By Pauline Cottee
As many couples know, the IVF journey isn’t an easy one. Initially, it is all the injections, the rollercoaster of hormones, the intrusive follicle scans, the pressure of producing a sample etc. Then it’s a case of, will we form an embryo that is suitable to transfer or to freeze? If this isn’t enough emotional turmoil, the two week wait following embryo transfer is then like putting a cherry of stress on top of the IVF cake!!!
Here, we have collated some of the more commonly asked questions from patients during the two week wait and the answers we typically give to help clear some of the myths and facts during the two week wait.
Can the embryo fall out after transfer?
Short answer, No. Unlike all the diagrams of the uterus you have ever seen, the linings of the uterine wall are closely aligned together. This alignment is quite a tight space and while it allows the embryo to move around to find the right spot to implant, it’s not big enough for the embryo to fall out. Similarly, the embryo will not flush out with urination. The embryo is transferred high up into the uterus; urine comes out from the urethra, whilst in a similar location, is from a different part of the body entirely.
Do I need to lie down after the transfer? Or take two weeks off work post transfer?
Again, No. there is no documented scientific evidence that suggests lying down after an embryo transfer (or an IUI insemination for that matter) increases the chance of the embryo implanting. Remember, the natural union of sperm and eggs, embryo development and implantation all happen when we don’t typically know it. You could be washing dishes, walking the dog, doing the grocery shopping, literally a million different things and an embryo will implant. The fact remains that getting up and getting on with life is the best thing you can do.
Psychological implications are very different, you may want to take a day off on transfer day to have a special welcome home party for the embryo, but, you’ll know best as to when to return to work. Unless your doctor has recommended you to stay at home in bed, you’re free to move around and get on with life as normal.
Should we avoid sex in between egg collection and embryo transfer?
This is not really a part of the two week wait, but still a common question we are asked. Unprotected sex should be avoided as any follicles that weren’t collected from, or had previously ovulated prior to egg collection may release an egg into the fallopian tube and result in an embryo. Multiple pregnancies increase the stress and chance of complications to the mother and the babies, and may lead you into situations where you may be asked to selectively terminate one of the growing foetuses. It’s an unlikely situation, but it can and does happen. And it is horrible. Your Doctor says no unprotected sex for a reason!
Do pineapple cores, pomegranate juice and McDonald’s fries help implantation?
Maintaining a good, well-balanced diet is the best thing for people in general and for women with embryos on board. We have covered the use of pineapples and pomegranates in a previous blog (see http://mpfertility.com.au/ivf/pineapples-pomegranates-pregnancy-promoters/ ) so have a read of our thoughts there. The re-emerging food kid on the implantation block appears to be McDonalds fries. And while I will be the first to admit they are quite tasty, the use of them in embryo implantation stems from nothing more than internet blog superstition- I’m deadly serious, google it! Apparently it’s the salt. The salt helps implantation *insert eye roll*. So before heading through drive-thru on the way home post transfer, remember, you had also better not cross a black cat, step on a footpath crack or walk under a ladder. There was also a great article (that has since been removed) that laughing as much as possible right after transfer was also the key. No… laughing does not do a thing for implantation, but a laugh does make all of us feel good!
Heat packs to keep the womb warm?
Another myth on the implantation block is the use of heat packs to raise the temperature of the womb. The idea being that when they are placed on the abdomen or lower back, you are raising the internal temperature of the uterus and that is a good thing. Same with really hot showers and baths, it’s not. Trust me, I’m an embryologist. We monitor incubators all day every day to ensure embryos are grown at a constant temperature that is the same as the human body. I can tell you first hand that embryos very sensitive to temperature. Normal body temperature is the best for them. If you were to actually succeed in your attempt to overheat the uterus with a heat pack, you will kill the embryo. If you need to use a heat pack for a different area of your body, we would recommend you ask your fertility nurse or specialist for advice.
Should I test early?
I certainly don’t mean to be a negative Nellie here, but again, our answer is no. The reason for this is that during an IVF cycle, the trigger injection that you use just prior to egg collection is made up of the same chemical that a home pregnancy test also detects. Testing early can therefore give you an incorrect result- positive or negative. The best way to know is to tough out the two weeks and then have the blood test which measures for a specific hormone secreted by an implanted embryo. It is a hard wait, especially when you see women on the “trying to conceive” pages doing it all the time, but don’t risk putting yourself through sheer psychological torture on results that may or may not be accurate.
I don’t feel anything or I have spotting- it must be a negative result.
In normal cases, many women fall pregnant and do not feel anything until they realise their period is late. The IVF train makes women more acutely aware of every little twinge, cramp and spasm of their uterus and its movement will be psychologically analysed to the max! Other women stress that they don’t feel anything and assume that the cycle has failed- no sore boobs, no cramping, nothing. Either way, these feelings or the lack of them do not mean that a cycle has been successful or not. Only the blood test can truly tell that. Bleeding post embryo transfer can be quite similar. Some spotting can occur following embryo transfer. It is often regarded as implantation bleeding, caused by the embryo burrowing into the uterine blood vessels and establishing itself in the uterine walls. Some women also experience bigger bleeds and still go on with their pregnancy. Only the blood test monitoring the implantation hormone can tell us what is correctly happening within the body.
How do I keep sane during this two week wait?
This is one of the hardest questions ever to answer. Mostly as everyone will go through this differently – some try their best to get on with it, others, it’s two weeks of sheer hell and anxiety waiting for the result. So how do women (and their partners) survive? We’ve already listed some things above (don’t test early, keep a good balanced diet etc.) but how do you turn the overthinking off?
– Make a list containing 14 things to do; see that movie you want to see, organise a date night with your partner, catch up for a coffee with a friend etc. and tick one off the list daily.
– Write a journal of your experience, what you feel – the good and bad. Write it so you can let your future children understand what you and your partner have been through to get them into your life.
– Practice knitting or crocheting, this sounds so old fashion but both of these activities will take some time to learn and there would be nothing grander than a pair of booties or a blanket that you have made for your baby.
– Read a book or binge watch that TV series you have been meaning to get around to watching
– At home pamper session; make your own facial scrub with kitchen ingredients; manicure and pedicure, foot massages, shoulder massages (if you can convince your partner to join in!)
– Avoid googling every symptom you have. It just leads to more frustration. I know this is easier said than done because who doesn’t love self-diagnosis (I google diagnosed my own foot fracture recently… see, I can’t practice what I preach… I’m human!)
– If the thoughts of testing are causing a high level of anxiety and you are not your normal self, always remember that you can call your fertility clinic for some very trusty and kind reassurance from the team that are looking after you. It’s completely okay and it’s much better spending a little bit of time chatting about your concerns and feelings. As an embryologist I would rather talk to the patient rather than let them feel like they’re alone in this.
If you have any questions please do not hesitate to get in contact with us. As always, please discuss any queries of your treatment plan with your fertility specialist.
Best of luck!
