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 they will introduce through the vagina to reach the endometrium. All this is done using and ultrasound scan to guie the process and guarantee the success of the embryo transfer.
Provided below is an index with the 7 points we are going to expand on in this article.
Symptoms after Embryo Transfer
Generally, women who start an IVF cycle with their own 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.
- Follicular puncture (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. This increases 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 15 days of uncertainty and concern ahead of her. During this time she will have to deal with not knowing if her treatment is successful 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, in order to try and predict a possible outcome.
However, most of these symptoms are more related to the hormonal treatment, administered to prepare the uterus and to the transfer technique itself. Indeed, many women claim not to have had any symptoms after a successful embryo transfer.
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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.
Many women experience minor blood loss after embryo transfer. This spotting is considered completely normal and usually disappears 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.
The embryologist Aitziber Domingo has this to say on the matter:
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.
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.
The increased feeling of tiredness is due to the increase of the hormone progesterone In a natural pregnancy, progesterone levels go up 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 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. As such. 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. Hence, not suffering from nausea after an embryo transfer does not indicate treatment failure.
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 anxiety generated during the 2-week wait can also produce the sensation of dizziness.
Other more rare symptoms may appear in the woman after the embryo transfer:
- Appetite loss.
- Bloated belly.
It is necessary to point out that in those cases where the symptoms prevent the patient from carrying out her normal life, 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 for an IVF cycle in a patient due to the processes of ovarian stimulation, follicular puncture, endometrial preparation, and embryo transfer.
However, 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 artificial 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.
When an artificial cycle is performed, the patient does not undergo ovarian stimulation and her ovaries are not as inflamed. This could be because she has vitrified embryos leftover from a previous cycle or because she is the recipient of an egg donation treatment.
These patients receive hormonal treatment only to prepare their endometrium. As such, the symptoms they experience are related to the transfer itself or the administration of estrogen and progesterone. Generally, these women suffer less abdominal discomfort or pins and needles, although there are always exceptions.
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. The resulting symptoms suffered by the patient are even fewer.
Furthermore, 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 can cause concern, and patients to ask questions such as "Is what is happening to me normal?" "Should I consult my doctor?" or "Does this mean I'm pregnant? It is best 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 is essential 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, the patient must consult the clinic.
The fertility center they will then carry out the relevant tests to determine the cause of these unusual symptoms after the transfer and thus give the best solution and most appropriate treatment.
FAQs from users
What symptoms can you have after the embryo transfer?
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.
Should I be worried if I have no pregnancy symptoms after embryo transfer?
After the embryo transfer, it is normal for patients to be especially attentive to any symptoms that may indicate that pregnancy has been achieved. However, the most common is not to notice any symptoms in these first days. Pregnancy symptoms are mainly caused by the elevation of the hCG hormone, and in these first days after the transfer the levels will be very low or undetectable.
In fact, many times the symptoms reported by patients are due to the medication we use to facilitate embryo implantation. Thus, progesterone can produce drowsiness, nausea, etc. The administration of hCG at the end of an IVF cycle can produce an increase in urinary frequency and the increase in the size of the ovaries due to the growth of multiple follicles or the medication used for an endometrial preparation can produce discomfort similar to that of menstruation.
Thus, we can conclude that there is no specific symptom of pregnancy at this early stage. Neither the absence of symptoms nor the presence of any of them can indicate whether the transfer has been effective. We have to wait for the beta-hCG test to be certain.
Is a cannula reinserted to absorb fluid from the uterus after embryo transfer?
If there is fluid inside the uterus (hydrometra), it would be best not to perform the embryo transfer, since the presence of this fluid can prevent embryo implantation. It would be best to freeze the embryos and transfer them in another cycle with a suitable endometrium. In any case, even if for some reason it is decided to perform the transfer, it is not advisable to introduce cannulas unnecessarily into the uterus, since this increases the possibility of injuring the endometrium.
The embryo transfer is critical for the success of the assisted reproduction treatment. If we have a good embryo and a receptive endometrium, but the transfer is not performed correctly, we can lose the possibility of achieving pregnancy. During the transfer, it is essential to avoid trauma to the uterus as much as possible. These would produce uterine contractions that would hinder embryo implantation.
What can pink discharge after embryo transfer indicate?
Once the embryo transfer has been performed, and up to the moment when the pregnancy test has to be done 10 days after the transfer (beta wait), there may be some discomfort that is usually normal.
One of these discomforts is bleeding, which is spotting that is less than a period and can range from pink to dark brown and is limited to two or three days after the transfer. This spotting is usually due to the cleaning of the cervix prior to the canalization or due to the canalization itself with the transfer cannula to enter the uterine cavity and leave the embryo inside the uterus.
However, as mentioned above, this is a spotting that is less than a period and is limited to itself, but if it occurs, it is necessary to contact your doctor who will give you the necessary indications to continue with the treatment.
Will I have the same symptoms after an embryo transfer from ovodonation?
The symptoms of embryo transfer obtained by ovodonation vary somewhat because the recipient woman has not undergone ovarian stimulation. Her ovaries are not swollen and the abdominal pains and pins and needles are minor. As for light bleeding and other symptoms, they can occur as per embryo transfer with her own eggs. The changes a woman's body undergoes during pregnancy are also the same as in a natural pregnancy.
Can I take a painkiller if I have a headache or abdominal pain?
In principle, it is possible to take painkillers for this type of symptoms, such as Paracetamol. However, if the pain is severe and persistent, you should consult the center's specialist first.
How likely am I to have OHSS symptoms after embryo transfer?
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).
What happens after an embryo transfer?
Once the embryo is deposited in the uterus, the patient must wait about 10-12 days approximately to perform a pregnancy test and assess whether the embryo transfer has been successful.
This period of time is known as beta waiting and the patient can continue with her daily routine, but avoiding heavy physical exertion.
To learn more about the technique of embryo transfer you can continue reading in the following article: Embryo transfer.
The two-week wait is the hardest moment after embryo transfer. If you would like 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.
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Roseboom, T.J., Vermeden, J.P.W., Schoute, E. et al. (1995) The probability of pregnancy after embryo transfer. Hum. Reprod., 10, 3035-3041.
Watters M1, Noble M2, Child T3, Nelson S4 Short versus extended progesterone supplementation for luteal phase support in fresh IVF cycles: a systematic review and meta-analysis. Reprod Biomed Online. 2019 Oct 24. pii: S1472-6483(19)30785-0. doi: 10.1016/j.rbmo.2019.10.009.
William B. Schoolcraft, M.D., for the ASRM American Society for Reproductive Medicine (April 2016). Importance of embryo transfer technique in maximizing assisted reproductive outcomes. Vol. 105, No. 4. Colorado Center for Reproductive Medicine, Lone Tree, Colorado
Forman EJ, Hong KH, Ferry KM, Tao X, Taylor D, Levy B, et al. In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial. Fertil Steril 2013;100:100–7.e1.
FAQs from users: 'What symptoms can you have after the embryo transfer?', 'Should I be worried if I have no pregnancy symptoms after embryo transfer?', 'Is a cannula reinserted to absorb fluid from the uterus after embryo transfer?', 'Which symptoms can be considered "bad" signs after embryo transfer?', 'What can pink discharge after embryo transfer indicate?', 'Will I have the same symptoms after an embryo transfer from ovodonation?', 'Can I take a painkiller if I have a headache or abdominal pain?', 'How likely am I to have OHSS symptoms after embryo transfer?', 'What happens after an embryo transfer?' and 'What are the common symptoms after embryo transfer if you get pregnant with twins?'.
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