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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.

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 afterwards. This cramping can be from a number of things and does not necessarily mean that a period will be starting nor does it indicate pregnancy.

Let’s discuss the common reasons why cramping may occur and whether or not you should worry.

Should You Be Worried About Cramps?

If cramping does occur 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 indicate 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 body 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 that over-the-counter pain medications such as tylenol be taken to help with the discomfort.

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 indicate 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 does increase with the presence of multiple large follicles and an enlarged ovary. Ovarian hyperstimulation syndrome is described by the Mayo Clinic as “an exaggerated response to excess hormones.” Both of these will cause a great deal of pain and need to be treated right away.

Crampings & 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 possible 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 likely perform at home. Your healthcare team will be able to 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 why cramping and pressure is 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.

Diving Deeper Into IVF

Going through IVF can certainly be an emotional rollercoaster. It’s a very joyful and exciting time when focusing on the ultimate 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 offers a descriptive explanation of the IVF process. Listed here are the typical steps you would expect to take:

  • Prior to the procedure, you will likely have a series of tests to include blood work, sperm analysis and an ultrasound.
  • Medications are then prescribed to stimulate the ovaries to produce multiple eggs.
  • Ultrasounds are often performed routinely to monitor the stimulation process.
  • Once sufficient eggs are produced, they are retrieved by a laparoscopic procedure. A small tube is placed through the vagina and into the ovary to collect the eggs by suction.
  • Semen is also collected so that it can be mixed with the eggs that are retrieved in a lab.
  • When the egg and sperm meet to create an embryo, it will be given about one week to grow before undergoing genetic testing in the lab.
  • Finally, the embryo is placed into the uterus through a very small tube that is inserted through the vagina.
  • Follow up blood work will be ordered to confirm pregnancy. In the event the test is negative, the cycle will be repeated.

Sexual Intercourse

It is always important to talk with your doctor regarding sex during or after the IVF process. Every case is different and may require specific guidance by the doctor overseeing your care. Some physicians advise to abstain from sexual intercourse due to 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 abstain from sex with her male partner, if she has one. If she does engage 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, in some cases, 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!).

Healthy Resting

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 up until the pregnancy test was taken two weeks later. However, in recent years research has shown that bed rest is actually not necessary. It has even been thought that going about your normal activity can be beneficial to the outcome.

You should plan to take it easy the day of 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.

Your IVF Is Showing Signs Of Success

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

  • Cramping as the embryo burrows into the uterus
  • Sore or swollen breasts due to an increase in estrogen levels
  • Bloating from ovaries being enlarged and possible fluid buildup in the pelvis
  • Spotting or light bleeding from implantation of the embryo
  • Fatigue due to your body working extra hard to maintain the pregnancy and develop milk-producing glands in the breasts
  • Nausea due to an increase in estrogen levels
  • Increased urination from an increase in HCG and progesterone levels
  • Constipation as the digestive system begins to slow down due to hormonal changes
  • 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 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.

Are You Still Worried?

Rest assured knowing that symptoms such as cramping are not always indicative of a negative outcome. In addition, they don’t always mean that pregnancy was achieved either. It’s very important to find ways to stay calm and positive in the days following your procedure.

There is truly no way to definitively tell if the embryo transfer was successful until the actual pregnancy test is taken approximately two weeks after. So think positive thoughts and settle in until it’s time for that pregnancy test!

Tune in to our podcast and learn more in order to stay safe and healthy.

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