What precautions should be taken after embryo transfer in IVF?

We usually tell our patients that, unfortunately, there is very little they can do to change the treatment outcome. The most common recommendation is avoiding physical efforts, risky situations. In IVF cases in which the ovaries have been stimulated, avoid sexual intercourse because that may cause bleeding inside the belly. In terms of diet, avoid toxins and things like that.

Other than that, we recommend leading a normal life. The outcome is not going to depend on what you’re going to do. It is going to depend on what the embryo does and the dialogue between the embryo and the endometrium.

Unless you need to lift heavy things at work, and you are exposed to toxic substances and things like that, so the environment that we do not recommend if you are waiting for your pregnancy test, you still can go to work or gym. You may need to change the intensity of your exercise, talk to your trainer about the positions that you can do, for example, in yoga and which ones you need to avoid, and that’s it. If it works, it is going to work anyway.

Well, actually, what is very important to remember after the embryo transfer is the doctor prescriptions – progesterone – is a highly important hormone in this period because you have to prepare the endometrium to accept the embryo and it has also other activities but it’s very important to er to stay close to the protocol and do all the medication as it was said by your doctor.

Please remember your medication, that’s a ‘number one’ precaution. This is of utmost importance. If you are on, for example, progesterone pessaries, 2 or 3 times a day, you have steroids or you have estrogen tablets, please do not miss these things until the pregnancy test. And then we’ll take it from there. This is one thing I urge everyone to make every effort to remember. I have sometimes seen patients who do not take it regularly. So try to take it as regularly as possible. If you schedule your alarm between 7 and 9 in the morning and 7 and 9 in the evening, that would be best. That’s the number one precaution that you should do.

Obviously, I don’t have to stress that alcohol is to be avoided. With regards to sexual activity, a lot of women try to avoid it, based on the feeling of safety or trying to minimise all the risk until the pregnancy test. It’s obviously understandable. But if I’m asked whether it is ok or not to have sexual activity, I would say yes – but obviously, you have to be guided by what you feel is more relaxing for you.

The most important thing is to continue all medication. If there is some medication before embryo transfer, it’s necessary to continue all medicine, minimum till the pregnancy tests. If you stop the medication, bleeding will probably occur, and everything will be bad.
The most important thing: don’t stop the medication, the doctor will not advise you that you should stop it. Then as I told you, for five days no sports, no swimming, no intercourse, no bath, only shower. As for food and drink, everything is possible, only not things which are not cooked like steak tartare (raw meat), raw eggs, raw fish, etc. Alcohol is not recommended, and smoking is very harmful to the embryo.

In this case, the first thing is to take the medications correctly, not to change any dosage. If you feel any side effects, tell us the doctors and don’t do anything yourself. During the whole waiting period and the early pregnancy, you will feel the same problems – same symptoms like bloating, swelling in the breasts, small clear vaginal discharge, sometimes mood changes. Those are normal things and those are also subjective things. And, as a doctor, from our side, we cannot evaluate if you succeed or not according to your subjective symptoms. Only, the blood test can give us a positive or negative answer.

Also, you have to avoid sexual intercourse, this is very important. Otherwise, for the eating side, avoid eating raw meat, and even if cooked, do not eat any brain, liver, kidney, etc. Don’t take any sweeteners, this is very important because, for example, aspartame that with a certain dosage can cause some congenital defects in the fetus. Because of this, during the first three months of pregnancy, we recommend that patients avoid drinks like diet coke as they contain artificial sweeteners.

Don’t take any medications by yourself if you feel anything is wrong. You might have some headache, some nausea, vomiting, etc. and if you feel anything like this you have to ask the doctor if you can take any medication. There are some medications that are safe during this period and during the pregnancy also, and your doctor will advise you about them.

There have been quite a few studies done in the literature, and also a systematic review, which shows that bed rest is not recommended. So if you have bed rest straight after embryo transfer, it doesn’t increase your chances to get pregnant. Therefore, the advice that we usually give is to go to the toilet to empty your bladder straight after the embryo transfer, and then just get dressed and go home, or go somewhere nice to chill. So bed rest is absolutely not recommended. I know that sometimes some patients feel a little bit more comfortable to hang around a little bit and stay with us a little bit. And by all means, they can stay in recovery a little bit longer if this is what they want.

But it’s not a requirement, and it’s not evidence-based at all. In terms of walking, again, of course, it’s perfectly fine to walk, to travel do short traveling, e.g. by car. Climbing the stairs is not a problem. Everything in moderation, but walking is perfectly fine. Running, if it is a fresh cycle, I would probably avoid strenuous exercise so running is one of those things that I would probably avoid at the beginning, primarily for the ovaries because they are still swollen. But if you had a frozen embryo transfer when there was nothing done to the ovaries then even running would be fine.

Aside from the aspects already covered (being mindful of your diet, activity and stress levels), make sure you are aware of the correct dosages of your medications and continue to take all medications as prescribed.  

After the embryo transfer it’s recommended to do a normal life. You have to avoid very extreme exercise, very extreme sports (like doing a marathon) or doing very very physical exercise but it’s recommended to do exercise and to do very normal activities. You can walk, you can jump, you can go upstairs and the embryo is going to be maintained inside the uterus so you don’t have to be worried about it. It’s recommended to do have a normal life, not to lie down a lot of time because it’s it’s seen that it’s not good for the embryo transfer but the most important thing to do a normal life, don’t think a lot about embryo transfer and in normal cases, in a normal pregnancy, you don’t know that you are pregnant and you are starting to do a normal life without any problem do all the activities that you would normally do. In any case it is the same, the embryo will stay inside the uterus and will do what it has to do: it will implant and it will start to develop, so you don’t have to be worried about it.

I think there’s not much precaution to be taken. The embryo is safe in an organ itself. You can just go back to living, go back to work, go back to do everything normally and that won’t affect the transfer at all. Just try to be as relaxed as possible – that’s the only tip I can really give.