Bed rest after embryo transfer: necessary or not?

Bed rest after embryo transfer: necessary or not?

19 February, 2018

The IVF process is not a quick or simple one, so after embryo transfer has taken place, many women are afraid that their actions can lead to failure. Thus, most women are worried that they may decrease their chances if they do not stay in bed after the transfer, especially if they need to go to work or resume their usual activities.

Opinions on this are diverse – from less than 10 minutes of rest after transfer, to 3 days and more. And who would not stay in bed 3 weeks after the transfer, if they knew this would increase the chances of success? Often women think that failure was due to the fact that they did not rest enough after the transfer and did not stay in bed all the time between the transfer and the pregnancy test.

However, analyzing the data from the literature (and only evidence-based medicine is our guide), we did not find any study that would suggest that bed rest would be beneficial. In 2014, researchers Abou-Setta and others, in their report analyzing the Cochrane medical database on this subject, make the following conclusion: there is insufficient evidence of the time the woman has to spend lying on her back after the transfer, and possibly it is not necessary at all.

If bed rest does not do any good, then could it hurt?
Gaikwad, Garrido et al. (Spain) reported in 2013, in a study published in the journal “Fertility and Sterility”, that 10 minutes of rest in bed after embryo transfer could be detrimental. Their study included two groups of women – one who was told to rest after the transfer for 10 minutes, and another group, who did not stay in bed after the transfer. Women who got up and were discharged immediately after the transfer had a 18% higher rate of success, and the spontaneous abortion rate was 10% lower than in the case of the group with bed rest.
The time that women are asked by doctors to spend in bed after the transfer varies. Research on this time – 10 minutes, 30 minutes (Purcell et al., 2006), one hour (I.Bar-HAVA et al., 2004) or one day (Z.Amarin et al. , 2004) – has found that the shorter the time the woman spent in bed after the embryo transfer, the better were her chances of success.
It should be noted that some evidence is contradictory and not all researchers say bed rest is detrimental to the success of IVF, but all conclude that rest is not at all beneficial.

Why is bed rest unnecessary?

The embryo
Certainly, the embryo will not fall out of the womb as soon as the woman gets up. Moreover (for those who are convinced that gravity has a role in embryo “expulsion”) – when the woman is standing, the uterus is in a virtually horizontal position.
Backed by millions of years of natural conceptions that have happened before IVF, we are sure that none of the women who became pregnant had thought to lie in bed on the 5th day after ovulation, when the embryo reaches the uterus.
The endometrium has its “movement” patterns, and when the embryo reaches the uterus, its function is to keep it in the uterine cavity, preventing expulsion or implantation in inappropriate areas. Therefore implantation does not depend on the woman's activities – once the embryo has reached the uterus, the endometrium does its job.

Circulation and blood flow
In addition, when we move, blood circulation in the body is improved, including circulation in the uterus. The longer we are immobilized in bed, the slower the blood circulation, which means that less blood is pumped to the uterus. So only proper blood circulation will favor endometrial quality and implantation of the embryo.

Thoughts and stress
When we are in bed, we have too much time for thoughts, which will inevitably lead to a dangerous cycle of self-indignation, stress and anxiety. Stress increases even more if this “rest” creates problems at work (especially if it takes several days). Such a situation is not good for anyone and is not beneficial to the success of IVF. 

There are many other reasons why bed rest could be detrimental to the success of embryo transfer, and those listed above are for informational purposes only. Please talk to the fertility specialist to decide what is best for your individual situation. But if you have been instructed to stay in bed after embryo transfer, you should ask about the reasons.

After the transfer we recommend:
DON’T...

  • exercise excessively – easy movement or walking has benefits, but do not overdo it;
  • pick up heavy objects;
  • intake a lot of caffeine;
  • have sex;
  • take hot baths – excessive heat can harm the embryo, so just take showers up to the pregnancy test;
  • listen to anyone with an unsuccessful IVF history. Avoid the negative energy, every woman is a very special case!

But DO...

  • follow the doctor's instructions;
  • get support from your partner, family and friends;
  • try to feel good – laugh, watch movies, read, go out for walks;
  • focus on work – many women say that work helps them to distract their attention and keep their positive thinking while they are waiting. But everything depends on the workplace and the way you feel supported – try to have a pleasant environment.