Foods To Avoid After Embryo Transfer

Introduction 

Are you a bit anxious before an embryo transfer? To feel more relaxed, as well as confident about what is ahead, it is essential to comprehend how to adequately prepare for it. A crucial aspect of preparing is being mindful of what you put into your body. In addition to helping you maintain your uterine health & hormone levels, a healthy diet may also maximise your odds of IVF success. This article suggests what patients should consume after an embryo transfer as part of their fertility journey.

Infertility

According to the World Health Organization (WHO), infertility is a disorder of the male or female reproductive system characterised by the inability to conceive after 12 months or more of unprotected sexual activity.¹ Infertility has an effect on the families and communities of millions of individuals of reproductive age across the globe. Worldwide, it is estimated that between 48 million couples and 186 million individuals suffer from infertility. ^{2, 3, 4} Two types of infertility exist: primary and secondary. Primary infertility occurs when a person has never experienced a pregnancy, but secondary infertility occurs after at least one pregnancy. Infertility therapy covers prevention, diagnosis, and treatment. Access to fertility care on an equal and fair basis remains a difficulty in the majority of nations; this is particularly prevalent in low and middle-income nations. In national universal health coverage benefit packages, fertility treatment is seldom emphasised. 

Infertility may result from a variety of reasons affecting either male or female reproductive systems. However, it is often impossible to pinpoint the exact reason for infertility. In the male reproductive system, infertility is often characterised by issues with the ejection of semen, ¹ the lack or low amounts of sperm, or defective sperm morphology and motility. In the female reproductive system, a variety of disorders of the ovaries, uterus, fallopian tubes, or endocrine system — among others — may cause infertility. Infertility in the female reproductive system may be caused by: 

• Tubal problems, including obstructed fallopian tubes, are caused by untreated sexually transmitted infections (STIs) with consequences of a botched abortion, postpartum sepsis, or abdominal/pelvic surgery. 
• Inflammatory uterine illnesses (such as endometriosis), congenital uterine disorders (such as septate uterus), or benign uterine disorders (such as fibroids) 
• Ovarian problems, including polycystic ovary syndrome (PCOS), as well as other follicular abnormalities. 
• Disorders of an endocrine system can lead to hormonal abnormalities in reproduction. The endocrine system consists of the hypothalamus and pituitary glands. This system is often affected by pituitary tumours and hypopituitarism, for instance.

IVF

IVF is an abbreviation for in vitro fertilisation. It is one of the most popular forms of assisted reproductive technology (ART). IVF uses a mix of medications and surgical techniques to fertilise an egg with sperm and implant the fertilised egg in the uterus. 

Initially, you take medicine that causes many of your eggs to develop and become fertile. The doctor then removes the eggs from your body and combines those with sperm in a laboratory to facilitate fertilisation. Then, one or more fertilised eggs (embryos) are placed straight into the uterus. If some of the embryos implant inside the uterine lining, you become pregnant. IVF is a lengthy procedure that requires many months to finish. Occasionally, it succeeds on the first attempt, but for the majority of couples, many rounds of IVF are required. If you're experiencing fertility issues, IVF will enhance your chances of becoming pregnant, but it's not a guarantee; everyone's body is different, and IVF won't succeed for everyone. 

Taking fertility medicines for a number of months is the initial stage in IVF in order to stimulate the ovaries to generate several mature, fertile eggs. This is known as inducing ovulation. You may have routine ultrasounds and blood tests to monitor hormone levels and egg production. Once your ovaries have generated enough mature eggs, your physician will remove them from the body, which is a procedure known as egg retrieval. Egg retrieval is a minor surgical operation performed in a physician's office or fertility centre. You will be given medication to help you remain comfortable and relaxed during the process. Using an ultrasound to view inside the body, the physician inserts a very thin, hollow tube into the vagina and into your ovary and egg-containing follicles. The needle is attached to a vacuum apparatus that delicately extracts the eggs from each follicle. 

It is termed insemination when your eggs are combined using sperm cells from the spouse or a donor in a laboratory. Sperm and eggs are placed in a specific container together, and fertilisation occurs. Sperm with decreased motility (that do not swim as well) might well be directly injected into the egg to facilitate fertilisation. As such cells in the fertilised eggs divide and develop into embryos, and laboratory personnel observe the development. 

Approximately 3-5 days following egg extraction, one or more embryos are implanted into the uterus (embryo transfer). The doctor implants an embryo directly into the uterus by inserting a tiny tube through the cervix and into the uterus. Pregnancy occurs when an embryo attaches to the uterine lining. Embryo transfer is performed at a doctor's office or fertility facility and is often painless. Plan to relax for the remainder of the day following embryo transfer. The following day, you may return to your routine activities. Women may also take progesterone tablets or get daily injections for the first 8 to 10 weeks following embryo transfer. The hormones facilitate the embryo's survival in the uterus.

What is an embryo transfer?

Embryo transfer is a phase in assisted reproduction in which embryos are implanted into a woman's uterus with the intention of establishing a pregnancy. This procedure is often used in conjunction with IVF and may be employed on humans or animals, with different aims in each case. Embryo transfer may be conducted on days two or three or later in the blastocyst stage, which was accomplished for the first time in 1984.⁵ Endometrial receptivity, embryo quality, and embryo transfer method are variables that may influence the success of embryo transfer. 

In the last step of in vitro fertilisation (IVF), the fertilised egg which has been allowed to develop for many days is transferred to the woman's uterus, where it will ideally implant, and develop into a baby, ultimately resulting in the delivery of a healthy baby. The IVF embryo is loaded onto a catheter, which will then be inserted through the woman's vagina and cervix and into the uterus. Generally, anaesthesia is not required; however, valium may be given. 

As each individual's cycle is distinct and regulated by a variety of carefully monitored elements, the timetable for an embryo transfer is typically varied. These parameters assist to schedule a number of crucial IVF cycle events, which in turn determines the trajectory of the subsequent IVF cycle step. As embryo transfer is the last step of such an IVF cycle, the day on which this happens is quite changeable; thus, it is essential not to commit yourself to a certain calendar or time frame throughout your own IVF or FET cycle.

Foods to eat during and after IVF

Foods to consume during an IVF cycle: 

• Plenty of water: It is thought that consuming large quantities of water promotes fertility. Therefore, before eating or drinking, sip water at room temperature. Additionally, ensure that you consume at least eight glasses of fresh, filtered water every day. 
• Consuming protein-rich foods aids in the creation of high-quality hormones and eggs, which are essential for reproduction. Zinc and carbohydrates must also be ingested frequently. Additionally, it is preferable to choose organic foods.

Foods to consume after an IVF cycle: 

The Mediterranean diet is a useful method to remember the essential elements needed for IVF treatment. According to research, a Mediterranean diet may help IVF success rates. It contains healthy fats, green vegetables, and foods rich in zinc and folic acid. Let's explore how each component within the Mediterranean diet helps maintain the optimal hormonal balance and energy levels essential for a successful IVF therapy. 

Folic Acid, often known as vitamin B9, is essential for DNA synthesis, red blood cell creation, and brain/immunological function. Researchers have found a correlation between folic acid consumption and IVF success.6 In addition, research links folic acid to a reduced incidence of congenital heart & neural tube problems in infants.⁷ The CDC recommends that women consume 400 micrograms (mcg) of folic acid daily. The following foods contain folic acid:

• Asparagus 
• Avocados 
• Corn 
• Complete grains (brown rice, oatmeal, barley, popcorn) 
• Citrus fruit (oranges, berries, grapefruit) 
• Leafy greens (spinach, turnip greens, mustard greens, brussels sprouts) 
• Sunflower seeds 
• Beans (pinto beans, chickpeas, black beans) 
• Broccoli
• Cauliflower 

Zinc is essential for cell division and the synthesis of progesterone. This could thicken her endometrium, which helps feed and maintain the embryo. foods high in zinc include: 

• Nuts (peanuts, pecans, cashews, etc.) 
• Lactic products 
• Potatoes 
• Mushrooms 
• Fish and seafood (predominantly oysters) 
• Lentils 

Healthy fatty acids, a study revealed that women who ingested a lot of monounsaturated fats were 3-times as likely to give birth to a healthy baby. In general, healthy fats derived from fish and vegetables are excellent choices for a fertility-friendly diet. We need fat in our diet in order to maintain a healthy hormonal balance and reduce inflammation. In addition, fish is rich in protein and iron, which encourage foetal development and the physical changes that occur during pregnancy. Healthy fats consist of: 

• Soymilk 
• Tofu 
• Oily fish (salmon, pollock, canned light tuna, catfish) 
• Avocados 
• Whole eggs 
• Sesame seeds 
• Peanut, olive, and canola oils 
• Nut butter (peanut butter, almond butter, etc.) 
• Olives 

If required, you may supplement your diet with the essential nutrients. Consult with your physician before adding these to your diet.

Foods to avoid during and after IVF

Foods to avoid during IVF treatment: 

Cheese: During your IVF cycle, you must avoid cheese completely. In particular, mould-ripened cheeses such as brie, camembert, etc. Consuming them exposes you to the danger of listeria infection. Additionally, avoid drinking unpasteurized milk throughout your pregnancy. 

Coffee: Even while experts recommend consuming roughly two cups of coffee each day, it is recommended to avoid coffee or see a physician. 

Alcohol: To boost your fertility, abstain from alcoholic beverages. It may cause ovarian dysfunctions if consumed. Women who use alcohol during pregnancy run the danger of miscarriage and other serious complications, such as harm to the baby's development, foetal disability, etc. 

Aquatic organisms: Aquatic foods are high in mercury content. Moreover, mercury might lead to birth abnormalities. Consequently, avoid consuming aquatic creatures. Additionally, you should avoid consuming raw or undercooked shellfish, oysters, crab, cold shrimp, and mussels. 

Simple Sugar: Refined sugar may be broken down rapidly and can raise blood sugar levels. Occasionally, alterations in insulin might lead to insulin resistance. This might decrease your reproductive rate. 

Synthetic Sweeteners: Avoid saccharine and other artificial sweeteners throughout the IVF cycle. And if you are used to your sweeteners, see your physician for a safe alternative. 

Raw Eggs: Salmonella, a bacteria that may cause food poisoning, is present in raw eggs. Therefore, any foods containing raw eggs, including cookie dough, Caesar salad, eggnog, etc. 

Saturable lipids: It is believed that consuming foods high in saturated fats has a deleterious effect on IVF therapy. Research revealed that women who frequently ingested saturated fats had less developed oocytes, and about 15% of embryonic cells were dividing at a slower rate.

Foods to avoid after IVF treatment:

Avoid consuming meals containing: 

• As noted before, consuming healthy fats is essential for maintaining hormonal balance. A diet high in saturated & polyunsaturated fats may diminish the likelihood of a successful IVF procedure. Pastries (cakes, cookies) and processed meats include saturated fatty acids (salami, bacon, sausages). 
• Simple Carbohydrates: Simple carbohydrates are rich in sugar and disrupt the hormonal balance of the body. Simple carbohydrates consist of white flour, white rice, sugary beverages, and snacks. Instead, consume whole grains. 
• Even though fish is a healthy element of your diet after embryo transfer, it is necessary to monitor your mercury levels. For instance, albacore tuna seems to have more mercury than canned light tuna, thus choose the latter. 
• Additionally, avoid alcohol, coffee, and sugary beverages.⁸ There is a relationship between soda as well as energy drinks and decreased fertility.⁸

Should I take any supplements?

There are two essential vitamins that should be taken at suitable levels by women trying to conceive. The first is the B vitamin folic acid. As folate, this vitamin helps the body produce healthy new cells and is present in a variety of foods. Folate-rich foods consist of green vegetables, citrus fruits, legumes, and whole grains. Additionally, pasta, breakfast cereals, and bread are enriched with folic acid. Daily folic acid requirements for women of reproductive age range between 400 and 800mg. Some physicians prescribe 1mg daily for patients expecting twins. The majority of women do not receive enough folic acid from food alone. 

Vitamin D is the other essential vitamin. Direct exposure to the sun results in the production of vitamin D. According to studies, up to ninety per cent of women have inadequate vitamin D levels. Some vitamin D may be found in fish and eggs, while cereals, milk and orange juice are fortified with vitamin D. Recent research indicates that women with normal vitamin D levels throughout pregnancy may have a decreased risk of miscarriage, gestational diabetes, preeclampsia, as well as premature birth. Through a simple blood test, vitamin D levels may be measured. Above 30mg/ml is regarded to be normal. Supplements are available. 

Docosahexaenoic acid (DHA) is an omega-3 fatty acid that is mostly found in fish. DHA aids in foetal brain development and improves attention and learning later in adulthood. DHA is also essential for healthy vision, the development of the neurological system, and good immunological function. The typical pregnant woman consumes barely two ounces of the recommended eight to twelve ounces of fish each week, according to experts. It is highly suggested to take DHA supplements containing between 300 and 600mg per day for at least six weeks prior to conception, during pregnancy, and while nursing. 

During pregnancy, the body's iron requirements practically treble. Haemoglobin, a protein in your body that helps transport oxygen to your cells and growing foetus, needs iron. The amount of blood in a pregnant woman's body grows by around 50%, necessitating extra haemoglobin. The CDC advises pregnant women to take a daily iron supplement of 30mg. Iron-rich meals, which include beans, red meat, green leafy vegetables, iron-fortified grains and cereals, are also advised. 

Calcium is essential for the development of nerves, muscles, and the heart in a foetus, as well as the formation of strong bones and teeth. The majority of women do not consume the necessary daily quantities of calcium. Each day, all women should consume four servings of dairy products or other calcium-rich meals. Milk, yoghurt, cheese, plus green vegetables are all great calcium sources. For pregnant and nursing women, the current U.S. Recommended Daily Allowance (USRDA) for calcium is 1200mg per day. 

Taking a daily prenatal vitamin is the simplest approach for women to guarantee the proper intake of folic acid, vitamin D, DHA, iron, and calcium. 

Coenzyme Q10 (CoQ10) and DHEA are two supplements often used to assist older women (over 35), and those with limited ovarian reserve increase their likelihood of conception. Women undergoing IVF often take these to enhance the number of eggs their ovaries produce. CoQ10 is an antioxidant required by all bodily cells, including the ovary. Meats, green leafy vegetables, nuts, and shellfish all contain CoQ10. Supplements are also available. The most frequent dosage of dietary supplements is 300mg twice a day. DHEA is a hormone that the female body converts into androgens. During the early stages of egg development, ovarian follicles have androgen receptors. These receptors emerge around 90 days prior to ovulation and fade approximately two weeks beforehand. According to studies, women with limited ovarian reserve do not make enough androgens, and DHEA supplements given early in follicular development may enhance egg quality and number. The suggested dose of dietary supplements is 25mg three times per day. Prior to IVF, women should ideally take CoQ10 and DHEA for 60 to 90 days.

Things to do after embryo transfer 

After embryo transfer, patients are recommended to relax in bed while at the clinic. Implantation occurs from 1 to 5 days following the transfer of a blastocyst. The implantation window for a day-3 transfer is between 6 and 10 days following egg retrieval. Take a week off work. Get enough rest and pay attention to your body. You may continue your regular activities, but you should refrain from any intense exercise during this period. 

Avoid vigorous physical exercise, like aerobics, running, jogging, and cycling uphill. You may instead engage in moderate physical activity, including walking, driving, and cooking. You may also work, but only if your job does not require heavy lifting or strenuous physical activity. Explore relaxation practises such as yoga, meditation, and Tai Chi to reduce stress. 

Have a diet as if you are already pregnant. Avoid processed meals, limit your sugar intake, consume healthy carbs, include oily fish twice per week, don't overlook proteins, and take a folic acid-containing multivitamin every day. 

Sexual contact should be avoided until the results of a pregnancy test are known. Sex may trigger uterine contractions, which may interfere with the embryo's implantation in the uterine lining. 

Medicine following the transfer, once the transfer has been conducted, our fertility specialist will offer instructions about the medication to be taken till the pregnancy test result. 

It is vital to avoid tub baths, swimming pools, and beaches in order to prevent dangerous diseases. Forego the bubble bath for a few weeks in lieu of fast, warm showers. 

Fluids assist maintain cell hydration, which is crucial for the correct functioning of cells (including the endometrial cells). 

Progesterone taking prepares your uterine lining for pregnancy. Progesterone produces an ideal environment for embryo implantation. 

Home pregnancy tests should be avoided! You may obtain a false-negative or a false-positive result. You should wait around two weeks after the embryo transfer before doing the first hCG test. Our fertility specialist will arrange your formal pregnancy testing.

Outcomes of embryo transfer

On the CDC's website, everyone can see the success rates of clinics, but it is only around the US. Individual clinic success rates are significant; however, it is recommended to be taken with 'a pinch of salt’. A clinic with exceptional success rates may reject couples with a lesser likelihood of pregnancy. Alternatively, physicians may be transferring an unsafely high number of embryos every treatment cycle.

What is the chance of successfully getting pregnant?

Generally, success rates are stated according to a patient’s age. IVF success rates are likely to decrease with age unless donated eggs are utilised. IVF is often effective, particularly for women under 35 or those who utilise donated eggs. In 2017, the CDC obtained national data on IVF success rates utilising non-donor eggs per egg retrieval (not per cycle).⁹ In other words, these are the probabilities of a live delivery after a single egg retrieval utilising either freshly retrieved eggs/embryos during the cycle or stored embryos for a subsequent embryo transfer cycle. 

The frequency of live births per egg retrieval is 54.5% for women younger than 35. The probability of live births per egg retrieval for women aged 35 to 37 is 41.1%. The probability of live births per egg retrieval for women aged 38 to 40 is 26.7%. The probability of live births per egg retrieval for women aged 41 to 42 is 13.8%. For women above the age of 43, the rate of live births per egg retrieval is 4.2%. Unfortunately, the success rate of IVF drops dramatically after age 40.¹⁰ This is why the majority of women over the age of 40 use donor eggs. Using donated eggs, IVF success rates are not as reliant on the age of the mom. Using donor eggs, the probability of live births each cycle is 55.3% with fresh embryos and 46.5% with frozen embryos. 

As indicated, the preceding data pertain to single egg retrieval. With numerous IVF rounds, the likelihood of success increases. Expect to endure many IVF trials to get the desired outcome, rather than relying on a single shot. According to research released in 2015, the live birth rate for the first IVF cycle was 29.5%. Success rates maintained at more than 20% through the fourth try. By the sixth cycle, 65.3% of women had a live birth. Despite the fact that prior suggestions indicated completing three or four cycles, it seems that the likelihood of success increases with each additional cycle.¹¹ However, the exorbitant expense of IVF and the psychological suffering experienced by couples make it difficult to undergo several IVF rounds. ¹²

Complications - Ovarian hyperstimulation syndrome 

Ovarian hyperstimulation syndrome (OHSS) is indeed a heightened hormonal response. It often affects women receiving hormone injections to encourage the production of eggs from the ovaries. The ovaries enlarge and become painful due to OHSS. OHSS is a potential IVF complication. Dostinex usage to prevent OHSS has no effect on IVF success.¹³. The ovaries enlarge, and fluid spills into the body in this illness. This disorder is more prevalent in polycystic ovary syndrome patients undergoing reproductive medications. Symptoms often manifest 4 to 5 days following the collection of a woman's eggs during IVF. Nevertheless, symptoms often disappear spontaneously with the commencement of the next menstruation or soon afterwards. When OHSS strikes a pregnant patient, the symptoms may intensify and linger for 2 to 3 weeks. To treat hyperstimulation during IVF, you may be prescribed cabergoline to alleviate your symptoms. To assist suppress ovarian activity, your doctor may also prescribe other drugs, such as a gonadotropin-releasing hormone (Gn-RH) antagonist or even letrozole (Femara). 

Summary

The choice to undertake IVF is a private matter influenced by family dynamics, relationship support, religious views, financial situation, lifestyle, and mental health. There are ways in which you can prepare your body for an embryo transfer. It is of particular importance that you are mindful of the food and drinks you choose to consume if you are undergoing IVF. It is important to avoid food high in saturated and polyunsaturated fats, in particular, processed foods. Try to swap simple carbs for whole grains to avoid disrupting hormonal balance. Also, you should be mindful of your choice of beverages and avoid alcohol, coffee and sugary drinks. Maintaining a healthy diet helps prepare your body for IVF treatment.