IVF treatment is a complicated assisted reproductive technique, which not only has the patients spend a lot but also takes an emotional toll. The two week wait period after the implantation of the embryo seems to be like a roller coaster ride time for the couples, as it seems to decide the fate of the cycle. As the embryo is transferred into the uterus by artificial means, the biggest fear that plagues the couple is that it might fall out of the uterus after the transfer.

The fear might be so great that normal activities like standing up, walking, having sex, peeing, coughing, sneezing and laughing might be seen as sinful ones by the prospective parents. Though people without medical background are justified in thinking that embryo can make its way out from the same route it went in, thankfully, the apprehension is baseless. For understanding why you need not be scared of such a possibility, it is necessary to comprehend how things actually work when the embryo implants itself into the uterus and what happens after that.

What happens during and after embryo transfer?

The primary step of IVF is embryo culture, during which eggs are combined with sperms in a lab dish and made to reach the embryo stage (a 3 day or 5 day culture depending upon the clinic protocol). The best amongst the cultured embryos is selected for uterine transfer. The embryologist first takes out the chosen embryo from the incubator and then transfers the same into the uterine cavity with the help of a thin and soft catheter. The right placement of embryo is ensured by using ultrasound guidance as the catheter is threaded through the cervix.

Once the embryo is transferred into the uterus, the patient is generally made to lie on her back for an hour or so. Since the process is ultrasound guided, the same is done with full bladder as a protocol of the scanning procedure. This means that the patient would need to urinate at the end of the transfer. Scary as it may sound, peeing after the transfer would not flush out the embryo from the uterus.

Though the doctors would not stop you from standing and doing all normal activities after the transfer, strenuous workout and lifting heavy objects need to be avoided and so do hot baths and Jacuzzis. During the two week wait, the woman needs to abstain from smoking, alcohol, caffeine and all other potential threats to the pregnancy.

Though best efforts are made for choosing the healthiest amongst the embryos and ensuring its proper placement during In vitro fertilisation (IVF), nature takes its course once the transfer has been done. Nothing can be done to influence the implantation of the embryo in the uterus, as it takes some time to develop and stick to the uterine walls and will do it successfully if it is meant to.

Is it possible for the embryo to fall out of the uterus?

The uterus can be pictured as a cavity, an empty space, within which the embryo(s) would be deposited and would roll around as the woman would stand up and walk around. In fact, it is quite possible for the woman to be obsessed about taking bed rest to maximize the chances of the embryo settling down and sticking to the uterine walls. The truth, however, is that the uterus is a potential cavity rather than a true one. It is a muscular organ, which originally has its walls touching each other and it increases in size as the embryo grows.

So practically, the tiny embryo would have a snug fit within the uterine walls and there is no chance that it would get dislodged and fall out. For a woman with receptive endometrial lining and healthy embryo, there is hardly a reason why pregnancy would not take place. No external influence such as exercise, walking or sneezing can interfere with the process of the embryo sticking to the wall. This is the miracle of nature which cannot be matched even by the most amazing innovations in science and technology.

While sexual intercourse may also be deemed as a peril to the transferred embryo, it has been proved that even orgasm cannot change the fate of a transferred egg. Though there are uterine contractions during orgasm, they cannot dislodge the embryo because the hormone called progesterone synthesized during the luteal phase ensures otherwise. Therefore, whether pregnancy is natural or assisted, there are hardly any reasons to be scared that you may lose the embryo to a free fall. If anything like that was possible, pregnancy would have been a rare event.

Should the woman take bed rest after embryo transfer?

As it has been clarified that the embryo cannot fall out of the uterus, it would be wise to know that bed rest is not necessary after the embryo transfer. In fact, it can make the woman physically uncomfortable and emotionally stressed out, as she has to be confined for no feasible reasons. And there is no reason that the woman should blame herself if the IVF cycle fails because not taking bed rest cannot be the reason behind it.

Surprisingly, even a little spotting and mild cramping during or after the IVF is not seen as a reason to worry because it could happen as a result of the embryo burrowing into the uterine lining and getting implanted therein. It is important for the patients to be aware of the implications of IVF so that they do not lose their sleep over trivial issues and rather try and concentrate on the joy that the coming days might have in store for them.

At Gaudium IVF, patients not only get comprehensive evaluation and best treatment for diverse infertility issues, but are also educated about the procedures and precautions needed after them. Also, visit the clinic to get a free second opinion from the award-winning fertility specialist, Dr Manika Khanna.