Did I ruin my chances because I went back to the office the day after my embryo transfer?
After an embryo transfer, even the most ordinary activities can suddenly feel as though they might matter. Should I rest? Should I take time off work? Should I be more careful than usual?
No. You didn't.
And you didn't ruin them by walking up the stairs, going grocery shopping, bending down to tie your shoes or going to the bathroom after your transfer either.
I know this fear well. After my own first embryo transfer, despite all my medical knowledge and a perfectly reasonable understanding of human anatomy, I remember being genuinely reluctant to go to the bathroom and empty my very full bladder. Some irrational part of my brain was telling me: What if the embryo falls out?
They couldn't, of course. The uterus is not an empty container with an open exit, and an embryo placed inside the uterine cavity cannot simply fall out when you stand up, walk, cough, use the toilet or climb the stairs.
But after an embryo transfer, rational thinking can become remarkably fragile. Suddenly, completely ordinary things start to feel potentially dangerous. Was that walk too long? Did I lift something too heavy? Should I have stayed in bed? Did I somehow disturb the embryo before it had a chance to implant?
Fortunately, this is one of those questions for which we actually have reassuringly good evidence. Bed rest after embryo transfer has been studied repeatedly, including in randomised controlled trials. It does not improve implantation, pregnancy or live-birth rates. In fact, some studies and systematic reviews have suggested that prolonged rest may be associated with slightly worse outcomes.
The American Society for Reproductive Medicine specifically recommends against bed rest after embryo transfer, based on good-quality evidence. So, unless there is another medical reason why you have been advised to restrict your activity, you can get up after your transfer and return to normal everyday life.
And I practised what I now preach.
After my second embryo transfer, when we were trying for our second child, I came home and looked after my very active two-year-old. That evening, we went to friends for dinner, where I ate what I still remember as the best Beef Wellingtons of my life. Two days later, I was back to my usual fitness classes and running.
The outcome of my two transfers was the same. Today, I have two healthy beautiful sons.
That is an anecdote, of course — NOT EVIDENCE. My pregnancies do not prove that eating Beef Wellington is beneficial after embryo transfer any more than somebody else's unsuccessful transfer after climbing the stairs proves that stairs are harmful.
The studies are the evidence. My story is simply there to remind you that life does not need to stop after an embryo transfer.
There are already so many things in fertility treatment that you cannot control.
Please don't add going to the bathroom to the list!