Things to Do or to Avoid after Embryo Transfer

There are certain things that you can do to help increase the chances of embryo implantation after an embryo transfer. Also, there are things that might hurt your chances of success which you should avoid. In this section, we have gathered information on the things that you should do or you should avoid in order to maximize your chances of success:

Things to do BEFORE embryo transfer:
- You will need to have one final ultrasound scan before your embryo transfer so that your IVF specialist can measure the endometrial thickness and make sure everything is in order for the embryo transfer procedure. Embryo transfer will not require anesthetics; therefore, you may have your normal breakfast on this day.
- Make sure that you have some time to yourself to relax and get rid of any negative thoughts you may have. Stress is our enemy; therefore, anything that will help you relax will help with your embryo transfer.
- Prior to embryo transfer, you may be prescribed a week of antibiotic use. During antibiotic use, it is important that you avoid sun exposure since antibiotics are sun-sensitizing drugs.
- It is strongly recommended that you do not smoke, drink alcoholic beverages or use recreational drugs while preparing for your IVF cycle. These can adversely affect egg and sperm count. 

Things to do AFTER embryo transfer:
- On the day of your embryo transfer you will need to have your progesterone level checked. If your progesterone level is low, you may need additional progesterone supplementation in the form of progesterone injections. We will be able to perform the test at our clinic and supplement you with the additional injection if necessary. Progesterone is a naturally occurring hormone which helps maintain the endometrial thickness and provide a favorable environment for embryo implantation. In natural pregnancies, progesterone is released by the corpus luteum after ovulation. In IVF cycles, this needs to be supplemented externally.
- After embryo transfer, you will rest for a few hours at our clinic then you can go back to your normal routine. Once the embryo(s) has/have been transferred, there will be no additional measures to take beyond what we already use.
- Even though we won’t know whether you are pregnant or not until you have your beta hCG pregnancy test 12 days after the embryo transfer, we will need to assume that you are pregnant and take certain precautions for some time until you are in the safer pregnancy period. These include:
* No caffeine for the duration of your pregnancy. If you cannot do without coffee, then we recommend using decaffeinated coffee. You should also be careful about tea consumption as tea also has caffeine. Herbal teas (excluding sage and fennel) can be used. If you have to have caffeine, limit your use of caffeinated drinks to 200 mg per day.
* No fizzy drinks, at least for the first 12 days until your confirmed pregnancy. You should also not be eating gassy foods as fizzy drinks and gassy foods can upset your stomach and we want to avoid stomach cramps and contractions as they may negatively affect embryo implantation.
* No intercourse for 12 days after your embryo transfer, until your confirmed pregnancy.
* Avoid public pools, saunas or any other places that may expose you to chemicals and bacteria until it has been established that you have a healthy progressing pregnancy.
* Avoid smoking, drugs and alcohol altogether after your embryo transfer. Once the embryos have been transferred, drugs, cigarettes and alcohol can have very detrimental effects on your baby’s development.
* No vigorous or high impact exercise until after clinical pregnancy confirmation. Walking and other light aerobic exercises are okay. Avoid heavy lifting greater than 10 pounds for the duration of your pregnancy.
* Minimize your medication use (other than what is prescribed to you by us). Should you require medication use for any condition after your embryo transfer, please consult with us or the doctor who will be following your pregnancy.
* Avoid eating mercury rich fish (tuna and swordfish), unpasteurized cheeses and raw meats .
* 4 mg of folic acid a day is the established dose which needs to be taken during pregnancy. Folic acid is essential for development of your baby. Folic acid deficiency during pregnancy is associated with neural tube defects; therefore, use of a prenatal vitamin complex is essential after your embryo transfer.
* Keep using your progesterone supplements (crinone gel 8%) until the 12th week of your pregnancy. 12th week is when the placenta takes over progesterone secretion, therefore, you will no longer need to externally supplement it. On the 11th week of your pregnancy, you can go down to 1 application per day and continue like that for one week and on the 12th week of your pregnancy, stop using the crinone gel altogether.
* Similarly, you will keep using your estradiol valerate supplements (progynova/estrofem) until the 12th week of your pregnancy which is when the placenta takes over secretion of estrogen. You can half your dose on week 11 and stop altogether on week 12.
* Flying is relatively safe after embryo transfer. Most of our patients fly back home the day after embryo transfer. However, if you have 48 hours to spare, then we recommend flying back home 48 hours after the embryo transfer. The first 24 hours should have more resting and less moving around, but you can enjoy Cyprus and do a bit of sightseeing the next day.

We wish you a successful embryo transfer!

---