One of the most common questions I get asked is “what should I do (or not do) after my IVF transfer?” When you have invested so much of yourself physically, emotionally and financially, you want to make sure you do everything right so as not to jeopardize a pregnancy. The worst part of this whole process is the two week wait. It’s as if time stands still as you anxiously await your pregnancy test.
The key to surviving the two-week wait is to get to a place where you have peace of mind, knowing you have created a fertile landscape and now you just have to wait and see if you have a healthy seed to grow. This seems like a good time to dispel a few myths about conception.
Myth: Embryos can slip out of the uterus
From the moment after you have your embryo transfer (ET), you fear it will fall out of your womb. Your uterus is a potential space like a deflated balloon, which expands with the growth of your baby when you are pregnant. The uterine lining is sticky like strawberry jam to keep the embryo in place. That means after your embryo transfer, it is safe to do the following:
• Urinate and defecate. It’s better to go rather than hold it in after an ET to avoid tensing up your uterus.
• Cough and sneeze. No amount of sneezing or coughing will impede implantation. When I conceived my daughter, I had a month- long cold that had me coughing until my ribs hurt after my frozen IVF transfer
• Go back to work within 24 hours. For many, work is a good distraction—unless your job involves heavy lifting or you find it overly stressful.
• Fly. Some couples travel out of country for IVF, such as to the Colorado Center for Reproductive Medicine (CCRM), a world renowned clinic. CCRM recommends forty-eight hours rest before flying home. On the other hand, if you are a flight attendant who is subjected to jet lag, irregular hours, and bending at the waist over twenty-five times per shift, your work can put you at risk. In this case, I would advise you to stay grounded
• Relax for the day after ET, but then get up and move around. A 2013 study found that bed rest after ET did not improve IVF success rates as it decreased blood circulation.
• Engage in light activity. Walking stimulates stress-relieving hormones. That said, you shouldn’t engage in vigorous exercise, especially if you are at risk for ovarian hyperstimulation (see Chapter 7).
• Have sexual intercourse. A couple of studies support sex as beneficial for implantation as a result of couple bonding and seminal fluid enhancing implantation. However, the stress of IVF lowers most women’s libidos. So if you are in the mood, go for it; if not, don’t sweat it.
How to make your uterus sticky to promote implantation
• Laugh. Laughter releases feel-good hormones (endorphins), which decrease the stress response, relax the uterus, and increase uterine blood flow. A study found laughter after embryo transfer increased pregnancy rates by fifteen percent. So watch funny movies, read funny books or magazines, and be around funny people.
• Be true to your emotions. A lot of women think that you have to think positive in order to get pregnant. Acknowledge your stress; don’t stress about being stressed. You cannot force positivity but you can foster it. (I will post The three Rs of positive self-talk in my next post . Stay tuned!)
• Acupuncture. Acupuncture has the potential to increase your chances of implantation by more than sixty percent when you do pre- and post-ET treatments. The pre-transfer treatment increases blood flow to the uterus to make it sticky, and the post-transfer treatment helps to relax the uterus for implantation.
Does spotting mean it’s over?
No. Please breathe now. There are several reasons for spotting outside of getting your period or having a miscarriage, including:
• The speculum and catheter used to pass through the cervix may have irritated the uterine lining.
• The progesterone supplements used in conjunction with IVF can cause spotting.
• Implantation spotting can occur when the embryo burrows into the uterine lining and implants (this does not happen to all women).
Even with the strategies and information above, I know that you will still grope your breasts daily to check if you are pregnant. This is futile as you have likely been given progesterone which may mimic pregnancy. And every pregnancy is different: one woman may experience no symptoms while others experience many symptoms.
At the end of the day, know that you are doing everything in your power to try to conceive. And I’ll be thinking of you with my fingers, toes and eyes crossed.
References:
[1] B Grajewski, Miscarriages amongst flight attendants background: Cosmic radiation and circadian disruption are potential reproductive hazards for flight attendants. Epidemiology; (2015) 26 (2): 192-203, 12p
[2] Gaikwad, Sharayu et al. Bed rest after embryo transfer negatively affects in vitro fertilization: a randomized controlled clinical trial. Fertility and Sterility. (2013) 100(3): 729-735
[3] Kelton P. Tremellen, Diana Valbuena, Jose Landeras, Augustin Ballesteros, Javier Martinez, Sergio Mendoza, Robert J. Norman, Sarah A. Robertson, and Carlos Simon. “The Effect of Intercourse on Pregnancy Rates During Assisted Human Reproduction.” Oxford Journals, Medicine & Health, Human Reproduction. (2000) 15(12): 2653-2658
[4] Giselle Crawford, Arpita Ray, Anil Gudi, Amit Shah, Roy Homburg. The role of seminal plasma for improved outcomes during in vitro fertilization treatment: review of the literature and meta-analysis. Hum. Reprod. (2015) 21 (2): 275-284
[5] Shevach Friedler et al., The Effect of Medical Clowning on Pregnancy Rates after In Vitro and Embryo Transfer. Fertility and Sterility. (2011) 95 (6) 2127-2130
[6] Wolfgang Paulus et al., “Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy”. Fertility and Sterility. (2002) 77 (4): 721–724
Thanks for this write up! It relieved me of anxiety and made me smile. Keep up the good work
Thanks so much for you comment Vera. It is much appreciated to know that I am contributing and making a difference. I apologize for my lack of technology and somehow did not get this message until now.
One hour after embryo transfer severe coughing….. will it effect implantation
Hi Niki, my sincerest apologies for not having seen your message until now which is 3 months later. There were technical issues and was not notified. I just wanted to follow up to see what happened and how you are doing. You can email me at mw@aliveholistichealth.ca
Thinking of you during these challenging times.
Thank you for this!! I’m mostly calm but I’ve had to stop taking my allergy meds for my ivf cycle and I’m pretty sneezy with it and have been worrying about it, so this has been very reassuring!!
I’m so glad that you found this helpful. I hope you can breathe easier knowing that sneezing, coughing, and walking will not impede implantation. I’ll keep my fingers crossed for you. Big hugs, Mary
Hi, thank you for your article it’s one of the best and most true, I’ve read so many articles on what to expect but this one is truly the best, I’ve had my IVF and on the long two week wait now, to everyone trying good luck!
Hi Nelly, I apologize that I did not see this message at all till now. Not sure what had happened. I just wanted to follow up with you to see how you are doing. …
Yes, i agree with Vera too.
I felt better after reading this too.
Thank you!
Thank you Sherli. Please keep me informed.
I have allergies and cough and sneez alot which l have been doing since blastocyst transfer yesterday. Was very worried that this pressure could affect implantation. One questions though, what is the best position to get us from bed?
Alice, I am just following up. I know it’s late and I’m sorry that we’ve had technical difficulties. It was not my intention to miss your comment. Just so everyone knows, sneezing and coughing will not have a negative consequence. You will not squeeze out the embryo. If it’s meant to stick, it will. I believe I even mentioned it in my book Pathways To Pregnancy that when I was carrying our daughter, I had a hacking cough for a month. My husband thought that I’d cough her out but she’s was a fighter and still is.
This is very reassuring! Thanks for your work in sharing your experience and findings! All the best!
Thanks for your kind words! All the best to you too!
Dear Mary,
Hope u r doing well.I shared my problem about ivf on last week..The result has come and its positive..My wife is soo happy now..The level of Beta Hcg is 1040 m/ u…Is it ok?? Or is it a increasing level?? Will the result is Healthy or something to worry?? 7
Hi I have done ivf 5 days ago but had to go back to work. I am alot on my feet at work. Is it a problem please advice.
Thank you
Thanks for reaching out. If you’re on your feet. It’s ok. Your uterus is not an empty vessel.
Think of it as a deflated balloon which inflates in time with a developing embryo meaning it should not fall out. Try not to do heavy lifting however.
Will keep my fingers crossed for you.
Blessings to you on this journey,
Mary
Hi Mary. Is there any restriction to the way you lie down in bed? I sleep side-ways most time and hope this is ok post-FET. Tq:
Hi Cam, It’s totally okay to lie on your side or any other position for that matter. Fingers crossed
Hi,
I am on day two of the wait and wanted to know if it’s ok to go dancing this weekend? Also, I didnt do pre-acupuncture, but do you think it would still help?
Thanks!
Jennylee
Hi Jennylee, Dancing is ok. If you’ve never danced before, I would say no. If you are in a social setting and everyone else is drinking and you aren’t is it awkward? Also, if for whatever reason you are not pregnant, will you blame it on having gone dancing? If the answer is yes, then I would say stay home and watch a funny movie which relaxes the uterus and helps implantation. If it’s a Day 5 embryo, you might be past the point for preimplantation acupuncture treatment. Still might be ok for Day 3 transfer. Do what feels good to you. hope this helps.
Hi,
Thanks for your post..actually my wife take IVF 2 days ago and from the day of transfer she got coughing..and it is not stopping yet..Will it make any negative effect on pragnency??
Thanks for your comment. Coughing will not impede implantation. If it’s a viable baby, it will be like a leech and stick! Fingers crossed for you and your wife. Please let me know how it turns out.
Hi there, thanks a lot for your info. I’m on Day 5 after ET. Had a cough and it stressed me out. Reading your article really helped me. Thanks again 🥰
Hi Suba, Thank you for your feedback. I am grateful that you feel a sense of relief with regards to the article. I have collaborated with 3 other experts for this Tuesday April 7 to provide a free webinar to “connect, calm and take back control during challenging times” It’s our way as a collective community to give back and make a difference in a way we know how. So please join us so you can feel more hopeful and less isolated in times of uncertainty. I’ll send you a link later today. All my best and keeping my fingers crossed for you.
Wow!! I like this, am on 9th day of 2ww but am having a dry serious cough and flue, was worried that i would cough my embryo out! .thank you so much for the advice, am now relieved. Hope for the best.
Thanks for your comment. Yes hoping for the best for you too!
Thanks for this informative site! I was relieved to read about the cough and the sexual intercourse. I had my second transfer almost two weeks ago (hcg test in two days…) and my libido had been going up in the last days quite crazily. I could not stand it anymore (i could not even concentrate at work) so this morning I let myself orgasm (ergh, twice), thinking also that my clinic said sex in the second week is ok… That should cover orgasm right? I felt much better afterwards… But it is hard not to worry. 🙂
Thanks for your feedback. Visualize orgasm relaxing your uterus and making a nice plush bed for an implanted embryo. And of course think about a sticky jam sandwich where the jam is the uterine lining and the bread is the uterus. Nothing will fall out. Please let us know how it all turns out.
Thank you for information, Mary ! I have been coughing after day 2 of my transfer and was worried that it won’t be a success. You won’t believe how your reassurance helps us so much. God Bless!
How did it go Lynette? Thinking of you
Hi, I just did the FET on 13 Dec, so today consider as the 4th day, I have a singing practice at church in 3days tome. I would like to know if it is a good time to start singing during this 2 weeks wait. I’ll be the backup singer during the Christmas celebration at my church on coming Sunday. Appreciate your advice. Thanks
Hi Denise, singing will be a very therapeutic and joyous activity to be doing while you are in your two week wait. Yes, please do this as it should have no ill effect on pregnancy outcome. … unless you are carrying a 20 plus pound book which I imagine would be highly unlikely. So go and enjoy that because hopefully this will also be a great distraction from worrying about if it’ll work. Fingers crossed.
Thanks A lot Mary…I just back from the rehearsal. As I was singing soprano so I need to use a lot of breath…not sure it’s because of the singing or because today is Day 7 after my transfer, I can feel like twitches below my belly button area. Do you think everything will be just fine? My actual performance on coming Sunday.
Thanks in advance Mary.
Thanks so much the info really helped.
Thanks your your feedback!
Dear Mary,
Hope u r doing well.I shared my problem about ivf on last week..The result has come and its positive..My wife is soo happy now..The level of Beta Hcg is 1040 m/ u…Is it ok?? Or is it a increasing level?? Will the result is Healthy or something to worry??
Sounds fantastic to me. Normally, at fertility clinics in Toronto, they do multiple betas every other day or so to make sure the pregnancy is progressing. So hopefully you are getting checked out and things look good.
Will visualize a healthy baby to term for you both. 🙂
Hi marh
Today is my 7th day of FET and I have been coughing 2nd day of my transfer and I felt something is detach from my uterus and I feel very sad Pls help me
Is due to coughing pressure I lost my embryo
Hi Smita,
Thanks for your concerns. Visualize your uterus as a jam sandwich. Your uterus is collapsed and not an open vessel. Your uterine lining should be sticky and tacky similar to strawberry jam and the uterus is like bread. Coughing hard, sneezing or going for a bumpy drive will not cause detachment. The truth is, you won’t know till your blood test. I had a woman this week who was adamant that she was not pregnant because she was feeling that her breast tenderness that she initially felt, went away the day she came in for treatment and that she was getting slight spotting as if she was starting her period. I told her that symptoms can come and go. Sometimes we may have symptoms of pregnancy and we’re not pregnant and other times, we have no pregnancy and we are. … She came in 2 days later and told me she had a positive pregnancy test. I know it’s easy to try to evaluate what you feel as evidence of pregnancy or not but the truth is, you don’t really know till you know. I will keep my fingers crossed. Please keep us posted on your fertility journey. If you want more information, I speak more about the 2ww as well as early pregnancy in my book Pathways To Pregnancy.
Wonder thanks a lot it’s really helpful now one can relax because the 2weeks wait is really something else
Love this article. On day two and I made sure to remind myself that nothing can stress me out during this time. I am doing my best to stay positive and I pray a lot. Good luck to everyone!
I appreciate this information. it really help because my ET is on the 21st June, 2018. Wish me luck.
I’m thrilled that this helps. Good luck for sure for your ET. I hope you are doing acupuncture before and after the transfer as well to make your uterus nice and juicy, receptive and relaxed.
Dear Mary,
Hope u r doing well.I shared my problem about ivf on last week..The result has come and its positive..My wife is soo happy now..The level of Beta Hcg is 1040 m/ u…Is it ok?? Or is it a increasing level?? Will the result is Healthy or something to worry??
Waiting for your reply Mam….
Hi Mary,
Thanks for this article. I work in a warehouse and do a lot of bending,reaching,standing for 10hours every night 4 days a week,sometimes 5 or 6,and lifting packages that could weigh up to 40-50lbs. I am concerned this will affect my pregnancy after I have my transfer which is coming up at the end of the month. I have gone through a lot and dont want to have to blame myself after going through this stressful stage but want to know if it’s safe to go back to such work. Please I look forward to your response as it will be very helpful. Thanks.
Thank you so much for this article. Very calming 🙂 Now I´m off to watch some Friends bloopers and laugh all afternoon long 😀
That’s sounds great to me. Fingers crossed.
My 5 day frozen embryo transfer is done on 20th September 2019 my doctor advised me to go for beta HCG test on 4 th Oct means on 14 days later from my ET date but on my 10 th day post ET checked beta HCG and result is 603.5 mIU/ml which means 3 week pregnancy is it the reliable report or false pregnancy due to any HCG injunction traces.mt eggs collected in the month of aug2019 means it is not fresh cycle
Hi Paty,
Thanks for reaching out. I need to be clear in what you are telling me. If you had HCG shot only at time of egg retrieval as part of your IVF cycle in August, then your current beta HCG after a FET definitely means you are pregnant. If however, during your Frozen embryo transfer (FET) your doctor administered HCG again, then you do need to wait longer than normal to clear the extraneous hormones from your system. I hope for the best. Let me know how it turns out.
Hi,
I had my FET done on 24th Oct and from 27th I got high fever and now cough. It is fine or will it affect the implantation. Please advise.
Hi Tanvi, Due to tech issues, I never received this message until now. Please accept my sincerest apologies and let me know what happened with your FET. I would love to hear back.
Thank you for this article.it is very encouraging. Wow.been in fear since the day of EF.I claimed stairs that day, on the second day.hubby made me so angry that I cried my eyes out.hope my babies are intact. And can I resume my work.I heard the embryo takes 2to 5 days to implant. How true is this.no sign of pregnancy yet.which is the Best way to insert the cyclogest,vagina or anus?
Hi Vera, I am sorry that I was not able to get into to reply. I’m wondering how you are doing. What happened? You can email me back at mw@aliveholistichealth.ca where I should not miss your message. Blessings to you on this journey.