What to do after embryo transfer? – Recommendations

By (embryologist), (embryologist), (embryologist), (gynecologist) and (invitra staff).
Last Update: 05/15/2023

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.

Provided below is an index with the 7 points we are going to expand on in this article.

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:

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.
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.

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.

Finally, it is important to have a positive attitude after the embryo transfer until the day of the pregnancy test. It is essential to avoid stress and anxiety and try to think about other things to reduce uncertainty during these days.

We recommend that you read the following article for further information on the subject: Should You Rest After Embryo Transfer in IVF?

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.

Some of the most common symptoms after embryo transfer, apart from the absence of menstruation, are the following:

  • 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 and discomfort around the abdominal area, 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.

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 generate your Fertility Report now. 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.

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

Can I take a bath after the embryo transfer?

By Rut Gómez de Segura M.D. (gynecologist).

Bathing in pools, spas, and tubs should be avoided for at least one week after the embryo transfer to avoid possible infection or interference with vaginal medication. There is no contraindication for daily showering.

What precautions should I follow after embryo transfer in ICSI?

By Andrea Rodrigo B.Sc., M.Sc. (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 B.Sc., M.Sc. (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.

Is it necessary to rest after the transfer?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

No, it is not necessary to rest beyond the 30-40 minutes recommended by the specialist immediately after the transfer. As we have commented above, after this time, the woman can continue with her usual life, always avoiding excessive efforts.

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

By Andrea Rodrigo B.Sc., M.Sc. (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.

Is it normal to notice flu-like symptoms after embryo transfer?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Experiencing cold-like symptoms and a stuffy nose is a common post embryo transfer symptom, actually. This phenomenon is commonly known as "IVF cold", and includes sneezing, nasal congestion and even coughing. As other symptoms, IVF colds are caused by changing hormone levels, whether you become pregnant or not. In fact, women taking birth control pills or undergoing hormone replacement therapy are likely to feel them too.

I have zero symptoms but got a BFP, is that normal?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Yes, symptoms are not an essential requirement for IVF to be successful. As explained earlier, it varies on a case-by-case basis. A woman not feeling common symptoms may get a positive pregnancy test (commonly referred to as BFP or Big Fat Positive), while others noticing every symptom listed above may end up not being pregnant.

What should I eat after IVF embryo transfer?

By Andrea Rodrigo B.Sc., M.Sc. (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 B.Sc., M.Sc. (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

I'm feeling thrush symptoms after embryo transfer, what is the cause?

By Sara Salgado B.Sc., M.Sc. (embryologist).

In some cases, fertility specialists prescribe antibiotics prior to embryo transfer in order to prevent the presence of bacteria and other organisms to interfere with IVF outcomes. The use of antibiotics can cause women to develop candidiasis (vaginal yeast infection), as they can change the balance of those "good" microorganisms which help keep a healthy vaginal environment.

Nevertheless, there is no scientific proof that taking antibiotics improves the outcomes of IVF embryo transfers, so women who are prone to yeast infections should consider the use of antibiotics as just a preventive measure.

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

By Andrea Rodrigo B.Sc., M.Sc. (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 B.Sc., M.Sc. (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 B.Sc., M.Sc. (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 B.Sc., M.Sc. (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 B.Sc., M.Sc. (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?

We make a great effort to provide you with the highest quality information.

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Amarin ZO, Obeidat BR. Bed rest versus free mobilisation following embryo transfer: a prospective randomised study. BJOG. 2004 Nov;111(11):1273-6 (View)

Cozzolino M, Troiano G, Esencan E. Bed rest after an embryo transfer: a systematic review and meta-analysis. Arch Gynecol Obstet. 2019 Nov;300(5):1121-1130 (View)

Gaikwad S, Garrido N, Cobo A, Pellicer A, Remohi J. Bed rest after embryo transfer negatively affects in vitro fertilization: a randomized controlled clinical trial. Fertil Steril. 2013 Sep;100(3):729-35 (View)

Purcell KJ, Schembri M, Telles TL, Fujimoto VY, Cedars MI. Bed rest after embryo transfer: a randomized controlled trial. Fertil Steril. 2007 Jun;87(6):1322-6 (View)

FAQs from users: 'Can I take a bath after the embryo transfer?', 'What precautions should I follow after embryo transfer in ICSI?', 'Are bloating, cramping and pain good signs after embryo transfer?', 'Is it necessary to rest after the transfer?', 'How long does it take for the embryo to implant after embryo transfer?', 'Is it normal to notice flu-like symptoms after embryo transfer?', 'I have zero symptoms but got a BFP, is that normal?', 'What should I eat after IVF embryo transfer?', 'When should I take a pregnancy test after a donor-egg embryo transfer?', 'What happens after embryo transfer on each day?', 'I'm feeling thrush symptoms after embryo transfer, what is the cause?', 'When is your period due if the embryo transfer doesn't work?', 'Can you fly right after IVF embryo transfer?', 'What is the best sleep position after embryo transfer?', 'How long after embryo transfer can you have intercourse?' and 'Can smoking affect implantation after embryo transfer?'.

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Authors and contributors

 Andrea Rodrigo
Andrea Rodrigo
B.Sc., M.Sc.
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 about Andrea Rodrigo
 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Patricia Recuerda Tomás
Patricia Recuerda Tomás
B.Sc., M.Sc.
Bachelor's Degree in Biology from the University of Alcalá de Henares. Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). Extensive experience working at several Assisted Reproduction laboratories. More information about Patricia Recuerda Tomás
License: 19882M
 Rut Gómez de Segura
Rut Gómez de Segura
Graduation in Medicine and Surgery from the University of Alcalá de Henares. Specialization in Obstetrics and Gynecology at the Hospital Costa del Sol in Marbella. Dr Rut Gómez de Segura currently works as medical director in the fertility center ProcreaTec in Madrid. More information about Rut Gómez de Segura
Licence number: 28/2908776
Adapted into english by:
 Romina Packan
Romina Packan
inviTRA Staff
Editor and translator for the English and German edition of inviTRA. More information about Romina Packan

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