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The Journey Of IVF Treatment: Cramping After Embryo Transfer

The IVF journey can certainly bring a mix of various feelings and emotions. It’s quite common to become nervous and worried when symptoms such as spotting or cramping occur. However, do these symptoms actually mean that something is wrong? Is it possible these symptoms could be a sign of pregnancy? We are going to break it all down and answer these common questions.

Going Through The IVF Procedure

Going through IVF can certainly be an emotional rollercoaster. It’s a very joyful and exciting time when focusing on the goal of conceiving. However, it can be a very nerve-wracking experience as well given the unknowns of what the outcome will entail and naturally worrying about what could go wrong.

The Mayo Clinic explains the typical steps you would expect to take for the IVF process:

  • Prior to the procedure, you will go through a round of tests, including blood work, sperm analysis, and ultrasound.
  • They will then prescribe medications to stimulate the ovaries to produce multiple eggs.
  • Ultrasounds are often performed routinely to monitor the stimulation process.
  • Once sufficient eggs are produced, a laparoscopic procedure retrieves them. They will place a small tube through the vagina and into the ovary to collect the eggs by suction.
  • Semen is also collected to be combined with the eggs that are retrieved in a lab.
  • When the egg and sperm meet to create an embryo, they will give it about one week to grow before undergoing genetic testing in the lab.
  • Finally, the embryo is placed into the uterus through a tiny tube that is inserted into the vagina.
  • Follow-up blood work will be ordered to confirm pregnancy. In the event the test is negative, the cycle will be repeated.

What Happens After An Embryo Transfer

Johns Hopkins Fertility Center describes embryo transfer as being “a process to deposit embryos into the uterine cavity by using a fine catheter that is passed through the cervix.” Ultrasound is often used to guide the catheter and confirm proper placement. Because IVF is an invasive procedure, it is common to experience cramping afterward.

This cramping can be from several things and does not mean that a period will start, nor does it show pregnancy. Let’s discuss the common reasons cramping may occur and when you should worry about it.

Experiencing Cramps After Embryo Transfer

If cramping occurs following the embryo transfer, it’s important to know that it does not always mean that a period is coming. It’s very common to feel a sense of worry and anxiety with every ounce of pelvic discomfort following the procedure.

However, the cramping does not always mean the transfer has failed nor does it automatically show that implantation and the early stages of pregnancy have begun.

After going through a procedure such as an embryo transfer, many people seem to be more in tune with their bodies and recognize the slightest cramping sensations that may not have been noticed otherwise. It’s important to understand that it is completely normal and expected for one to experience these sensations following their procedure.

The medications that are often prescribed, along with the procedure itself do typically affect the body’s reproductive organs, causing discomfort or bloating. It is also commonly recommended to take over-the-counter pain medications such as Tylenol to help with the discomfort.

Cramping & Fertility Drugs

Fertility drugs are a common and necessary part of the embryo transfer process. It is typical for a combination of drugs to be prescribed prior to the procedure. Web MD offers a list and description of the many medications that could be used with infertility.

Medications such as Bravelle, Fertinex, or Follistim are used to stimulate the ovaries in order to produce mature eggs for retrieval. These often need to be administered through injections that you will probably perform at home. Your healthcare team will instruct and guide you through this process.

Fertility medications alter your body’s hormonal balance, so it makes sense that you would experience some discomfort as your body adjusts. Cramping is one of the most common symptoms, and it is completely normal. As your hormone levels stabilize, your discomfort should subside.

Another reason cramping and pressure are quite common following fertility medication injections is that the ovaries become enlarged as the follicles increase in size. Fluid can also accumulate in the pelvis, which can also cause one to cramp and bloat.

Cramping & IVF

Cramping during the IVF process is a very common side effect. Because of the hormonal changes that are happening from the drugs, along with the procedure itself, some pelvic discomfort is quite typical.

If pregnancy is achieved through IVF, it is common to experience cramping and mild discomfort as the embryo implants itself into the uterine wall. These sensations can often mimic period-like symptoms, which can cause some to become worried. However, as the embryo burrows into the uterus, it is likely that cramps, and possibly even spotting, will occur.

Cramping & Post-IVF Anxiety

Anxiety after the embryo transfer can lead to cramps or make the normal cramps more severe. This is because stress and anxiety can cause the body to produce more of the stress hormone cortisol, which can lead to muscle tension and cramping.

Therefore, it is important to relax and de-stress after the procedure to help ease any cramping. There are a few things you can do to help de-stress, such as taking deep breaths, listening to calming music, reading a favorite book or watching a favorite movie, and spending time with loved ones or friends.

When To Call
Your Doctor

If severe cramping and heavy bleeding occur, it is important that you contact your doctor right away. When over-the-counter medications are not helping to ease the pain, that can be a good indicator that you need to be seen in the office.

In these instances, the cramps will become intense and are often accompanied by heavy bleeding and possibly even nausea. This could show a worrisome condition, such as ovarian torsion or ovarian hyperstimulation syndrome.

Torsion occurs when the ovary actually twists itself, restricting its blood supply. Though rare, the risk of torsion increases with the presence of multiple large follicles and an enlarged ovary. The Mayo Clinic describes ovarian hyperstimulation syndrome as “an exaggerated response to excess hormones.” Both will cause a great deal of pain and need to be treated right away.

Is Sexual Intercourse Okay?

It is always important to talk with your doctor regarding sex during or after the IVF process. Every case is unique and may require specific guidance by the doctor overseeing your care. Some physicians advise abstaining from sexual intercourse because of the risks of infection or potentially altering the outcome of the transfer.

If a woman is undergoing the IVF process as a gestational surrogate, it’s crucial that she abstains from sex with her male partner, if she has one. If she engages in sexual intercourse, she could become pregnant with her partner’s child, not the intended parents’! Talk about a big “oops.” Though rare, it has actually happened before!

However, sometimes, doctors allow their patients to continue having intercourse and actually recommend you do so. According to a study published by Human Reproduction, “women exposed to semen via sexual intercourse exhibited a significant improvement in the proportion of transferred embryos that remained viable by 6-8 weeks gestation.”

In most situations, it’s best to ask your doctor’s advice (and then be sure to follow it!).

Necessity Of Bed Rest

After undergoing IVF, most doctors will tell you to resume normal activity. In the past, it was common practice to place patients on bed rest following the procedure until the pregnancy test was taken two weeks later.

However, in recent years, research has shown that bed rest is actually unnecessary. It has even been thought that going about your normal activity can be beneficial to the outcome.

You should plan to take it easy on the day off and the day following your embryo transfer. It’s a great time to lounge around in PJs and catch up on your Netflix queue! It’s common to feel some bloating and discomfort in the days following the procedure, so it is important to listen to your body and not overexert yourself.

How To Know Your IVF Treatment Is Showing Signs Of Success

The following are potential side effects you may experience following a successful IVF procedure:

  • Cramping as the embryo burrows into the uterus
  • Sore or swollen breasts because of an increase in estrogen levels
  • Bloating from ovaries being enlarged and fluid buildup in the pelvis
  • Spotting or light bleeding from implantation of the embryo
  • Fatigue because your body is working extra hard to maintain the pregnancy and develop milk-producing glands in the breasts
  • Nausea because of an increase in estrogen levels
  • Increased urination from an increase in HCG and progesterone levels
  • Constipation as the digestive system slows down because of hormonal changes
  • A missed period when the embryo implants into the uterine wall and prevents the lining from shedding

A lack of any symptoms at all? That’s not a cause for worry either. Many women report feeling no symptoms after the embryo transfer, yet a couple of weeks later, they find out they’re pregnant.

Bottom line? There’s really no way to predict the outcome of your IVF procedure based on how you feel. We know it’s hard to be patient! Try to keep your mind distracted and engage in healthy activities during your two-week wait. Of course, should you experience any symptoms that are severe or particularly worrisome, contact your healthcare team right away.

Why Wait For Two Weeks Before Getting Tested?

As soon as you have completed your embryo transfer, it is understandable that you will be eager to find out if the procedure was successful. However, it is important to resist the urge to take a pregnancy test too early. Here’s why:

hCG in Trigger Shots

If you’ve recently undergone an embryo transfer, it’s important to wait at least two weeks before taking a pregnancy test. This is because the trigger shot used during the procedure contains hCG (human chorionic gonadotropin), which can give false-positive results on pregnancy tests. So, if you take a test too soon after your embryo transfer, you may get a positive result when you’re not pregnant.

To avoid this, it’s best to wait until at least two weeks have passed before taking a test. This will give your body time to produce its hCG if you are indeed pregnant.

If you’re impatient to find out if the transfer was successful, you can ask your doctor to perform a blood test to check for hCG levels. This can usually be done about a week after the transfer. However, it’s important to remember that even if your hCG levels are high, it doesn’t mean that you’re pregnant. So, don’t get your hopes until you’ve taken a pregnancy test that comes back positive.

Low Likelihood Of Detection

One of the main reasons you should not test for pregnancy too early after an embryo transfer is because if you had three-day or four-day embryos transferred, the chance of obtaining a positive pregnancy test result before six days have elapsed is extremely low.

The Unnecessary Anxiety Can’t Be Good For You

Testing too early can be problematic as it can lead to false-positive results. This means that the test may show that you’re pregnant when you’re actually not. This can obviously cause a great deal of stress and anxiety.

False-positive results may lead you to believe you’re further along in your pregnancy than you actually are. This can lead to inaccurate expectations and, potentially, disappointment if things don’t progress as you thought they would.

Know You Are Not Alone In This

No matter what you’re feeling after the transfer, your fertility agency is with you. We understand this process can be emotionally and physically challenging, and we’re here to support you every step of the way. Please reach out to us if you need anything. We’re here for you.

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Eloise Drane
Eloise Drane, Founder

"I believe that we are all placed on this earth for a purpose. Each one of us has a specific calling in this world and although it is different for everyone, we are here to serve one another. My purpose is to help women who wish to become surrogates and egg donors and the hopeful parents who wish to partner with them. I feel very lucky to be living my purpose."