While an embryo transfer is a less intense procedure on our bodies compared to an egg retrieval, stress and anxiety is often much higher with transfers. So much energy, time, and resources go into making an embryo, so it’s normal to feel anxious and want to do everything possible to increase your chances of it working. There is a lot of information out there regarding advice for transfers, but not all of it is helpful. We want you to have the most accurate and effective tools to support your transfer cycle, so we put together our best tips based on current research studies and our over 15 years of integrative experience supporting women through these cycles.
Many of these tips came from our April 2022 Instagram Live interview with Reproductive Endocrinologist Dr. Sheeva Talebian from the Manhattan IVF clinic CCRM NY. Please follow us @lilyandhorn or @emwfertility to watch the interview and for more advice on transfers and all things integrative fertility!
Work with a trained experienced fertility Acupuncturist
Receiving care from an acupuncturist in the months leading up to and including IVF cycles (retrievals and transfers) has shown to produce better live birth outcomes. We recommend acupuncture once a week in the months leading up to the transfer cycle and twice a week during your transfer cycle, especially if you have a history of a thin lining or Asherman’s syndrome. Your acupuncturist may also recommend dietary changes, supplements and herbs customized for your specific case. Always check with your RE and Acupuncturist on when to discontinue herbs and supplements in your transfer cycle. While customized approaches are best on a case-by-case basis, there is some good research showing Vitamin E, L-Arginine and moxibustion can be helpful to thicken the uterine lining and make it more receptive.
Maintain a healthy diet and exercise routine
While exercise during retrievals and fresh transfer cycles is prohibited due to risk of ovarian torsion, it is ok to exercise during a frozen embryo transfer cycle. Go for moderately intense movement 3-5 days a week. If you are used to pushing hard to your max in workouts, try to pull back to 80%. Check in with your body and ask “does my body feel like it’s running from a bear?” If so, slow down. If you are not used to exercise at all, walking at least 30-45 min a day is helpful for managing stress (and it’s hormonal changes) while also being good for blood flow.
The Mediterranean diet is our go-to for fertility, but in our clinic, we modify it based on each patient’s case. It’s a good place to start though. For details on this diet and its fertility benefits, read our blog here. Stay hydrated (a good calculation is your body weight in pounds divided by two…drink that many ounces of water a day). Minimize alcohol and caffeine…one small cup of coffee or tea a day and four or fewer alcohol units a week.
Don’t stress about your stress and anxiety…it’s normal and won’t interfere!
It’s helpful to process emotions in the moment during your cycle. Don’t resist crying or talking about what you are feeling when it comes up because you think you need to be completely Zen through this. We’ve seen lots of women maintain calm and the transfer doesn’t work, while others can’t stop crying daily and it does work. Processing your emotions as they present is the fastest and healthiest way to navigate them and will help you feel better faster too. Studies show that all women experience anxiety during IVFs. One study showed women who reported the highest levels of anxiety have similar pregnancy rates to those with the least. However, another study women who took steps/actions to manage their anxiety (think acupuncture, meditation, talk therapy, yoga) had better outcomes than those who did nothing. Try naming what you are feeling (“I’m scared it won’t work” “I’m angry I have to do this”, etc) and talk about it with a trusted loved one or therapist. Don’t judge what comes up…they are just feelings. It will help you move through the emotion rather than stay in it or resist it. More on coping here!
Don’t Ice Progesterone Injections
While it is tempting to ice the injection site to numb it, don’t do this! Progesterone injections are in an oil suspension and cold will make it harder to inject and absorb. Instead, apply warmth, walk around or do lunges before and after the injection, and massage the area afterwards. Have a nurse draw a target area on your backside so you aim for the best spot and don’t get too close to sciatic nerve, which can be painful. These shots are intimidating, but you’ve got this!
Transfer day is here!
It’s a big day and it’s normal to feel nervous. You have 2 assignments…get through the amazingness of transfer process (it’s really quite cool) and then laugh! Laughter has been shown to potentially improve implantation rates, so tell your loved ones to communicate things that will make you laugh and plan to arrange entertainment around this too (so no watching Game of Thrones or anything scary or sad!). This goes for the three days after a blastocyst embryo transfer too, which is your implantation window. Acupuncture before and after the transfer (within 24 hours) can also help improve implantation rates. Getting it onsite at your clinic is even better! Take it easy after your transfer as if you have a cold or flu…rest, but don’t be inert, hydrate, and nourish yourself. Some women swear by eating a little pineapple and its core each day around the transfer. While there isn’t much data to back this up, we think fruit is fine and healthy, so give it a go!
Happy, healthy distractions
While we are advocates of feeling your feelings, it’s also not a bad idea to have happy, healthy distractions on-hand for when you need to give your nervous system a break. Think a saucy fun novel, a brilliantly funny TV series or an interesting/inspiring podcast. We suggest choosing topics that have nothing to do with fertility, pregnancy or parenting. Give yourself a little escape with it.
To test or not to test
Some clinics tell their patients not to take home pregnancy tests prior to the official blood test. But for some women, testing ahead of time gives them a heads up so the call with the official test is a little easier to process. There is no right or wrong here. A home test just gives you a heads up. Keep in mind, in rare cases, it can be wrong, so you still need the official blood levels to call it. If testing at home makes you feel you can cope better, it’s fine to do. Just remember, home tests are not 100% accurate, so you still need the blood beta hCG levels, which will also give your RE an indication of how strong the levels are if they are positive, and a baseline from which to track the rising hormones. If testing at home makes you more anxious, just wait for the official levels, which often comes with a plan for next steps from your doctor.