What to Do After Embryo Transfer to Increase Success

By Dr. Kenosha Gleaton, OBGYN. 

Some of this content has been repurposed from Natalist’s Guide to IVF, written by Halle Tecco and medically reviewed by Dr. Dana McQueen. 

Embryo transfer is one of the last steps of in vitro fertilization (IVF) and can elicit a wide range of emotions from excitement to anxiety. Unfortunately there is no secret food, supplement, or activity that will guarantee success, but there are some ways to potentially support your IVF journey and your chances of conceiving. Let’s learn a bit more about the embryo-transfer process. 

Understanding the Post-Embryo Transfer Phase

The embryo transfer phase is one of the final stages of IVF. When someone makes it to this stage, they have already taken various IVF medications, have had an egg retrieval, and those eggs have been fertilized and monitored outside of the body. [1] Embryo transfer involves the insertion of an embryo into the uterus, with hopes that it will implant and a viable pregnancy will follow. [1] 

The post-embryo transfer phase is about a five day to two week window when you are waiting to find out if the embryo did implant. The best way to confirm a successful embryo transfer is through a blood test, however some early pregnancy tests strips may be able to confirm a pregnancy as early as five to six days after your transfer. There are many factors that can influence someone’s success rate, including their age, sperm health, the clinic, the embryonic stage, and more. [1] 

5 Things to Do After Embryo Transfer to Increase Success

The best way to encourage success after an embryo transfer is to follow your provider’s instructions exactly. Ask for their guidance on your diet, exercise, and medication routines. There is no surefire way to guarantee success, but certain habits may support a positive outcome. Here are some examples. 

Take it Easy and Manage Stress

If you’ve been battling infertility for a while, you probably know how frustrating it is to hear “don’t stress”- If only it were that easy! The truth is, research is mixed on whether or not stress levels can influence poor outcomes. Some data show that those with higher levels of infertility-related stress may be less likely to achieve pregnancy, while other research suggests there is no real correlation. [2-3] At the end of the day, it is still encouraged that you find ways to promote relaxation and self-care. Mental health is a huge part of the IVF process and it’s important to give yourself a break and a pat on the back for making it to this step. You may want to take a day or two off of work to relax and reflect, or get back into the swing of things if you find that is more helpful for you. Consider phoning a friend, journaling, connecting with your partner, or even watching a good comfort show.

Maintain a Balanced Diet

Good nutrition is one of the best ways to prepare your body for pregnancy. [4] Ideally you’ve been eating a healthy and balanced diet for months while preparing for your IVF journey, and it’s important to keep up these habits as you wait for your pregnancy test results. A study led by Dr. Audrey Gaskins evaluated the relationship between adherence to certain dietary patterns and outcomes of fertility treatments across 357 women and 608 cycles, including IVF.  [5] The study found that adherence to a pro-fertility diet was associated with an increased probability of live birth. [5] The pro-fertility diet included higher intake of supplemental folic acid (folate), vitamin B12, vitamin D, low (rather than high) pesticide residue produce, whole grains, dairy, soy foods, and seafood (rather than other meats). [5]

Other studies have also been conducted on the impact of dehydroepiandrosterone (DHEA) and antioxidants like CoQ10 for people undergoing fertility treatments. Results showed that patients treated with DHEA retrieved more oocytes (eggs) during egg retrieval and had a higher pregnancy and live birth rate than control groups. [6] Researchers also found that CoQ10 and other antioxidants may be associated with increased live birth rates and pregnancy rates. [7]

With all of this being said, you should never take any supplements, medications, or make radical changes to your diet without the approval of your provider. Speak with them if you have any questions or concerns about your current diet or supplement routine. 

Have you heard about pineapple or french fries being good luck charms? Read about these theories and other IVF superstitions here. 

Continue with Prescribed Medications

Unfortunately the rigorous IVF medication and injection schedule is not always over immediately after an embryo transfer. Depending on your health history and treatment protocol, your provider may also have you on progesterone and estrogen supplementation for a few days to a few weeks after transfer. [8] This hormone prepares your body for pregnancy and is extremely important for encouraging embryo implantation. [8] Make sure you speak to your provider about your medication schedule so you don’t miss any important doses. It can also be helpful to triple-check that you have enough on hand. 

Moderate Physical Activity

Physical activity is a great way to improve your health, both physically and mentally. It is encouraged that those preparing for pregnancy aim to be their healthiest selves, meaning adequate amounts of exercise as well as a healthy diet. [9] While this is true leading up to egg retrieval and transfer, many clinics will ask that you approach exercise very carefully in the days after embryo transfer. Some will encourage “couch rest” for about 24 hours after transfer day, while taking it easy for another 3-4 days. [8,10] This means opting for a walk around your neighborhood or light yoga rather than going on a run or lifting heavy weights. [8,10] Of course, you should always speak directly with your provider for their recommendations on your post-transfer activity. 

Take on the Pregnancy Mindset

Even if you haven’t gotten a positive result yet, you may want to assume some of the healthy habits that you would have if you were pregnant. [8,10] This means avoiding alcohol, toxic chemicals, extreme temperatures, high caffeine intake, and certain foods. [8] You’ll also want to take a women’s prenatal vitamin and other supplements as recommended by your provider. The bottom line is that you should treat your body the way you would if you knew for certain that the transfer was a success!

Things to Avoid After Embryo Transfer

In addition to the things you should do, like eating a healthy diet and taking it easy, there are some things you may be advised to avoid after an embryo transfer. For example, many clinics will advise patients to avoid having sex for up to a week after embryo transfer. [11] This is known as pelvic rest, and can give the embryo optimal time to implant into the uterine wall. A study found that people who adhere to this recommendation were less likely to have a miscarriage. [12] In addition to no sex, it’s generally recommended that you avoid placing anything in the vagina that has not been approved by your provider. This includes tampons, sex toys, douching, etc. [11] 

As already mentioned, other things to avoid after an embryo transfer include eating or drinking alcohol, high-mercury fish, raw or undercooked meats, unpasteurized dairy products, etc. [8] It’s also recommended by some clinics that patients avoid high intensity activities and workouts for at least a few days after transfer. [8,10] Your healthcare provider can give you more details on what to do and avoid to encourage positive outcomes. Read about beta hCG levels after a transfer → 

Natalist's Role in Your Journey

The journey to parenthood through fertility treatments like IVF can be deeply personal, emotional, and at times, challenging. It’s common for the days following an embryo transfer to be filled with anticipation and hope. We don’t know of any magic tips to guarantee a successful outcome, but we do know that living a healthy lifestyle and nurturing yourself in the days after a transfer is a good start. Taking a comprehensive prenatal vitamin is one way to encourage your nutrition. If you want to learn more about the ins and outs of IVF, consider purchasing Guide to IVF, an informative and empowering e-book for those considering or going through assisted reproductive technology. We’re crossing our fingers for you! 

References:

1. Choe J, Shanks AL. In Vitro Fertilization. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562266/
2. Miller N, Herzberger EH, Pasternak Y, et al. Does stress affect IVF outcomes? A prospective study of physiological and psychological stress in women undergoing IVF. Reprod Biomed Online. 2019;39(1):93-101. doi:10.1016/j.rbmo.2019.01.012
3. Aimagambetova G, Issanov A, Terzic S, et al. The effect of psychological distress on IVF outcomes: Reality or speculations?. PLoS One. 2020;15(12):e0242024. Published 2020 Dec 14. doi:10.1371/journal.pone.0242024
4. Nutrition During Pregnancy. FAQ001. American College of Obstetricians and Gynecologists. June 2023. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
5. Gaskins AJ, Nassan FL, Chiu YH, et al. Dietary patterns and outcomes of assisted reproduction. Am J Obstet Gynecol. 2019;220(6):567.e1-567.e18. doi:10.1016/j.ajog.2019.02.004
6. Xu L, Hu C, Liu Q, Li Y. The Effect of Dehydroepiandrosterone (DHEA) Supplementation on IVF or ICSI: A Meta-Analysis of Randomized Controlled Trials. Geburtshilfe Frauenheilkd. 2019;79(7):705-712. doi:10.1055/a-0882-3791
7. Showell MG, Mackenzie-Proctor R, Jordan V, Hart RJ. Antioxidants for female subfertility. Cochrane Database Syst Rev. 2017;7(7):CD007807. Published 2017 Jul 28. doi:10.1002/14651858.CD007807.pub3
8. Getting Through The Two-Week Wait. Shady Grove Fertility. March 14 2023. https://www.shadygrovefertility.com/article/getting-through-two-week-wait-0/
9. Good Health Before Pregnancy: Prepregnancy Care. FAQ 056. American College of Obstetricians and Gynecologists. December 2021. https://www.acog.org/womens-health/faqs/good-health-before-pregnancy-prepregnancy-care
10. Can I exercise during fertility treatment?  Shady Grove Fertility. July 19 2023. https://www.shadygrovefertility.com/article/can-i-exercise-during-fertility-treatment/
11. Can I Have Sex During Fertility Treatment? Shady Grove Fertility. August 21, 2021. Accessed May 2023. https://www.shadygrovefertility.com/article/can-i-have-sex-during-fertility-treatment/
12. Crawford NM, Steiner AZ. Intercourse after Embryo Transfer and Pregnancy Outcomes. FertStert. Volume 101, Issue 2, E28-29. February 2024. doi.org/10.1016/j.fertnstert.2013.11.107

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University.  She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.