after embryo transfer

At least once a month I have a woman in my office crying because her IVF cycle didn’t work and she believes in her heart that she is to blame. Typically she will say she “did too much after the transfer.” Women are so hard on themselves.

These women will say that after their next transfer they will stop work and go on complete bedrest. This is NOT a good idea. In fact, a few well done, randomized trials suggest it is actually harmful to take bedrest after embryo transfer. That’s right - you might be doing more harm by resting in bed after an embryo transfer. You are better off resuming normal activities. Now, “bedrest” has been defined in several ways: lying still for 10 minutes after the embryo is transferred up to 2 weeks of bedrest. In all instances there is NO benefit to any sort of rest after the transfer. Got it - no bedrest. But what else can you do or not do to increase your chances of taking home a healthy baby after an embryo transfer?

  1. Stay on your medications exactly as prescribed. Do not skip a dose and do not stop because you have bleeding. Over 80% of IVF patients will have bleeding at some point after the embryo transfer until the end of the first trimester. Typically it is light unless you are miscarrying. If you start having heavy bleeding call us and we’ll give you some advice but we will NOT tell you to stop your medications until we’ve done blood work or some other testing to determine whether your bleeding is normal or a concern.
  2. Avoid heat. No hot baths, saunas, hot yoga, heating pads or anything that might raise the temperature of your uterus. Not only might this cause miscarriage, it might increase the risk of the fetus having a neural tube defect.
  3. Laugh. This seems odd, but there are some studies suggesting women who watching funny shows after embryo transfer they are more likely to have success. This speaks to the mind-body connection. When you are laughing you are not stressed.
  4. Take folic acid. A study out of Boston looked at folic acid intake (combining diet and supplement pills) and found the group that took a higher amount had higher live birth rates after embryo transfer. Unless you are in a high risk group (e.g. obese, history of a child with a neural tube defect), you should take 0.4-1.0mg (400 - 1000 mcg) of folic acid daily.
  5. Consider acupuncture. I can’t recommend doing day after day or week after week of acupuncture as there is no science to support this type of treatment but there is some science to support using it on the day of the embryo transfer (before and after the embryo is placed). We have the Acubalance (www.acubalance.ca) group provide this at our clinic.
  6. Do not exercise rigorously. I have no science to support this advice but if you kept training for a marathon or did boot camp every day I am certain you (or your partner) will blame yourself if the embryo does not stick.

 

If you look at this list you will realize something: there is not much you can do to change the outcome. The success rate is 99% determined by the embryo and the uterus interacting. God forbid the embryo transfer is not successful, do not blame yourself. It was never really in your control - it was in the control of the uterus and the embryo.  Talk to your doctor and see what they can do to help with the embryo and the uterus.  Do not give up hope.

 

Email for references: btaylor@olivefertility.com

Dr. Beth Taylor MD, FRCSC
Reproductive Endocrinology & Infertility