Embryo transfer with IVF: recommendations for the behavior of the expectant mother. In vitro fertilization (IVF): how to behave after embryo transfer Do I need a hospital stay after transfer

After the operation, during which the embryo was implanted into the woman's body, the expectant mother may not feel any significant changes, however, in reality, continuous metamorphoses take place in the body at this moment. The result of these processes is pregnancy, that is, the attachment of the embryo to the uterus. This moment will not pass unnoticed for a woman.

First of all, the medical staff will puncture the woman and take the eggs. Further, the woman's eggs, together with the treated partner's sperm, are placed in a special incubator, where they are cultured for 24 hours. On the first day, doctors can only give a preliminary assessment of the process. On the second day, usually the egg, fertilized with the partner's sperm, already turns into an embryo. At this stage, specialists can select the most "promising" eggs.

After that, at least four days must pass before a new stage begins, at which the most important process is carried out - directly transfer to the embryo in the uterus.

On the same day, doctors take blood from the expectant mother for tests for progesterone and estradiol levels. These data will be needed in the near future in order to be able to appoint support for the initial stage of gestation. In addition to tests, you will need to undergo an ultrasound examination to obtain objective information about the state of the ovaries and the uterine cavity.

The state of the ovaries after stimulation is quite specific, since the procedure provokes the appearance of yellow body cysts. This condition will not cause any inconvenience to the expectant mother, since this is a natural reaction of the body. In some cases, a complication arises - ovarian hyperstimulation syndrome, but an experienced doctor can easily identify the pathology.

Determining the day for implantation

The choice of a suitable day for the procedure is influenced by many factors, including:

• woman's age;
• the number of eggs;
• the rate of development of embryos;
• the number of transfers performed earlier;
• the patient's history.

Period after surgery

After the IVF procedure, over the next fourteen days, you should not take any deviation from the normal state as a sign of pregnancy. At this stage, a woman may feel mild nausea, weakness and dizziness, but this does not guarantee that the operation was successful. The exact result can be found out only after tests for human chorionic gonadotropin are taken.

Many women immediately after implantation rush to buy pregnancy tests, but their result is also not indicative. Many experts strongly advise against getting carried away with such experiments, so as not to be disappointed in vain. Sometimes, expectant mothers simply do not have the patience to wait for the outcome of two weeks. It should be understood that a negative pregnancy test does not mean that the embryo transfer procedure was unsuccessful.

How to prevent OHSS

All that is required from a woman to donate blood is a careful attitude to her health. We have already mentioned that OHSS can develop after surgery. If a woman turns to a reproductive specialist in time, then difficult consequences can be avoided.

Among the clinical manifestations of ovarian hyperstimulation syndrome are:

• bloating, abdominal discomfort;
• pain in the ovaries or uterus;
• persistent migraines;
• various visual defects - the appearance of "flies", blurring;
• swelling.

Usually OHSS develops rather slowly, which allows you to cope with it with the help of a well-chosen course of treatment. The amount of time it takes to recover from OHSS also depends on the support program chosen.

Support program

In most cases, doctors draw blood within seven days after implantation to determine the correct support program. It includes qualified control over the processes occurring in the woman's body, and the prevention of possible complications. When doctors feel that there is a danger of pathology, they take blood for tests every few days.

Spotting is a sign that the chosen support program is not suitable for the expectant mother. Some women mistake them for menstruation, but in reality this is evidence that the level of hormones in the woman's body is disturbed. Therefore, doctors must change the amount of drugs that the expectant mother uses. At the slightest suspicion, you should immediately contact a reproductive specialist who can adequately assess the woman's condition.

Physical exercises

If before the procedure, mom's life was not particularly dynamic, then in the first fourteen days nothing will change significantly. Experts recommend not to get involved in fitness, jogging and other sports activities during this period. This is due to an increase in the size of the ovaries. For the same reason, a woman after implantation does not want to have sex - this may be accompanied by painful sensations.

In no case should you go to extremes and lie in bed from morning till night. After embryo transfer, a woman's immobility has only a negative effect: blood circulation worsens. This results in a decrease in the flow of oxygen to the embryo.

The best and most adequate solution for spending time in the first two weeks after implantation is quiet leisure. It is best to walk more in the air, get out into nature. Better to quit smoking and drinking alcohol.

It is very important to avoid stress as any conflict situation can negatively affect the program.

Diet after embryo transfer

In the first fourteen days after the procedure, there is no need to radically change the menu. As in other periods, you should only eat healthy foods. It is important that meals are varied and regular.

A special diet is usually prescribed in the event that something went wrong in the woman's body after the embryo transfer. With ovarian hyperstimulation syndrome, it is not recommended to eat foods high in salt. In no case should you go on a hunger strike, as this will be an unnecessary burden for a weakened body.

A woman is required to consume a fairly large amount of liquid - at least one and a half liters. However, it is best to drink pure water - not mineral or carbonated. Gas-provoking juices are also not suitable for this period.

Of course, there are situations when reproductive specialists decide that a woman's menu should be changed. In such situations, you should not neglect the recommendations of a specialist. Most often, changes in the diet involve the consumption of large amounts of greens and the restrictions on the use of salt already mentioned above.

Sedatives

Often, during the waiting period for results, women have a very bad mood. During this long period, you can help your body cope with stress. Most often, experts recommend taking soothing herbal teas and valerian. The use of medications must be agreed with your doctor without fail.

After embryo transfer, most women complain of fever. These experiences are quite justified, because colds in the first fourteen days after the procedure can have a negative impact on the development of the embryo.

Experts say that in this case there is no reason to worry, since this is normal in this state. However, it is necessary to monitor body temperature with special attention. It is best to record these indicators in a notebook every day so that you can assess the state of the body. If the temperature does not rise above 37.5, then the embryo fixation is normal.

In addition to fever, there are several more signs that indicate that a woman is soon expecting a pregnancy:

• swelling of the mammary glands;
• discoloration of the nipple;
• acute reaction to various odors;
• pulling sensation in the lower abdomen.

According to statistics, about 40 percent of all cases of using the IVF method end with a positive result. Repeated attempts at implantation are guaranteed to lead to pregnancy.

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Instructions

After the in vitro fertilization procedure, women begin to listen to their bodies, look for signs, confirmation in dreams and omens, and sometimes fall into severe depression without finding them. Some ladies control their every breath and movement, fearing to interfere with the birth of a baby. All this, oddly enough, only prevents pregnancy. For a successful IVF, doctors give a number of recommendations.

After IVF, try to drink as much liquid as possible, at least two liters per day, eat protein products (fish, meat, nuts, dairy products). Fermented milk products, herbs and dried fruits are also welcome in the diet. Avoid foods that can cause flatulence (grapes, fresh fruit, sodas). Don't get carried away with buns and potatoes, as they are hard to digest. Give up alcohol and do not abuse coffee, strong tea.

Provide a good blood supply to the uterus. Continuous lying is not the best way to do this. Walk in the fresh air as often as possible, walking will help improve blood circulation, ensure blood flow in the pelvic region and uterus. While lying down, it is recommended to put pillows under your feet, this position contributes to the flow of blood to the pelvic organs and relaxation of the uterus.

Provide yourself with a calm state of mind and a positive attitude. Read interesting good books, listen to pleasant music, go to museums and theaters, watch your favorite films and TV shows. Be in nature more often, communicate with pleasant people. Believe in the best and enjoy life. It is also worth noting that few women manage to get pregnant on their first attempt after IVF. It is highly likely that you will have to go through this procedure again.

After the transfer itself, the next two weeks outwardly nothing may happen, but there are constant and continuous processes in the uterus, which should end with the attachment of the embryo to the uterine wall, that is, the beginning of pregnancy. The very moment of attachment is "implantation"; it is impossible to feel, no subjective signs indicate it until the 14th day after the transfer, until the day of donating blood for hCG. Nausea, dizziness, breast swelling, drowsiness, absence of premenstrual symptoms, etc. - nothing is objective, nothing should be focused on as an argument for or against.

What will happen after the embryo transfer

After the puncture and collection of oocytes, 4–5 days pass, and a new stage of the IVF protocol begins - the transfer of embryos into the uterine cavity. The transfer itself takes 2–5 minutes, but on the day of transfer, blood is also taken for the hormones progesterone and estradiol - this will be needed in the near future. Indeed, after the transfer, most modern IVF clinics provide support for the initial period of pregnancy, and this support can be objectively assigned only on the basis of data on the level of hormones.

Of course, an ultrasound scan is also done without fail - what is the condition of the uterus and ovaries? The thickness of the endometrium is very important. What do the ovaries look like (and, accordingly, how will they function)? The type of ovaries is specific, their stimulation leads to the formation of large cysts at the site of the follicles - but this is not a painful condition, but a transient, common and inevitable after hormonal exposure. In extremely rare cases, at this stage, an experienced physician may detect signs of impending ovarian hyperstimulation syndrome (OHSS) - a rare but formidable complication of IVF.

After the transfer itself, the next two weeks outwardly nothing may happen, but there are constant and continuous processes in the uterus, which should end with the attachment of the embryo to the uterine wall, that is, the beginning of pregnancy. The very moment of attachment (implantation) cannot be felt. Nausea, dizziness, breast swelling, drowsiness, absence of premenstrual symptoms, etc. - nothing is objective, nothing should be focused on as an argument for or against. The exact answer to the most important question cannot be obtained until the 14th day after the transfer, when blood is donated for chorionic gonadotropin (CG).

Likewise, pregnancy tests are not indicative before the 14th day. Although doctors advise their patients not to have tests to avoid disappointment, most women start urine tests 8-10 days after the transfer. Statistics show that if the test result is clear, then the probability of pregnancy is high. But if the test is weak or completely negative, then the chances of pregnancy are still quite high. That is, we can say that a positive test even before the 14th day is a good sign, and a negative test is not always an indicator of failure.

Two weeks before donating blood for hCG, a woman needs to actively monitor her condition. First, it is very important to catch the signs of ovarian hyperstimulation syndrome (OHSS) at the earliest stage. Bloating, pain in the uterus and ovaries, unusual swelling, headache for no apparent reason, visual impairment in the form of "flies", fog, blurred images may serve as a reason for an immediate visit to a reproductive specialist. OHSS develops gradually, and with adequate treatment, it disappears quickly enough. Therefore, it is better not to start its detection and treatment. In addition, if a woman develops OHSS even to a very mild degree, then the support program must be changed.

For high-quality support, blood for hormones is taken a week after the embryo transfer and on the 14th day - simultaneously with the analysis for hCG. In most cases, this frequency is quite enough for adequate control of the ongoing processes and prevention of complications. But in special cases, tests can be done every 3-4 days.

Vaginal spotting may indicate the need to change support. This is by no means premature menstruation, but an indicator of a violation of the ratio of hormones in a woman's body, which requires a dose adjustment of drugs. Therefore, you need to contact your reproductive specialist immediately.

How to behave after embryo transfer

Your life will not be limited if, before the program, you did not have a penchant for extreme. Physical activity must be limited, fitness, jogging, power loads in the gym must be excluded - enlarged ovaries can respond to soreness. Sexual life is not excluded, but it can be limited at the request of the woman: because of the pain associated with an increase in the size of the ovaries, and fear for the fate of pregnancy.

On the other hand, you cannot prescribe yourself to bed rest: immobility leads to a deterioration in blood circulation and reduces the flow of oxygen to the uterus and fetus. This can play a negative role in the implantation processes.

In a word, the optimal daily regimen for two weeks after the transfer is a quiet, calm pastime in the fresh air, walking in nature, not shopping, limiting smoking (if you still smoke), avoiding stressful situations with others.

There will also be no significant changes in the diet. Meals should be healthy, varied and regular. Only if the doctor suspects the development of OHSS can he prescribe a special diet, for example, with salt restriction. There is no need to start fasting these days or change the usual diet: this is an extra burden on the body. You need to drink enough liquid - 1-1.5 liters per day, while avoiding mineral and carbonated water, as well as gas-forming juices (primarily grape).

If a fertility specialist recommends a change in diet, listen to his advice. Salt restriction, excess water, and consumption of greens are usually part of the prevention and treatment of OHSS.

Two weeks is a long time, the tension of expectation is an ordeal for the psyche. If your mood worsens, sleep is disturbed - do not neglect simple sedatives. Valerian in any form, sedative fees - all this can be used to remain calm while waiting for a positive result. It is better to discuss any other sedatives with your doctor - how safe they are for a possible pregnancy.

In a word, these two weeks are both very significant and very common - don't make a horror story out of them, be calm.

/ Useful information

16.05.2011

The long-awaited day of embryo transfer has arrived. Behind the long-term treatment, endless examination, hormone intake, bruises from injections, worries about the endometrium, follicles, monitoring, puncture ... That's all. You can exhale. It's done, we just have to wait. Do you need to relax? Is there life after embryo replanting or is everything just beginning? What can and cannot be done? How to protect yourself from mistakes and protect such a tiny, but already dear baby? We learned about this in a conversation with Ph.D., obstetrician-gynecologist-endocrinologist, reproductologist of the international center for reproductive medicine "Mercury" Elena Popenko.

- Elena Vasilievna, what is the danger of the period "after embryo replanting"? Or can you relax and go about your business, continue to lead an ordinary life?

"After replanting embryos" - that's not what doctors usually say. We have another term "after embryo transfer". But if you understand it this way, then you can also do that. We have many cases when a very short period of time passes, and the patients after embryo replanting digging potatoes in the garden; go shopping with string bags of groceries to feed their tired husband from work; doing creative work - gluing wallpaper and making home repairs to do something during sick leave. And then they go to the hospital and can no longer keep what they were treated for so long. I really want to appeal to such patients:

"WOMEN! Feel loved, tender and weak! These are the men who must take care of you now! Carry, carry food, take out the trash and equip your home! Let it fall on their shoulders. Let them be strong and courageous! You have been waiting for this wonderful event for so many years, you have become pregnant. After embryo transfer, think about yourself and your future baby. "

Time after embryo transfer - a really dangerous period: the embryos have not yet taken root, they have just got into a foreign environment for them and settle down in a new place. Usually, if you move to a new house, you don’t like one thing, then you need to rearrange the other, then hang the curtains, paint the walls, then open the window. So are the kids. In order not to disturb them, it is advisable to lie down at home, sleep, and rest directly on the day after embryo replanting. And observe specially developed rules of conduct.

What to do "after embryo replanting" so as not to harm yourself and the child?

• Obligatory bed rest. Especially the first 10 days after embryo replanting... You can get out of bed, but in order to visit a doctor. These first days are very important as the embryo implantation will take place. It is known that blastocysts are implanted on the first day (the day of transfer is not considered), and blastomeres in the first 2-4 days.
• Sexual rest up to 3 months. It is very important. Up to 12 weeks, the threat of miscarriage is relevant.
• Follow the instructions of your doctor. Any information is available now, any recommendations can be found on the Internet. But remember. Only the attending physician is aware of your problems and treatment, only He can provide effective assistance at the right time
• After embryo replanting watch your diet. You need to eat protein foods. You can cook for vegetables, meat, steamed fish, in the oven, on fire, or in boiled form. It is advisable to use milk, dairy products, cook porridge, you can drink juices, fruit drinks, rosehip decoctions, green tea.
• After replanting you need to measure the basal temperature every day at the same time and note it in a notebook. This should be done without getting out of bed, at the same time with a mercury thermometer. If the basal temperature figures are below 37 degrees C for 3 days, urgently call the center for consultation with specialists. We have a 24/7 phone, so do not hesitate. Even at night, we have attendants on our phone who will give advice or contact the attending physician.

Found some info, I hope it will be useful. I wish you all GOOD LUCK.

Post-transfer lifestyle

1. Never have sex after a puncture (that is, between a puncture and a transfer), although doctors allow it.

2. Immediately after the transfer, when you were brought on a gurney and loaded onto the bed, you need to completely relax, put your legs straight or slightly apart from the side (whichever is more convenient), and your arms along your body. IN NO EVENT SHOULD THROW YOUR HANDS OVER THE HEAD (many people love to lie so much in life), or fidget on the bed (like - “cold-hot-fix the blanket, take a mobile phone, etc.). If something bothers you or is uncomfortable, then ask other girls (who have not yet transferred embryos) to give you, fix, tuck a blanket, etc. That is, you can not strain any muscles at all FOR AT LEAST an hour (or better, two). It is no longer possible, because I want to write, but this business cannot be tolerated at all. This is the time you will spend on a drip (if right after the transfer) and chatting with other girls.

3. Well, I will not write about the mood - it is clear that you need to aim for success and stay calm.

4. Discuss the situation with the doctor in advance, if you start having pains, then how to eliminate them (cannot be tolerated). Pain occurs in those whose periods are usually painful. They are the same as for menstruation, but they can be stronger. And they cannot be tolerated. The most harmless remedy is no-shpa. But, unfortunately, it does not help everyone. Everything else is more harmful. But in the period 3-7 days (the first day is the day of the puncture), you can take almost everything (even analgin and other GINA). But it is necessary to discuss this with the doctor. Candles with papaverine (absolutely harmless) help well, but, again, not for everyone

5. Further, in the period 3-7 days, maintain a half-bed mode. No stress, no household chores. Walking on a bench in the yard (went out quietly into the yard with a booklet, sat on the bench for a couple of hours - and back to bed). No partying with a dog, no shops, etc. Forget about all this. After the 7th day, you can already start moving slowly. But everything is very, very moderate

6. Household chores for many do not go anywhere. Therefore, for example, my husband bought me a bar stool. I still do everything sitting on it at the cutting table - and my dishes and food.

7. After the transfer, immunity always falls. Therefore, if you feel that you suddenly get sick (autumn-winter, especially), immediately put on a dropper with immunoglobulin. You will immediately feel completely healthy (during this period, you cannot take any of the strong medicines).

8. Almost everyone has a feeling that menstruation is about to begin. Don't be upset in any way. This can happen even with a successful attempt, this is not an indicator. We must wait for the results of hCG and then everything will be clear. And not a minute earlier.

How to behave and what rules to follow after transferring embryos into the uterine cavity.

Embryo replanting is the final procedure in the course of infertility treatment using in vitro fertilization. The resulting embryos are placed into the uterine cavity using a special guide. The cells and the amount of the medium in which they are transferred are very small and therefore never fall out and flow back, there is no need to be afraid of this. In the future, they either "take root" or not, but after embryo transfer, we recommend bed rest for 3 hours and half-bed rest (lie more, move only if necessary, avoid long journeys if possible) for 2-3 days. From the 4th day you can lead a normal life, except for the following: - lift weights over 2 kg, jump, run; - to live sexually before the next menstruation; - take hot baths and wash in the bath (you can take a shower); - it is advisable to avoid hypothermia and overheating, beware of colds; - without special instructions (which can only be given by a doctor) take medications; - if possible, avoid all kinds of conflicts; - It is advisable to avoid obstruction of the stool, but if it bothers, you can take laxatives in moderation (preferably duphalac).

Recommended: Maintaining a normal but more relaxed lifestyle, walking more. You can sleep in any position convenient for you (on your back, stomach, etc.). If you live in another city, you can go home 4-5 days after embryo transfer by any means of transport. Measure basal temperature daily and mark it in your chart.

Diagnosis of pregnancy. 14 days after the embryo transfer, in the absence of menstruation, a urine test "for pregnancy" should be performed or blood should be donated for hCG. A positive result and more indicates the onset and progression of pregnancy, but does not exclude the possibility of an ectopic pregnancy, therefore: 21 days after the transfer of embryos (in the absence of menstruation), it is necessary to appear for an ultrasound examination, in which you can accurately determine the location of the ovum. The gestational age is calculated from about 3-7 days from the start of stimulation with menopausal gonadotropic drugs (humegon, or menogon, or pergonal, or puregon, etc.), or 7-10 days before the transfer of embryos into the uterine cavity. With ultrasound, the ovum begins to be clearly visualized only 3 weeks after the embryo transfer. If menstruation does occur, stop measuring temperature, taking medication and returning to normal life. Most often, the treatment carried out does not change the duration of your menstrual cycle, but sometimes menstruation occurs earlier or later by 1-3 days. A low hCG value often indicates an undeveloped pregnancy, but it is better to donate blood for hCG again after one to two days. In case of failure, a repeated course can be carried out in the next cycle or after having rest 2-3 menstrual cycles, and if part of your embryos was frozen, then you can transfer them directly in the next cycle. "

“Medicines allowed during pregnancy.

After the transfer, the houses should be:
No-shpa in tablets and / or in ampoules,
Papaverine in candles
Progesterone oil solution 2.5% 1 ml in ampoules,
Dicinone in ampoules (respectively, syringes),
Tranexam 250 mg tablets,
Magne B6 / Magnelis tablets
support drugs (Utprozhestan / Dyufaston, Proginova / Divigel / Krainon, etc.) are in abundance.

If you start to smear in the protocol or in the first weeks of pregnancy:

A very large percentage of IVF pregnancies are accompanied by bleeding of varying severity, especially in the first 12 weeks, without negative consequences for the baby. If you have a discharge, call your doctor.
Do not panic, drink Valerian or Persen, lie down.
If you don't get through to the doctor:
Increase support: add Proginov 1 t and an injection of Progesterone in oil 2.5% 1 mg, cancel Thrombo-Ass / AspirinCardio and Fraxiparin / Clexane.

If it smears with brown or pale pink, then add 1 injection of Progesterone oil solution of 2.5%, 1 ml per day until it stops smearing.
- if it smears pink - 1 tablet of Tranexam 250 mg 3 times a day, but not more than three days + add 1 injection of Progesterone oil solution of 2.5%, 1 ml per day until it stops smearing.
- if red blood - on the first day 3 injections of Ditsynon (every 4 hours for an injection). Further, if blood persists, 1 injection per day + 2 Tranexam tablets per day, but not more than three days. + add 1 injection of Progesterone oil solution 2.5%, 1 ml per day + 1 t. Proginovy \u200b\u200b/ 1 packet of Divigel per day until it stops smearing. If possible - drip IV magnesium (once a day) or take it in tablets 1x3 times a day.
- if there is heavy bleeding - CALL IN "AMBULANCE" !!!
And lie! "

“What happens to the embryos after the transfer?

What and when happens to three-day embryos:

1DPP ... The embryo grows and develops

2DPP ... The embryo reaches the blastocyst stage
3DPP ... The blastocyst is pecking out of the shell on this day

4DPP ... Blastocyst attaches to the wall of the uterus
5DPP ... Implantation begins, the blastocyst begins to implant into the uterine wall
6DPP ... The implantation process continues and the morula grows deeper into the wall of the uterus
7DPP ... Morula is completely implanted in the uterus and has a placenta and germ cells.
8DPP ... Placental cells start producing hCG into the blood
9DPP ... hCG gets stronger as the fetus develops
10DPP ... More hCG is produced as the fetus continues to develop
11DPP ... The level of hCG is high enough for a blood test to show it

Five days or blastocysts:

1DPP ... The blastocyst is pecking out of the shell on this day

2DPP ... Blastocyst attaches to the wall of the uterus

3DPP ... Implantation begins, the blastocyst begins to implant into the uterine wall
4DPP ... The implantation process continues and the morula grows deeper into the wall of the uterus
5DPP ... Morula is completely implanted in the uterus and has a placenta and germ cells.
6DPP ... Placental cells start to release hCG into the blood
7DPP ... hCG gets stronger as the fetus develops
8DPP ... More hCG is produced as the fetus continues to develop
9DPP ... The level of hCG is high enough for a blood test to show itAs we all know, we count the day of transfer as 0DPP.

All fulfillment of our greatest desire - three-digit hCG, early pregnancy and healthy babies !!! "