Symptoms After Embryo Transfer – Most Common Positive Signs

By BSc, MSc (embryologist), MD, PhD, MSc (gynecologist), (embryologin), (embryologist), BSc, MSc (embryologist), (gynecologist), BSc, MSc (embryologist) and (invitra staff).
Last Update: 05/21/2020

Embryo transfer is the last step the patient faces in the process of in vitro fertilization (IVF). This procedure is simple and does not require sedation, but needs to be performed under sterile conditions.

This process consists of placing the embryo or embryos in the uterus of the future mother. For this purpose, the gynecologist will use a transfer cannula that he will introduce through the vagina to reach the endometrium. All this will be carried out in a guided way through an ultrasound scan to guarantee the success of the embryo transfer.

Below you have an index with the 7 points we are going to deal with in this article.

Symptoms after Embryo Transfer

Generally, women who start an IVF cycle with their eggs must go through 4 distinct treatment steps:

Ovarian stimulation
The patient is given different hormones that will result in an increase in the number of eggs in her ovaries.
Ovum pick-up
an aspiration needle is inserted into the woman via the vagina to reach the ovaries and collect the eggs that have grown inside.
Endometrial preparation
In the days prior to the embryo transfer, the patient receives a hormonal treatment based on estrogen and progesterone to increase the thickness of her uterine endometrium so that it is in perfect condition to receive the embryos.
Embryo transfer
placement of the embryo in the uterus by means of a transfer cannula that the gynecologist inserts through the cervix.

After the embryo transfer, the woman will have 14 days ahead of her, during which she will have to deal with the uncertainty and concern of not knowing if her treatment has given the expected results until the pregnancy test is performed. Therefore, it is completely normal that after the embryo transfer, the woman is more aware of all the symptoms and changes that her body experiences to try to predict a possible outcome in advance.

However, most of these symptoms are more related to the hormonal treatment, administered to prepare her uterus and to the transfer technique itself. Many women claim not to have had any symptoms after a successful embryo transfer.

The following is a description of the main symptoms faced by a patient undergoing IVF treatment with her eggs after an embryo transfer.

Abundant vaginal discharge

Patients often experience changes in their vaginal discharge. Among them, the most frequent change shown by women is an increase in the amount of discharge in the days following the embryo transfer.

These alterations are produced as a consequence of the woman's hormonal levels and the progesterone administered vaginally, which serves to maintain the endometrium in an optimal state to support the embryo implantation.

Slight bleeding

Many women experience minor blood loss after embryo transfer. These spots are considered completely normal and usually disappear 2 or 3 days after the embryo transfer is performed.

Generally, bleeding is due to the channeling through the cervix that is done in the embryo transfer process by inserting the cannula through the cervix.

This is what embryologist Aitziber Domingo says about the symptom:

After the embryo transfer, patients may notice a brown or pinkish stain due to the introduction of the catheter, which may rub against the walls of the cervix.

Breast changes

After a few days following the embryo transfer, it is normal for the woman to notice changes in her breasts. Her breasts may be a little harder than normal, swollen and soft, and she may also notice some tingling in her nipples and darkening of the areolas.

These breast changes are common symptoms in women and also due to the administration of hormones before the embryo transfer.

Fatigue

The increased feeling of tiredness is due to the increase of the hormone progesterone, which in a natural pregnancy grows in concentration to maintain the lining of the uterus where the embryo implants.

Therefore, patients undergoing embryo transfer after IVF or ICSI must take progesterone supplements to maintain this lining.

Nausea

Nausea is the classic symptom of pregnancy during the first trimester, although it should be noted that it is also very common after the administration of the hormones of an assisted reproduction treatment. This is why this symptom can be confused with a pregnancy symptom.

However, it should be noted that not all women who become pregnant and not all women who have undergone assisted reproduction treatment have nausea. This means that not suffering from nausea after an embryo transfer does not indicate treatment failure.

Frequent urination

Many women undergoing assisted reproduction treatment are injected with the hormone hCG, the pregnancy hormone.

In a natural pregnancy, hCG is produced by the embryo's gestational sac and helps maintain and progress gestation. This hormone increases in blood and urine shortly after embryo implantation, so the determination of hCG is essential to confirm pregnancy.

One of the side effects of hCG is the increased urge to urinate. However, it will not be known whether this increased urinary activity is due to an actual pregnancy or to the additional injections the woman is having.

Absence of menstruation

Undoubtedly, the absence of menstruation is one of the first symptoms that can make you suspect a possible pregnancy.

Nevertheless, it should be noted that after an embryo transfer, a patient must wait approximately 14 days for her menstruation to start in the event of a negative result. Depending on the patient's menstrual cycle, this delayed menstruation can be confused with a pregnancy sign.

Pins and needles, dizziness, and pain in the abdominal and lower back

Pins and needles, dizziness, and pain in the abdominal and lower back areas are common complaints after embryo transfer. These symptoms are usually caused by the hormones of ovarian stimulation or endometrial preparation. Certain discomfort and pain can also be caused by the follicular puncture process itself.

The very anxiety generated during the 2-week wait can also produce the sensation of dizziness.

Other

Other more rare symptoms may appear in the woman after the embryo transfer:

  • Insomnia.
  • Appetite loss.
  • Constipation.
  • Bloated belly.
  • Headache.

It is necessary to point out that in those cases where the symptoms prevent the patient from carrying out her life normally, a specialist should be consulted to treat them appropriately.

Transfer of frozen embryos or embryos from egg donation

So far we have discussed the symptoms that a patient undergoing an IVF cycle experiences due to the processes of ovarian stimulation, follicular puncture, endometrial preparation, and embryo transfer.

Still, the symptoms described for women who have undergone a frozen embryo transfer vary somewhat since this transfer has not been performed in the same cycle as the ovarian stimulation. Furthermore, those patients who have undergone an egg donation treatment will not have undergone a process of ovarian stimulation and follicular puncture.

Therefore, patients with frozen embryo transfer and donated oocytes will only have to undergo endometrial preparation and embryo transfer. In these cases, what is known as the substituted cycle or natural cycle will be carried out.

If you would like to learn more about frozen embryo transfer, you can visit the following article: Frozen Embryo Transfer: What are its Success Rates?

Substituted Cycle

When a substituted cycle is performed, the patient does not undergo ovarian stimulation and her ovaries are not as inflamed. This is because she had vitrified embryos leftover from a previous cycle or because she is a recipient of an egg donation treatment.

These patients only receive hormonal treatment to prepare their endometrium and therefore the symptoms they experience are those related to the transfer itself or the administration of estrogen and progesterone. Generally, these women suffer less abdominal discomfort, pins, and needles, although there are always exceptions.

Natural Cycle

There is also the option of transferring cryopreserved or donated embryos in a natural cycle, where the natural hormones of the patient's menstrual cycle are used and the evolution of the endometrium is controlled through ultrasound scans. In this case, progesterone is only administered in the luteal phase of the cycle, close to the embryo transfer. Therefore, the symptoms suffered by the patient are even less.

On the other hand, the stress suffered by women when they take advantage of a natural cycle is less, since they do not have to pay attention to the administration of the drugs during the whole process.

When to consult a doctor after the transfer

Suspicion of the slightest post-transfer symptom causes some concern and causes women to ask questions such as "Is this normal what's happening to me" "Should I consult my doctor," or "Does this mean I'm pregnant? It is recommended to remain calm and above all to be clear that there are no specific symptoms of anything, unless there is heavy bleeding.

If within 14 days of the embryo transfer, uncontrollable bleeding similar to that of a period appears, it will be necessary to go to or call the reproductive center where the treatment was performed. It is important not to confuse this heavy bleeding with implantation bleeding, which is a lighter spotting than menstruation.

If there is acute and persistent pain in the abdomen, or general discomfort with pain, headaches, fever, and other symptoms that are abnormal for the woman, it is essential to consult the clinic staff.

In the consultation of the fertility center, they will carry out the relevant tests to determine the cause of these unusual symptoms after the transfer and thus be able to give the best solution through the most appropriate treatment.

FAQs from users

What symptoms can you have after the embryo transfer?

By Dra. Rut Gómez de Segura (gynecologist).

After an assisted reproduction treatment it is natural to try to guess some symptoms that indicate if the treatment has been successful.

However, the most normal thing is that during the two-week wait you will not feel any pain, bleeding, or symptoms that would indicate whether the pregnancy has been achieved.

Furthermore, each patient is different and may have different symptoms of pregnancy depending on their treatment.
Read more

Which symptoms can be considered "bad" signs after embryo transfer?

By Sara Salgado BSc, MSc (embryologist).

After an embryo transfer, women are advised to visit the fertility clinic again if they feel any of the following symptoms, which are considered to be negative:

  • A heavy, period-like bleeding appears within 14 days, especially in cases of frozen embryo transfer.
  • A severe, persistent abdominal pain.
  • Your general state of health gets worse with symptoms such as flu-like general pain, migraine, fever, etc.

At the doctor’s office you will undergo any tests required in order to determine what is causing these unusual symptoms after the embryo transfer. There, you will be provided with the most suitable treatment for your particular case.

What are the most common symptoms after embryo transfer with donor eggs?

By Sara Salgado BSc, MSc (embryologist).

When a woman conceives with donor eggs, the symptoms she is expected to feel in case of a successful outcome are those of any other natural pregnancy. The only difference may be due to the side effects derived from the fertility drugs recipients should take for endometrial preparation.

The following post may provide you with further information: Early pregnancy signs after donor-egg IVF.

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

By Sara Salgado BSc, MSc (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 BSc, MSc (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.

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.)

How likely am I to have OHSS symptoms after embryo transfer?

By Sara Salgado BSc, MSc (embryologist).

It is estimated that 5% of women will develop mild symptoms of OHSS in IVF treatment, while the incidence of severe OHSS is less than 1%. Common symptoms include: pain, vomiting, nausea, diarrhea, abdominal distension, etc.

You can find more details on this side effect of ovarian stimulation here: Ovarian Hyperstimulation Syndrome (OHSS).

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

By Sara Salgado BSc, MSc (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.

What are the common symptoms after embryo transfer if you get pregnant with twins?

By Sara Salgado BSc, MSc (embryologist).

When a woman is pregnant with twins, her beta-hCG levels are considerably more elevated than those of singleton pregnancies. Also, she might experience exaggerated pregnancy symptoms, yet it depends on each woman, as explained above.

Suggested for you

To learn more about the technique of embryo transfer, you can continue reading the following article: Embryo transfer.

The two-week wait is the hardest moment after embryo transfer. If you want to know some tips to overcome it click here: What is the two-week wait? Tips to survive it.

In the following post you will find recommendations to follow after an embryo transfer: Post embryo transfer tips & precautions.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Authors and contributors

 Aitziber Domingo Bilbao
Aitziber Domingo Bilbao
BSc, MSc
Embryologist
Bachelor's Degree in Biology from the University of the Basque Country. Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid, and Master's Degree in Biomedical Research from the University of the Basque Country. Wide experience as an Embryologist specialized in Assisted Procreation. More information about Aitziber Domingo Bilbao
 Blanca Paraíso
Blanca Paraíso
MD, PhD, MSc
Gynecologist
Bachelor's Degree in Medicine and Ph.D from the Complutense University of Madrid (UCM). Postgraduate Course in Statistics of Health Sciences. Doctor specialized in Obstetrics & Gynecology, and Assisted Procreation. More information about Blanca Paraíso
License: 454505579
 Laura Parra Villar
Laura Parra Villar
Embryologin
Graduate in Biology from the University of Valencia (UV) and embryologist with a Master's degree in Biotechnology of Human Reproduction from the University of Valencia in collaboration with the Valencian Institute of Infertility (IVI). More information about Laura Parra Villar
Licence number: 3325-CV
 Marta Barranquero Gómez
Marta Barranquero Gómez
Embryologist
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
 Rebeca Reus
Rebeca Reus
BSc, MSc
Embryologist
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information about Rebeca Reus
Dra. Rut Gómez de Segura
Dra. Rut Gómez de Segura
Gynecologist
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 Dra. Rut Gómez de Segura
Licence number: 28/2908776
 Sara Salgado
Sara Salgado
BSc, MSc
Embryologist
Degree in Biochemistry and Molecular Biology from the University of the Basque Country (UPV/EHU). Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid (UCM). Certificate of University Expert in Genetic Diagnosis Techniques from the University of Valencia (UV). More information about Sara Salgado
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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