Embryo Glue: The 5 Secrets Everyone Should Know Post-Embryo Transfer

There may be no more anxiety-ridden interval than the time between the embryo transfer and the first pregnancy test. Simply stated, it is sort of terrible. Those nine days can feel like nine years. Every symptom you feel (or don’t feel) can take your mind to places you didn’t think it was possible to go. However, while the rollercoaster of emotions is real, the good news is that you are not alone. Nearly every woman who has come before you and every woman who will come after you find the time between the transfer and the pregnancy test to be incredibly stressful. Here are five tips on how to best deal with your emotions during the transfer-to-test interval.

  1. Movement: Standing up after the embryo transfer is finished ranks up there on many women’s top 10 list of scariest activities while going through fertility treatment. The “if I move these embryos are going to fall out sensation” is super common, but it isn’t super credible. In fact, there is absolutely NO medical evidence to show that movement, be it in the form of a trip to the ladies room or a bumpy car ride home, will negatively impact your chances of pregnancy. Don’t sideline yourself just because you had an embryo transfer.  Movement won’t be the factor that makes or brakes the pregnancy.
  2. Diet: Food gets a lot of credit and a lot of flak when it comes to fertility. Pineapples will make your embryo stick, and hot dogs will make your embryos not stick. And although who doesn’t love a sweet pineapple in the middle of July, there is no evidence that food will improve or harm your chances of pregnancy. Bottom line, don’t lose sleep over what you have and have not taken in—your “intake” will not impact if your embryo takes up a permanent spot in your uterus.
  3. Exercise: There may be no more controversial words than exercise and fertility. These two engender A LOT of emotions. And while it may seem like it from what you hear and what you read, in reality exercise and fertility are by no means oil and water. Exercise—be it walking, running, cycling, or swimming—is not a no no post-transfer. While you may have to curtail your specific activity based on if you had a fresh or frozen embryo transfer, breaking a sweat won’t break your chances of pregnancy.  We do usually recommend a 48-hour period of relaxation after the transfer—but after that, most forms of exercise are okay. Just touch base with your doctor.   We will say, for those of you who will look back and blame yourself if the transfer does not work, we recommend you don’t engage in any activity that will make you think twice.  We can tell you there is no sound data to suggest moderate exercise after an embryo transfer will lower implantation rates, but we want you to have zero regrets!
  4. Coffee: Don’t say sayonara to Starbucks just because you had an embryo transfer. Coffee is not the culprit for your infertility and is cool (or hot!) post-transfer. While you should taper the amount of caffeine you ingest (<200mg/day), you can continue to indulge your caffeine kick.
  5. Stress: It’s nearly impossible not to count down the days from the transfer to the pregnancy test. The anxiety, anticipation, and stress mount as the time between these two events is minimized. These emotions are totally normal. Everyone has them. Engaging in activities that can help alleviate your stress is recommended but not mandatory  (although de-stressing will do your mind good, it won’t make a difference on the outcome of the transfer). On the flip side, if you can’t take your stress level below a 10 no matter what you do, don’t freak out. Stress post-transfer has not been demonstrated to decrease the chances of pregnancy.  

It’s important to always remember that whether you DO or DO NOT get pregnant, post-embryo transfer has to do with the quality of the embryo, the genetics of the embryo, and your uterine lining—not what you DID or DID NOT do. Unfortunately, you can live your best you and still not get pregnant. And while we don’t have all the answers for what makes some transfers work and others not, we promise to keep searching for that evasive “embryo glue”—and if we find it, we won’t keep it a secret!

Are We Doing Leftovers Tonight…What’s in the Freezer?

Nothing tastes better the day after, the week after, or certainly after it’s been sitting in the freezer for a while (except maybe Haagen Dazs coffee ice cream!). With this being said (and true), it’s hard to believe that frozen embryos are as good as, if not better, than fresh embryos. Explaining this to patients can be incredibly confusing—and rightfully so. Who wouldn’t think that fresh chicken is better than the stuff you defrosted last night?

Given our perception of food and what happens after a stint in the fridge or freezer, it can take a while to convince patients to take a pass on the fresh embryo transfer and opt for a frozen one. However, embryo freezing has come “a long way, baby” since the first baby was born in Australia in 1984. Currently, nearly half of IVF transfers in this country are frozen embryo transfers. So why the shift? Changes in the freezing process and techniques have resulted in frozen embryo transfer success rates that in some cases top those of fresh cycles. Data from our OB friends have shown that babies born after frozen cycles do better in utero and as infants than babies born after fresh cycles! Large studies have shown lower rates of preterm delivery, low birth weight, growth restriction, and mortality after frozen embryo transfers—pretty impressive stuff.

Furthermore, the congenital anomalies/malformations that arise after frozen embryo transfers are no different than after fresh transfers. Your next question is likely…why? What could possibly be better about something that was frozen and then thawed rather than something that was hot (or fresh) off the press? Here’s the deal.

Researchers believe that it has something to do with the uterus and the endometrium’s ability to receive the embryo after a fresh vs. a frozen embryo transfer. The thought is that maybe the high estrogen levels seen in many fresh IVF cycles, while beneficial to the ovaries, may be detrimental to the uterus. An “unhappy uterus” means “unlikely to have implantation.” And if you take it one step further, maybe the high estrogen levels not only decrease the chance of implantation but also the ability of a good placenta to form.

Poor placental development will ultimately translate into poor fetal growth (hence, the higher incidence of growth restriction and low birth weight after fresh embryo transfer cycles). Whatever it is, the data are fairly impressive. And while we are all rah-rah-go frozen embryo transfers for the above reasons, there are also two more important reasons to raise the pom-poms:

  1. When embryos are not transferred back into the uterus during the fresh cycle, it gives your body a chance to go back to baseline. Deep breath in, deep breath out! The pause allows your body and, in many ways, your mind to reset. Without a pregnancy in the uterus to provide the juice to keep the ovaries revved up and enlarged, you will get a period about 7–14 days after the retrieval. And this breather is more than just getting your pants to button again (although it does feel good!). It allows your body to return to baseline and prepare for pregnancy with a more normal hormonal environment.Additionally, for those of us who are exercise fanatics, once you get a period you can resume your normal activities (#run #spin #yoga). While we know that exercise is not the most important thing in the world, it and any activity you do to keep you sane are pretty important. If we can help you maintain some normalcy in the midst of shots, vaginal ultrasounds, and never-ending blood draws, we most certainly want to do that.
  2. Recently, embryo freezing has taken on a whole new meaning; it now is a major player in the genetic testing of embryos game. Call it what you want: PGS, CCS, TE biopsy. Embryo testing has become all the rage. It provides patients with important information, significantly increases success rates, and majorly reduces the twin rate. It’s the triple threat! However, in order to get an accurate read on all of your embryo’s genetic material it takes time. In a fresh embryo transfer cycle, time is of the essence. But if you freeze the embryos, time is also frozen. With the embryos on ice, you have time for chromosomes to be checked and your chances increased.

Bottom line, fertility treatment can be a cold place if you don’t have up-to-date information on what’s going on in the field of reproductive medicine. Be fluid; don’t be “frozen” in your thinking patterns or your plans. Medicine changes faster than ice melts in the summer. Ask your fertility doctor about what’s hot and what’s cold. You might be surprised at what’s hiding behind the frost!