (alternate nostril breathing), or baddha konasana (butterfly pose) to help regulate the hormones and improve transportation of nutrients and blood flow in your uterus. Also, it is advisable to abstain from sexual intercourse immediately after embryo transfer.

What are the positive signs after embryo transfer?

Even though you might be too eager, it is always best to undergo a blood pregnancy test only after the advised two-week wait period. Keeping emotions aside, this can be important to avoid false alarms.

According to a study published in the Journal of Clinical Epidemiology, around 50% of women with successful pregnancies experienced symptoms within 36 days of their last menstrual period (LMP) and 90% within 8 weeks of LMP (3).

While some of you might experience no symptoms at all, the following may be the potential positive signs of pregnancy after embryo transfer:

1.    Missed periods

If you have a regular cycle, then missed periods are the best indication of a successful embryo transfer. You can use over-the-counter pregnancy test kits to confirm this. If you are pregnant, your body will start producing hCG, which can be detected by these kits. Once confirmed, consult your doctor for a scan and further confirmation.  

2.    Spotting

When an embryo embeds itself in the lining of the uterus, it can cause a small amount of blood loss, which is called spotting. Spotting is different from period and the former is usually light-pink to dark brown.

However, if you are undergoing an IVF treatment, spotting might also be a false alarm due to:

• The result of the IVF treatment and the hormonal medications you have been taking.
• Bleeding at the start of the period, which occurs due to loss of progesterone and indicates that implantation has not taken place

3.    Tender and sore breasts

If your breasts are swollen or tender to the touch you might be pregnant. The areolas may also appear darker. However, this could also be a side effect of progesterone and fertility medications.

4.    Increased need to urinate

If you are making frequent trips to the bathroom during the two-week wait period, it may indicate that you are pregnant. This happens due to an increase in levels of hCG, progesterone, and extra rush of blood in your body. However, if you are experiencing painful urination, bleeding, or vomiting, contact your doctor.

5.    Lower back pain

Apart from the above-mentioned early signs, lower back pain is usually one of the symptoms that may occur after 7 days after embryo transfer. It happens when the ligaments of your body naturally stretch and become softer to prepare for the pregnancy term and labor. This can result in strain on joints and the pelvis and cause pain in the lower back.

Some of the other positive signs after embryo transfer are bloating, nausea, excess vaginal discharge that has a milky-white appearance, mood swings, high basal body temperature, cramping, and pelvic pain.

If you notice these, it may be a good sign. The next step is to do an at-home test and visit the doctor to confirm the pregnancy. Your fertility doctor will further guide you, fix schedules, and prescribe medications for the rest of the term of the pregnancy.

IVF can be stressful anxious but knowing what to avoid and what do after embryo transfer can help ease your anxiety while you wait to do the pregnancy test.