Wednesday, January 25, 2012

Why bed rest after embryo transfer is a bad idea

Many doctors advise bed rest after ET. Ironically, even if doctors don't , many patients ( and their family members) will impose this on themselves . Many patients are worried that their embryos will fall out if they walk around, which is why they remain flat in bed after their embryo transfer.

This is completely illogical ! Your embryos are safe in your uterus. Nothing you do can harm them , so please do not worry about this. However, it's hard to change preconceived notions - especially when they are so deeply embedded.

I first try to use logic. I ask them - Do people rest in bed after having sex in their bedroom ? If they don't need to take precautions in their bedroom, why should you take any ?

The reply usually is - But isn't IVF artificial ?

This is illogical. IVF is not artificial or unnatural. All that we are doing in an IVF cycle is mimicking what would normally happen in the bedroom, but is not happening naturally, because of a medical problem. The test tube acts as a fallopian tube for helping the embryo to grow in vitro for a few days, that's all !

Once it reaches the uterus, it really does not matter that the embryo has spent a few days in the IVF incubator ! It behaves exactly the same way as an embryo created after well-timed sex in the bedroom. Whether the embryo was formed in vitro or in vivo does not matter as far as implantation is concerned.

If logic fails, I try appealing to emotions. I remind them that God has designed the body with enough sense, so that the embryo cannot fall out , so there's no reason why they should worry !

In fact, bed rest can actually be harmful and counter-productive and I believe it reduces the chances of success. For one thing, it increases stress levels and makes the long 2ww even worse. It demoralises patients, who sit and brood about their chances of success all day long, thus helping to drive them ( and their spouses) crazy ! It causes constipation; and increases the risk of deep vein thrombosis. Prolonged physical inactivity is medical harmful !

Even worse, it encourages a subtle form of blaming the victim if the cycle fails. It's physically impossible for a healthy young woman to sleep all day long in bed , so they are not likely to do so. Now, if the cycle fails, she is quite likely to blame herself for the failure ! ( " I got up to have a shower, which is why my embryos fell out " ). Even if she does not blame herself, family members may do so - or her doctor will , because he needs to provide an explanation why the cycle failed even though he provided such good quality treatment.

Please do remember that implantation is a normal biological process , whether your embryos were created in vivo or in vitro ! This is not influenced by diet or activity - and is completely
out of our control. Please don't let your mind play games with you.

Keeping physically active; and keeping yourself gainfully occupied and your mind engaged will help you cope with the stress of an IVF cycle much better, so there's no reason why you should not go back to work after your embryo transfer.

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  1. Great. Dr- thanks so much- I am a police officer and due to knowing I am a couple of days pregnant via IVF at the age of 27 after losing both my tubes to ectopics would you advise to carry on as a normal officer getting involved in fights, brawls and risk of injury on duty- or keeping mentally a tube behind a desk? Any info on tese types of jobs would be beneficial as not all women do an office job and would like your opinion on this type of
    situation ... What do you think about stress and the chances of ivf as my job is highly pressured and stressful most days! Cheers, Jen

  2. Anonymous10:00 PM

    Dear Dr,

    Do you know that in Chennai there is a famous lady IVF specialist who keeps her patient on bed rest for 3 months or when necessary (!!!) all 9 months :D Actually people- including my sister who is a gynaecologist thinks that it is OK. When I did not take bed rest people around me looked as if I am crazy. For sure when my IVF failed they would be talking about my foolishness of not taking bed rest at my back. That lady doctor has built hotels or accomodation for her patients nearby her clinic :) Everything is business now-a-days and if you learn to tell or scare your patients by telling that keeping their leg down from their cot after an embryo transfer is the biggest mistake they could ever make- BELEIVE ME YOU WILL BECOME THE BEST IVF DOCTOR FOR MOST IVF PATIENTS IN INDIA. Why miss a chance :P?

    Actually I have to counsel my mom that bed rest will not make any difference- even then she is not quiet happy. She began saying how a woman got her child after going to so and so and taking bedrest for 3 months :) My husband fortunately could understand scientific papers and I showed him some publications. To tell the truth even after that he had his own fears. Both these people fear and uncertanity made me walk and sit as if I am walking with a broken leg:) Joys of IVF hmmm....

    Dr, sometimes in this world (not only IVF and bed rest) there is nothing stronger than some fallacies. Fact has to remain silent :)

  3. Dear Jen,

    This is an interesting question ! Fortunately, most women don't have such colorful jobs as you do , so this is not a common problem.

    I do not believe getting involved in fights or brawls will affect your pregnancy outcome at all. The uterus is well-designed and your embryo is safe and secure. I am surer many of your female colleagues continued working on their beat for the first 6 weeks of their pregnancy because they may not have even realised they were pregnant. Farmer woman and women on construction sites have had babies through the centuries inspite of hard labour during pregnancy; and the fact that you did IVF does not change the way body handles the pregnancy once the embryo reaches the uterus .

    Having said that, please don't do anything which you'll blame yourself for later on ! If you feel you'll be happier ( and that your pregnancy will be safer) if you do a desk job, please request this. It's OK to make requests if they contribute to your peace of mind.

  4. Anonymous10:09 PM

    dear dr
    this is my 1st ivf and im worry coz dr said my right is block and my hub counting is less
    so plz tell me what i do?can it sucess?


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