Saturday, March 05, 2011

What can I do to improve the chances of my embryos implanting ?

This is one of the commonest questions patients ask me. A good IVF clinic is quite good at making good embryos in the lab. However, once they are transferred into the uterus, then whether they will implant to not is a biological process which is not in anyone's control ! It can be quite scary to think that the fate of your embryos is in your hands - and that if you make a false move, you may lose the embryos !

The actual IVF treatment, leading upto the egg collection is full of action ! You are taking injections every day and the doctor monitors you closely. It's fun watching your follicles grow on the ultrasound screen and actually seeing your embryos can be a very emotional moment in your life ! However, after the embryos are transferred, you are pretty much on your own. You have no idea what's happening to your precious embryos inside your uterus and there's no medical monitoring or contact, so you are pretty much in limbo until the day of the HCG test. Not for nothing do women dread the IVF 2ww !

Your mind plays all kinds of games with you ! Are your breasts feeling fuller than usual ? Was that a uterine cramp ? Does the discharge you are getting mean the embryos are falling out ? Does the backache mean the cycle has failed ? Is the bloating PMS or an early symptom of pregnancy ?

You try to compare notes with other women - but realise that there is so much variability and so many old wive's tales, that it's hard to make sense of anything which is happening to you. Your imagination runs riot - and your husband can be completely unhelpful when he tells you to "stop stressing out" and to "just relax" !

It's difficult to find anyone who can empathise with the suspense and anxiety you find yourself in - and every hour seems to last for one day . You are petrified that a false move will jeopardise your precious embryos ! Is it safe to run to catch the bus ? Is it OK to drive ? Does straining in the bathroom cause the embryos to get dislodged ?

Just what's happening in your uterus ? Are the embryos implanting ? Or dying ?

The truth is that there's very little you - or anyone else - can do to affect the outcome of the cycle after the transfer is over - it's very much a "no-woman's " land ! Because human reproduction is an inefficient process, most embryos do not implant to become babies. This is true in the bedroom as well, but when the embryos do not implant after an IVF cycle , women always blame themselves !

" I killed my embryos ! I let my family down ! I will never give my husband a baby ! I am cursed ! I failed again !" These are familiar refrains you may hear, even though you do your best to remain calm and collected.

What makes a bad situation worse is how clueless your husband can be ! He often does not know what to say - and what he does say, he often does badly. He may say things like - " Don't worry - it's not the end of the world ! " " I am sure it will work the next time !" And you feel like saying - " You are an idiot if you do not realise it is the end of my world ! " " And how do you know it will work the next time ? " The poor guy is just trying to provide moral support, but you may find yourself taking our your anger on him !

And the "well-wishers" who blame the IVF failure on the fact that you did not rest or took too much stress are often the last straw which can break your back !

Please do not beat up on yourself ! While doctors do provide luteal phase support with hormones to try to improve the chances of successful embryo implantation, the truth is that the outcome of every IVF cycle is always unknown. All you can do is to improve your odds by finding a good clinic - the rest is outside your hands !

Please remember the Serenity Prayer
God grant me the serenity to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference.
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