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