Instructions given to patients following embryo transfer have changed many times over the years.
Patients were hospitalized for a week with bedpan privileges only whenIVF was first introduced. This was supposed to give the embryos a chance toimplant so they wouldn’t fall out.
Someprograms did embryo transfers in the knee-chest position forpatients withanteverted uteri. Too manyIVF programs, including some of the mostprestigious ones, believed that the uterus is a cup and when you turnit upside down, the contents (embryos) fall out due to gravity.
What to know about activity after an embryo transfer
In truth, the uterine cavity is like a Jell-O mold, and theembryos are like mini-marshmallows. No matter how you spin the container, the marshmallows don’t budge. Theuterus is that container. Otherwise, we wouldn’t letpatients get up to empty their bladders as soon as the transfer is done.
It took a studysome years ago to show that there was no difference in pregnancy rates between patients who had absolutely norestrictions onactivity post transfer, compared to those who were told to be on bed rest for 2-3 days afterwards.
However, manypatients are notcomfortable with the idea of normal activity and put themselves at restriction because of the prior customs. For those women we suggest they follow a “couch potato” prescription, while clarifying the fact that activity levelwill neither help nor hinder embryo implantation.
What to avoid, and why
Heat is onerestriction that does seem to be valid. Bathing,especially hot baths, as well assaunas, hot yoga, heating pads, oranything that mayraise the local temperature should be avoided. Studies fromScandinavia show increases in neural tube defects in fetuses ofpregnant women who use saunas.
Staying away from intense exercise post-retrievalmakes sense due to ovarian condition. Ovaries full of corpuslu*teum cysts are prone to torsion or rupture with high impact activity.Common sense dictates that low impact, mild exercise (slow walking, treadmill)is permitted, as long as thepatienthas no resulting discomfort,recognizes it is not harmful, and will not second-guess herself if shedoes not conceive.
Recent data suggests that bed rest during pregnancy is useless. Furthermore, it may cause an increased risk of thrombotic episodes. Given thehigh hormonal state in anIVF cycle (although less so for frozen transfer cycles), the same concerns should hold true.
The bottom line
Virtuallynothing the patient does posttransfer will influence the outcome of the cycle. However,taking a middle ground between bed rest andvigorous exercisetorelieve worry and stress is warranted.
