It’s finally that time. You went through the retrieval (or retrievals), and you now have a precious, little embryo to transfer. Now what? What can you do to ensure your best chance of success for your upcoming transfer (FET)?
ACUPUNCTURE: Receiving fertility acupuncture and laser acupuncture treatments leading up to your transfer can improve your chances of success. I typically recommend a minimum of 3 treatments and ideally 6-8 treatments leading up to your frozen embryo transfer during your Estrace protocol. These are usually booked 2x per week to get the recommended amount. The goal for these treatments is to improve blood flow to the uterine lining, balance hormones, reduce stress, reduce inflammation, and improve endometrial receptivity. Getting acupuncture on the day of your embryo transfer (before and after) has been clinically shown to improve chances of conception by 15% as well as reduce miscarriage rates. At Acubalance we go on-site at Olive Fertility Centre but check in with your local fertility clinic to see if they offer on-site acupuncture for embryo transfer day. Check out our video here on what to expect for embryo transfer day acupuncture. I also recommend having an acupuncture treatment during the implantation window. This is an acupuncture treatment times 2-5 days after your transfer (which is roughly when the embryo should be implanting) to focus on stress relief, reduce uterine contractility, improve uterine receptivity, and encourage healthy blood flow to the lining.
DIET: One of the most common things I get asked about is what to eat or not eat while preparing for an embryo transfer. I generally recommend a plant-filled, whole foods, anti-inflammatory diet in general for hormone balance and fertility. There is no one food to eat (despite what you may have heard about pineapple core) that will boost your chances of pregnancy. It’s important to just eat well overall. Stay away from the foods that you know your body doesn’t like. Does dairy make you bloated? Does take out from that one particular restaurant always make you constipated? Donuts make your energy levels fluctuate too much throughout the day? And please, stay away from McDonalds french fries after your embryo transfer. I know it’s a “good luck charm” but there is nothing the inflammatory oils and genetically modified potatoes will do for you. If you are feeling a bit lost with diet and fertility, I highly recommend downloading our fertility diet e-book for in-depth information. Make sure to have a warm, blood sugar stabilizing breakfast the day of your transfer. Bring a snack in case they run late so your blood sugar doesn’t drop or fluctuate too much. Try to fill up your bladder with warm water as opposed to cold or iced.
EXERCISE: Whatever your doctor has said you should do for exercise you should listen to. If you have not been given specific instructions based on your individual concerns, whatever exercise your body is already used to will be great to do leading up to your transfer. I would avoid intense exercise and aim for 3-4x per week of 30ish minutes of moderate cardio or strength training. After your transfer, keep it light but please continue to move. Unless your doctor has recommended you do so, I do not ever recommend bed rest post transfer. It is important to keep your blood flowing, and regular every-day movements will help with that. So go for walks and continue your light exercise. If you are having a fresh transfer and you just had your retrieval, your ovaries will still be swollen and you should not be exercising at all.
SUPPLEMENTS: Always ask your doctor and follow their instructions about which supplements you should be taking, especially in combination with other medications. I typically recommend my fertility patients to be taking a prenatal vitamin with adequate levels of folate, vitamin d, and omega 3 fatty acids before, during, and after transfer day.
REST: Make sure you are getting enough sleep leading up to your transfer. Aim to go to bed before 11pm and get at least 7 hours of sleep for optimal hormone balance. With the anticipation leading up to your transfer you may have to incorporate a more relaxing night time routine. Light some candles, take a warm bath or shower, journal, meditate, etc.
MENTAL HEALTH: Embryo transfers are stressful. You worked so hard to get to this point and it can be a lot of pressure. It is so incredibly important to prioritize self care during this time. It’s time to be very selfish with your time and energy to make sure you are nourishing yourself enough and making space for a baby into your life. I love recommending meditation to my fertility patients. Studies show even 10 minutes per day can have profound physiological benefits. I also love the fertility related guided imagery meditations by Anji, Circle and Bloom, and Belleruth Naperstek. There are also some great free guided imagery meditations on YouTube.
RECEPTIVITY PREP: Does your fertility clinic offer an ERA (endometrial receptivity analysis)? An ERA is a biopsy of the uterine lining done during a mock transfer cycle and tests for uterine receptivity. This can give you the exact timing that your lining needs (ie how many hours of progesterone beforehand) in order to be the most receptive for an embryo. This is a good option for patients that only have one or two embryos or have had failed transfers before. You may also ask your doctor if they offer microbiome testing like the EMMA and ALICE test which can test for subclinical uterine infections and the health of the uterine/vaginal microbiome to see what can be optimized for the transfer. I’ve had a small number of patients discover they have subclinical endometritis and need to go through a round of antibiotics before they are able to transfer. Want to support your microbiome anyway? Ask your doctor if you can try probiotic suppositories for a cycle or two before your transfer (and including the transfer cycle) to optimize your microbiome and improve pregnancy rates.
There are some do’s and don’ts for transfer that your fertility center will explain to you. Follow these to a T. For example, take your medications exactly as instructed, avoid putting heat directly on your lower belly or low back after the transfer, avoid swimming or baths after your transfer for a certain amount of time, and no sex or orgasms until fetal heartbeat is found on ultrasound. These may vary depending on the fertility clinic. Read more on the do’s and don’ts following transfer.
Other things to do on transfer day:
- Start your day relaxed and slow. Try to get the entire day off if you can.
- Laugh. A 2011 study posted in Fertility and Sterility showed that laughter after an embryo transfer increases conception by 16%. So watch a funny movie, a comedy stand up, or anything that makes you laugh!
- Keep warm. Bring warm, cozy socks or even a blanket to keep warm and ensure good blood circulation.
- Bring a support person or object. Anything to keep you grounded and positive.