By Andrea Rodrigo BSc, MSc (embryologist).
Last Update: 12/11/2017

After an IVF embryo transfer (ET), achieving success depends exclusively on the embryos and their implantation potential. In spite of that, it is common for patients to ask themselves many questions, including what to do and what to avoid, if rest is necessary and to what extent, what are the precautions to be taken… In short, anything that may help to increase the chances for pregnancy.

Once the patient has left the transfer room, a completely different life from the one she had during the treatment begins: The embryo(s) have already been transferred, and here starts the countdown until the pregnancy test.

The different sections of this article have been assembled into the following table of contents.

Tips & precautions

There are many recommendations to follow after an embryo transfer. However, the most important thing for you to do is as simple as continuing with your normal lifestyle, trying not to become too obsessed with getting pregnant. To sum up, these are the most basic tips that every IVF patient should follow after an ET:

Rest
After an embryo transfer, a 30-minute rest at the clinic is recommended. There is no need for extending this reasonable time period, and patients can return home to continue with their normal lifestyles. It is, however, advisable to avoid great physical efforts, such as vigorous sports or heavy lifting. Aside from that, you can rest assured that you can continue with your normal daily activities.
Daily activity
Except for vigorous activities, life goes on after the embryo transfer and daily activities such as going out, walking, driving and even working can be carried out without any problem provided that they do not imply a huge physical effort.
Drinking plenty of water
It is always highly recommendable to drink abundant liquids, observing that micturition is normal and restricting the consumption of salt as much as possible.
Sexual intercourse
It is also important not to engage into sexual intercourse before taking the pregnancy test. This period is known as pelvic rest.
Hot water immersion baths
The patient must prevent herself from hot water immersion baths of the type bathtub, swimming pool, or beach in order to avoid possible infections and not to interfere with the medications taken.
Medication
The only medications to be administered are the ones prescribed by your OB/GYN during the treatment, in which extra doses of progesterone are usually maintained to support the functionality of the corpus luteum until approximately the week 12th of pregnancy. In that moment, the gynecologist may decide to reduce the dose or to stop it, since by that time the placenta already generates concentrated-enough progesterone to make external support unnecessary.

If medication is required due to any type of discomfort like headache, toothache, or any other infection alike, it is advisable to talk to the specialist who monitored the treatment. Either way, analgesic consumption is not a problem as long as it is paracetamol or any other similar painkiller.

Staying positive
Optimism can make a difference after an embryo transfer. Avoiding stress and anxiety, and not becoming obsessed with the potential outcomes is material to achieving success in IVF. Having hobbies and leisure activities of your choice can be extremely helpful to prevent yourself from overthinking. Meditation and yoga classes can be helpful as well.

Symptoms & positive signs

Symptoms vary from woman to woman, and even between pregnancies among women who have been pregnant before. Neither should you be concerned if no symptoms appear—it is not mandatory for every IVF patient to feel them. And most importantly, it does not translate into implantation failure by default.

The most common symptoms after embryo transfer can be caused by the beginning of a new pregnancy or by the fertility drugs you are taking. In other words, they do not indicate failure or success. These are the most frequent ones:

  • Abundant vaginal discharge during the first days after the ET, due to elevated/altered hormonal levels and the vaginal administration of progesterone.
  • Spotting or mild bleeding caused by the passage of the catheter through the cervix; it often disappears within 2-3 days.
  • Breast changes caused by the exogenous administration of hormones before the transfer (estrogens and progesterone).
  • Fatigue as a side effect of your increased progesterone levels, which can be caused either by pregnancy or progesterone supplements.
  • Nausea, due to increased hormonal levels.
  • Frequent urination caused by rising hCG hormone levels, either caused by a new pregnancy or as an adverse reaction of hCG injections.
  • Missed/delayed period
  • Discomfort around the abdominal area and lower back pain caused by hormonal changes after ovarian stimulation and the preparation of the endometrium.

The symptoms that we have just listed can appear irrespective of whether it was a Frozen Embryo Transfer (FET) or a fresh transfer, or if it was a day-3 or day-5 embryo.

It is advisable for you to contact the center that has been monitoring your treatment in case symptoms like bleeding, fever, vomits, swelling and abdominal pain, or even shortness of breath, show up.

If you need to undergo IVF to become a mother, we recommend that you use "The Calculator". In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.

Also, the report will inform you about the promotions or special prices that the clinics selected offer so you can benefit from them as well.

When to test for pregnancy

In natural pregnancies, the embryo attaches to the uterine lining about 6 to 8 days after entering the uterus. This means that embryo implantation occurs at blastocyst stage. In short, even though this is the precise moment when implantation takes place, the entire process can take up to one week to be fully completed.

In an IVF cycle, day-3 embryos should remain in the uterus at least for three more days until reaching blastocyst stage and being able to implant. However, day-5 embryos are already at blastocyst stage, which means that they are able to attach to the uterus immediately after the ET.

The only thing left to do to finish the unending wait is to do the pregnancy test. It is usually done 10-15 days following the date when the follicle puncture (egg collection) was performed. In case it was a Frozen Embryo Transfer (FET), it can be done within 10 days, counting from the stage of embryo development in which the embryo was at the moment of the ET.

It is totally unadvisable to do a pregnancy test earlier than indicated, since the pregnancy hormone (hCG) increases progressively. For this reason, if one takes the test too early, you may get a false negative result, as the levels of hCG are insufficient as to be detectable.

This test may be performed in two ways: in urine or in blood. To do this, the patient must follow the instructions facilitated by the fertility center. Irrespective of wether you get a positive or negative outcome, you should always communicate it to the clinic, so that the guidelines to follow from that moment on can be established.

In the event of the result being positive, it is highly possible that you are advised to make an appointment with your gynecologist to have a first ultrasound done and check that everything is right.

If the result is negative but there is no vaginal bleeding, it is very possible that you are recommended to repeat the test within one week, as after this time period it could turn into positive.

If your menstrual period shows up, it means that a new cycle has started, and that pregnancy has not occurred. In other words, that unfortunately your IVF embryo transfer has failed.

The most important thing to do now is to keep calm and follow step by step the guidelines established by your fertility clinic. Take into account that their goal is the same as yours.

FAQs from users

What precautions should I follow after embryo transfer in ICSI?

By Andrea Rodrigo BSc, MSc (embryologist).

The precautions to take after embryo transfer in ICSI are exactly the same as in any other infertility treatment: Avoiding stress, reducing the intake of caffeine or stopping it, avoiding vigorous exercises, abstaining from intercourse, not having hot baths, and staying positive above all.

Are bloating, cramping and pain good signs after embryo transfer?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, these are considered to be normal symptoms after embryo transfer. As for pain, it is possible that, due to the stress generated during the treatment, the medications administered, and the manipulation of the uterus during the embryo transfer, the woman has headaches, stomachaches, or backaches.

If they range from mild to moderate intensity, there is no reason for you to be concerned. However, if it turns into an unbearable pain, we recommend that you visit your doctor.

How long does it take for the embryo to implant after embryo transfer?

By Andrea Rodrigo BSc, MSc (embryologist).

As explained above, it takes more than one week for the embryo to implant since fertilization. To be precise, implantation takes place 6-8 days after the embryo enters the endometrial lining.

What should I eat after IVF embryo transfer?

By Andrea Rodrigo BSc, MSc (embryologist).

In general, you should follow a healthy, balanced diet, avoiding junk food above all. Ideally, your diet should include a mix of fruits, protein- and carbohydrate-rich foods, vegetables, etc. Also, you should avoid taking caffeine. If you can’t stop drinking caffeinated drinks, limit your intake to a maximum of 200 mg per day.

When should I take a pregnancy test after a donor-egg embryo transfer?

By Rebeca Reus BSc, MSc (embryologist).

Like in any other IVF procedure, after an embryo transfer with donated eggs, women have to go through the two-week wait or 2WW, a time period necessary for beta-hCG levels to be detectable by a pregnancy test.

The presence of the hormone hCG in blood increases gradually from embryo implantation up until the end of the third trimester approximately. This, along with other hormonal changes, is the reason why the common pregnancy symptoms appear (nausea, vomiting, etc.)

What happens after embryo transfer on each day?

By Andrea Rodrigo BSc, MSc (embryologist).

Supposing that the embryo continued to develop and that pregnancy occurred as expected, this is what one should expect from Day Post Transfer (DPT) 1 to 11 approximately:

  1. The embryo turns from a 6-8 cell embryo to a morula
  2. The cells of the morula continue dividing: the embryo reaches the blastocyst stage
  3. Once a blastocyst, the embryo starts to hatch out of its “shell”
  4. It begins to attach itself to the uterus
  5. The implantation process continues: the embryo attaches deeper into the uterus
  6. The implantation process continues
  7. The embryo implantation process finishes and the cells that will form both the placenta and the fetus begin to develop
  8. The production of hCG starts, and it begins to enter the bloodstream
  9. Fetal development begins and hCG levels continue doubling
  10. Fetal development continues and hCG levels continue increasing
  11. hCG levels start now to be high enough to be detectable by pregnancy tests

When is your period due if the embryo transfer doesn’t work?

By Andrea Rodrigo BSc, MSc (embryologist).

Firstly, if adequate hormone replacement therapy is given in the luteal phase, then your period should not show up until fertility medications are stopped. In general, your period should not appear earlier than 12 days after your ET.

Can you fly right after IVF embryo transfer?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, there is no problem with that. Your embryos will be okay, floating freely inside your uterus. You can travel without being concerned about staying laying down, or your embryos falling out after transfer.

What is the best sleep position after embryo transfer?

By Andrea Rodrigo BSc, MSc (embryologist).

Actually, you can choose the sleep position that is most comfortable for you. It’s just as simple as that. There is no recommended sleep position, or a position that is unadvisable.

In fact, the common belief that bed rest is necessary after an ET is a myth that can be counterproductive, as it increases the levels of stress in the woman. It is erroneous to think that gravity can make the embryos fall out or reduce their possibilities of implanting.

How long after embryo transfer can you have intercourse?

By Andrea Rodrigo BSc, MSc (embryologist).

It depends on a case-by-case basis, so you better follow your doctor’s instructions. Anyway, pelvic rest may be recommended anywhere from 5 to 15 days after the embryo transfer.

Can smoking affect implantation after embryo transfer?

By Andrea Rodrigo BSc, MSc (embryologist).

Smoking tobacco can affect the proper growth of the embryo—and fetal development in case pregnancy occurs. Moreover, it can reduce your fertility and reduce your chances of getting pregnant. For this reason, we strongly recommend that all IVF patients stop smoking before, during, and after their infertility treatment at once.

Suggested for you

This post is a summary of the general tips and symptoms that you are likely to feel after an IVF embryo transfer procedure. However, if you want to delve deeper into the most common symptoms after an ET, we recommend that you go visit this complete guide: Symptoms After Embryo Transfer: Most Common Positive Signs.

If the two-week wait has already come to its end for you, and you found out that you are pregnant… Congratulations! But now, what’s next? To learn more about the signs and symptoms often associated with embryo implantation, check this out: What Are the First Signs & Symptoms of Embryo Implantation?

Finally, we have made references to day-3 and day-5 embryo transfers, and the main difference between them when it comes to determining the moment of embryo implantation. Want to get more details about the differences between them? Get answers here: Embryo Transfer on Day 3 or on Day 5?

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Authors and contributors

 Andrea Rodrigo
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information

10 comments

  1. Featured
    Sana

    Hi, my wife she had her embryos transferred today and after almost 6 hours she started vomiting, is that ok? I am a bit worried. Pls tell me something soon. Thanks.

    • Sandra FernándezBA, MA

      Hello Sana,

      Yes, that is a normal symptom after embryo transfer. It is caused by the medications she’s been taking, and because of the transfer itself, but it does not mean the treatment has failed.

      Just keep calm during the 2ww 😉

  2. Featured
    Kylie

    Hey gurls, I’m on my 3rd day post transfer, 2 beautiful embryos (day 3). It was my first IVF attempt due to bilateral hydrosalpinx… I’ve read it’s very complicated for a person with hydrosalpinx to become pregnant… I’m on the 2ww and freaking out!!! If I succeed, it will be my 1st baby and to be honest I thought I would never make it due to the hydrosalpinx, but support from my partner has been material for be to be where I am at this moment!! No words can describe how grateful I am… fyi, I’ve had no symptoms except for a very mild pain on my ovaries… Is it normal?

    • Sandra FernándezBA, MA

      Dear Kylie,

      I’m sorry to tell you that a natural pregnancy is not possible with bilateral hydrosalpinx. However, these patients are able to become mothers thanks to IVF, as it is your case.

      Moreover, performing a tubal occlusion procedure before starting the treatment can be highly beneficial to prevent the fluid in your fallopian tubes to spread and become toxic for the embryos. I don’t know if you have had it already done or not.

      Wishing you lots of luck.

      Best.

  1. PRINCE

    Thanks for this beautiful answer. Actually I was worried, but you have calmed down my nerves.

  2. AngieV

    Tomorrow will be 2 weeks since my transfer!!! Bloodwork in the morning and results in the afternoon. That will feel longer than the 2 weeks we had to wait!!!

  3. Malih

    Hi, I had a single, 5day embryo transfer done last Monday, 14th June. I had no symptoms and no brown bleeding. But this morning I woke up with nipple pain but not breast pain, and my legs are like tired or organism pain. What could really cause it? Could I be pregnant?

    Thanks

  4. Nana

    I’m 1dp5dt with an average blasto. This is our 2nd cycle and our embryo quality was nowhere near what we got on cycle 1; which thankfully we have x3 top graders on!!

    I’ve been feeling AF symptoms before transfer and even more so now. Throbbing pain down my right thigh, lower back ache, sore boobs & those mood swings! However I’ve been having a burning sensation on the left side of my abdomen. Never experienced that before!!

    The 2ww is exhausting no matter how many words of encouragement. Just wish there was a way to look inside the womb during this time… Fingers & toes crossed this cycle works. Baby dust to all mummy’s-to-be x

  5. Yousra

    I just had 2 embryos transferred last Tuesday 7th June. Until now, I feel good except sometimes some very slight pain in the ovaries area. Do I understand that everything is ok? Or there are some symptoms that should appear so that it shows that I`m pregnant?

    • Nana

      Every lady is different and most likely things are going well for you and your embryos! Side effects from the pesky pessaries don’t help neither (that’s if you get the symptoms) but not long now before you can test. Best of luck to you.