Q. Can we have sexual relations after embryo transfer ?
A. It is better to avoid sexual intercourse after embryo transfer for a period of 15 days until the pregnancy test and for 20 more days if the result is positive. In IUI cycles, sexual intercourse is permitted after the procedure until the pregnancy test.
Q. What food restrictions should I follow?
A. All vegetarian food is allowed during these treatments. Non-vegetarians can avoid excess consumption of red meat and eggs. Fruits and salads can be taken in plenty. Avoid fasting until the pregnancy test. Chicken and fish can be consumed in moderated portions. Some people believe that mango and papaya in excess can cause abortion so you may avoid these fruits after embryo transfer
Q. When can I resume work at office?
A. We normally advice 3 – 4 days of restricted activity after embryo transfer (not complete bed rest). However, you can resume work the next day if there is not too much of travel and physical stress involved in your work pattern. Most available research suggests that resting does not help the pregnancy outcome so there is no advantage of staying at home and discontinuing office and work after the procedure.
Q. What about travel restrictions ?
A. All modes of transport are fine as long as you avoid bumpy drives, potholes and autorickshaws. Train and car are equally safe for all Mumbai patients and also for patients returning to their hometowns in Gujarat or maharashtra. It is also safe to catch a flight on the same day as the embryo transfer but if you wish you could rest for a night and fly the next day. Yes, you can also sit on the back seat of a two-wheeler without any problems
or cause for concern.
Q. How many times can I climb a staircase?
A. As many times as you wish. Of course it would be preferable if you did so slowly and without exerting yourself too much.
Q. Do I have to sleep in a straight position?
A. No, you can sleep in any position that you are comfortable with, even on your stomach if you wish. External pressure is not transmitted to the uterus as it is well protected in the pelvic bone. So also, a small child sitting on your stomach cannot cause any harm to a potential pregnancy.
Q. What about hair color, Hennna and tattoos ?
A. Non-ammonical hair color is supposed to be safe but can be avoided if not very urgent. Henna is safe. Tattooing can be done before embryo transfer, better to avoid thereafter. Bleaching creams are to be avoided as are ointments for pimples and acne. Waxing is fine and permitted.
Q. Why am I being asked to repeat the pregnancy test?
A. Sometimes, the first reading of serum beta hCG (pregnancy test) may be < 100 mIU/ml which indicates implantation. In that case the clinic will ask you to repeat the test after 48 hours. If the level doubles in 48 hours, we probably have a good pregnancy. However, if the reading remains low or does not double, it is know as a biochemical pregnancy which usually ends in a miscarriage. We understand your anxiety but there is no way to resolve
the issue until the second test is performed. Please continue all medication until the second test is done. Biochemical pregnancies are often due to some genetic defects in the embryo or some hormone deficiencies which cannot be diagnosed or corrected.
Q. Why did my cycle fail?
A. We understand your feelings in case of failure. It is important to remember and understand the success rates which have been told to you at the beginning of the cycle. Please do not blame failure on anything that you feel you did wrong (such as eating out, traveling long distances, bumps or jerks with a autorickshaw, cold, cough, fever, or any other such events). As counseled earlier you have to remember that you have to often do multiple
cycles before attaining success. You can request a meeting with the doctor in the evening hours, preferable more than a week after the negative test (to allow for emotional recovery) and then discuss things out. Doctor will review the file and the cycle events and counsel you about the possible reasons (for example – egg or sperm quality, some problem in the womb which could not hold on to the embryos although they were of best quality and other
Q. Common prescriptions for problems after embryo transfer
- Cold: Tab Cetzine / Alerid twice a day for excess sneezing. Excessive sneezing will not affect the result or pregnancy outcome
- Cough: Syr Chericof 2 tspf three times is safe even in early pregnancy. For excessive coughing, can take a spoonful of Syr Benadryl or Corex at bedtime for a good nights sleep. Again this will not affect the results
- Fever: Tab Crocin or any paracetamol tablet twice or thrice as required is safe in pregnancy. If it persists, you will need to consult your GP for further tests and medication. Antibiotics are ok and all you need to do is inform him that you might be pregnant so that he can select appropriate medication for you.
- Pain in abdomen: Mild cramping and pain are normal during treatment. Can take a tablet of Drotin or Cyclopam for relief. If pain persists please contact the clinic for further action
- Rash / allergy: Inj Gestone or any progesterone can cause skin rashes and allergies in 10% of patients. Cetzine / Cetgel tablets can be taken twice daily for relief. In case of excessive rash, you could contact your GP. He might have to administer a shot of dexamethasone (4 – 8 mg) for instant relief. Also, you need to discontinue the gestone injections and switch to vaginal tablets of microgest / naturogest / susten / gestofit 200 mg to inserted
in the vagina three times daily. Results will not be affected by this change.
- Constipation: This is common with progesterone – can take Syr Duphalac 15 ml twice daily for the whole 15 days. This will also help relieve gas. In case this does not help, can take Naturecare – 1 large tablespoon in a glass of water at bedtime. Also, Syr Cremaffin 2 taspf at bedtime is a good remedy for constipation
- Gas: For excessive gas, you can take tab Pankreoflat – 1 after lunch daily
- Injection pain: Most of the initial shots are water soluble, quickly absorbed and relatively painless. However, injections of gestone / progesterone are oil based and will form lumps (often painful) at the site of injection. It helps to massage the site of injection for 5 minutes with the ice-pack provided to you immediately after injection for 5 minutes. Also, application of thrombophob gel is useful in some patients. In case of severe discomfort,
stop the injections and change to Capsules of microgest / naturogest / susten (200 mg) to be inserted vaginally three times daily or Susten 8% vaginal gel to be inserted vaginally twice daily
- Excessive vaginal discharge: This is common in the first half of treatment when you are receiving injections for multiple egg production. If there is itching or foul smell, you can insert Tab Clingen -3- vaginal tablets for three consecutive nights.
- Pre-menstrual cramps, backache and leg pain: If this happens do not assume that treatment has failed as the same symptoms are caused by progesterone injections and vaginal capsules. You have to wait for the pregnancy test before assuming failure of treatment.
Bleeding before the pregnancy test: This could be either due to implantation of the embryos (especially multiple pregnancy) which is a good sign, mild breakthrough bleeding (which is common when you are taking vaginal progesterone) or failure of treatment (pre-menstrual bleeding). In either case, we can’t do anything until the pregnancy test, so please be patient and wait for the results before assuming failure or success.