Monday, March 09, 2015

Bed-Rest After IVF – Let’s Put to Rest this Fallacy


It’s not uncommon for gynecologists in India to routinely prescribed bed-rest after an embryo transfer. They scare patients into believing that if they don’t rest, their embryo will get dislodged and fall out of their uterus. Some also go to the extent of insisting that the patient shouldn’t even get out of bed to go to the wash room. Others will tell the patient that she should prop her hips up with a pillow, to ensure that her embryos stay safe and secure in her uterus. 

The Truth

The fact is that this is just a whole bunch of hogwash; IVF clinics across the globe tell their patients that they should resume their normal activity soon after embryo transfer. Once the embryo is inside the uterus, it can’t just fall out, regardless of whether the patient coughs, sneezes, strains or goes bungee-jumping! This is true irrespective of whether the embryos reach the uterus via the fallopian tube (as it does when couples have sex in their bedroom) or when we transfer it via the cervix using an embryo transfer catheter

Bad Advice

The embryo doesn’t give two hoots about whether it spends 3 days in the fallopian tube or 3 days in the test tube. This does not impact embryo implantation and no amount of physical activity can dislodge the embryo from the uterus. Once an embryo inside the uterus, it is snug, safe and secure, like a pearl in an oyster ! So why then do doctors continue giving such bad advice to their patients?

I think some of these are very old-fashioned doctors. When they don’t really have anything else to offer patients, they advise them to rest in bed!  This is a historical hangover, and has been the standard advice which has been given over the centuries to a woman when she had a complicated pregnancy. It’s easy for doctors to advise bed rest; it doesn't cost them anything to do so.  However, it has a significantly negative impact on the patient.

The Negative Impact of Bed Rest

Most doctors don’t even realize that they are unwittingly causing a lot of harm to their patients by giving them this kind of advice:

•    Bed rest disrupts the household
•    It causes a number of  physical problems for the poor patient (back pain, an increased risk of deep vein thrombosis ( DVT) , muscle weakness & atrophy)
•    The emotional price that bed-rest exacts is immense. An idle mind is a devil’s workshop, and bed rest adds to the patient’s stress levels. When she is stuck in bed, the only thought that keeps going through her head all day is about what is happening to her embryos and whether the cycle will work or not
•    The 2ww lasts much longer when you have to spend it in bed (when a patient is preoccupied, her mind is distracted, and she focuses on other things)
•    If the patient doesn’t get pregnant, she blames herself and feels that her embryos fell out because she did not heed the doctor’s advice

Intuitively, bed-rest after IVF makes a lot of sense; this is why many women will impose it upon themselves even if the doctor hasn’t advised it. If bed rest isn’t recommended, and the patient fails to get pregnant, they end up blaming the doctor because they believe that bed rest could have changed the outcome.

Vested Interests

For some doctors, advising their patients’ bed rest, is a way of covering their bases. In case the cycle fails, they can always blame the patient for the failure. Another reason doctors advise bed rest is because they do not want their patients to go to another center for their IVF treatment. The leading clinics in India are located in the large cities, and doctors in small towns who do IVF want to hang on to their patients and they scare them by saying that if they travel to Mumbai for their IVF, their embryo will fall out due to the movement caused by the journey. This is rubbish, but it's very easy to take ignorant patients for a ride, especially when there are already so many myths and misconceptions about bed-rest during pregnancy.

Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better!


2 comments:

  1. Anonymous1:26 PM

    Hi thanks for article is very infirmative and encouraging.after my et my gyn says no sitting on the floor till 2ww.plz tell me as a muslim how i perform namaz after et. Can i per form namaz on the floor can i bend my legs plx advise.

    ReplyDelete
  2. Yes, of course you can do namaz on the floor. Your embryos are safe in your uterus !

    ReplyDelete

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