What You Need to Know After Your ET

Immediately Post-Transfer: First 60 Minutes

After the embryo transfer is complete, your bed will be wheeled from the procedure room into a private room, all while you remain laying flat on your back. Most clinics have a 30- or 60- minute rule, in which they want you to remain laying flat for 30 or 60 minutes. Almost all embryo transfers are conducted with the assistance of ultrasound guidance. While the reproductive endocrinologist inserts the catheter and positions it inside your uterus, another member of the medical team is monitoring the transfer via a trans-abdominal ultrasound. This makes it possible for your RE to see the optimal place to release the embryo(s).All ultrasounds work best if the sound waves travel through fluid (versus air or tissue), so you will likely have a very full bladder before the transfer starts. After waiting for the procedure to begin (have you ever known a doctor to be on time?) and several minutes of having your abdomen pushed on with cold hands and a cold gel-covered ultrasound wand during the transfer, you will feel like you are about to burst.The need to empty your bladder after embryo transfer is often mentioned by patients as one of the most uncomfortable parts of the process. The good news is you don't have to sacrifice comfort to increase your perceived chances of success. Your doctor doesn't want you to be unnecessarily uncomfortable, and he/she will be happy to have their staff help you - with a bedpan. Don't pass up the opportunity to relieve your bladder, no matter how self-conscious or embarrassed you may feel about the bedpan. Given that you've already dropped your pants for the doctor and his/her staff every time you see them, it really isn't such a stretch to use the bedpan. If you feel like you need to go, just do it. Your nurse won't care in the slightest and your bladder will thank you.

After the Embryo Transfer: Instructions for the First Two Days

After you are released from the clinic or outpatient center, you will be given post-transfer instructions. Doctors will have different discharge instructions depending on a patient's medical history and their own preferences. In general, Reproductive Endocrinologists recommend:
- no heavy lifting for 48 hours
- no strenuous physical activity, such as running or zumba aerobics for 48 hours
- no tub baths or swimming for 48 hours
- no douching, tampons or using a bidet
- no alcohol, smoking or recreational drug use
- no intercourse and no orgasms (this stays in effect until you can see a fetal heartbeat via ultrasound or you have a negative pregnancy test)

Unless advised otherwise, you can:
return to work immediately (assuming it does not require heavy lifting, physical exertion or being submerged in water)
- engage in light activity (housework, driving, shopping)
- travel
- engage in sexual activity other than intercourse for your partner's pleasure - no orgasms for you! (this stays in effect until you can see a fetal heartbeat via ultrasound or you have a negative pregnancy test)

Won't My Embryos Fall Out if I Walk Around?

Thankfully, they won't. You will probably feel like tiptoeing around on a layer of foam for at least the first few days, and if that makes you feel better then go ahead and do it. But there's no need. Remember that in a spontaneous pregnancy, the egg is released from the fallopian tubes, the sperm travels all of the way up the vaginal tract, through the cervix, all the way through the uterus and into the fallopian tube. Fertilization typically takes place inside the fallopian tube, which is where the egg and sperm usually meet. The tiny embryo moves through the tube and into the uterus, where it can, given the right circumstances, implant in the uterine wall. If oocytes or embryos could "fall out" of the uterus, not many people would get pregnant at all. The uterus is defined as a potential space; that is, it is completely closed with the inside walls all touching, and can expand as needed to create space for a growing baby. Think of your uterine walls like a deflated balloon made out of sponge. In its normal, resting state the balloon will be small, the spongy walls will all be touching, and there will be no air inside. If you start to inflate the balloon, it expands to accommodate the volume of air that is put inside it. But while it is deflated and the walls are touching, you could put a marble inside and it would stay where it is until you start to inflate it.

Does Spotting Mean Its Over?

No. Please breathe now - you're turning a remarkable shade of blue. Your body has been going through a lot during your IVF cycle. Hormones, injections, stress, egg retrieval (if it is a fresh cycle) - none of these should be discounted. And during the transfer your doctor probably used a speculum so he/she could visualize your cervix, then the catheter had to pass through the cervix, and then the catheter may have irritated a tiny bit of the lining. In addition, you are likely on some hormone supplements including progesterone, which can cause spotting. Any of these things could cause a little spotting, and not necessarily immediately. There is another thing that can cause spotting, and this is a happy possibility: it's called implantation spotting. Implantation spotting happens when the embryo burrows into the uterine lining and implants, so that it can begin growing. Implantation spotting often looks different from other types of spotting; the color is a light pink or light brown and it may be "streaky" in appearance.Some women say that in addition to spotting, they also feel some mild cramping a little before or at about the same time the spotting begins. The feeling typically does not last long, as the embryo is quite tiny and only causes a mild disruption in the uterine lining.Not everyone experiences implantation spotting, so it is one of those aspects of the post-transfer period that tends to make women question everything. Are the cramps the beginning of my period, or are they implantation cramps? Is that spotting implantation spotting or is it the beginning of my period? I don't have any spotting or cramping - so maybe the embryo didn't implant! And on and on, until we are in a two week frenzy of anxiety and nerves.

有点太早了..

Diet guide for first trimester Pregnancy 怀孕初期（1－3月）饮食宜忌 Always remember to maintain a balance diet and take everything in moderation. Always consult your doctor if you have doubts.

宜吃食物：

1. 生姜――对身体虚寒孕吐厉害者有帮助。治疗孕妇着凉感冒有效。不能过量，会便秘上火。
Ginger – helpful for MTB with weak body and who has bad morning sickness. Effective treatment for pregnant women who change a cold or flu. Must not consume too much, will be lead to constipation and heatiness.

2. 板栗――活血化淤，止血的功效，孕妇常吃可以健身壮骨，有利骨盆的发育成熟，消除疲劳。但消化不良者，糖尿病人不得吃过量。板栗核桃粥对阴道出血，头晕耳鸣，小便频密有食疗作用。
Chestnut - Promoting blood circulation, pregnant women can eat for stronger bone health, development of pelvic, fighting fatigue. However, those with indigestion, diabetics should not eat too much. Walnut and chestnut porridge is effect for stopping vaginal bleeding, dizziness, frequent urine.

3. 草莓――有多种矿物质及维生素，明目养肝。丰富膳食纤维和果胶可帮助消化，适合因怀孕便秘的女性食用。常吃草莓，对头发皮肤有保健作用。
Strawberry - Has a variety of minerals and vitamins. Good for Liver and eyesight. High in dietary fiber and rich in pectin. Help to improve digestion. Suitable for women suffering from pregnancy constipation. Eating strawberries also promote better hair growth and complexion.

4. 蘑菇――白蘑菇，洋蘑菇。有大量植物纤维，具预防便秘，促进排毒，预防糖尿病及降低胆固醇含量的作用。含多种抗病毒成份，能增强免疫力。
Mushrooms - white mushrooms, Western mushroom. It is rich in plant fiber, helpful in the prevention of constipation. With a variety of anti-viral ingredients that can enhance immunity. Promote detoxification, prevention of diabetes and lower cholesterol levels.

5. 芝麻－－钙含量高，对胎儿的发育有促进作用。洒少量在菜肴或白饭上，也可在煮粥时加入。芝麻有大量油脂，有润肠通便的作用。
Sesame - high calcium content, good for the development of the fetus. The sesame oil is helpful in the prevention of constipation. Conveniently sprinkle a small amount on rice or vegetable dishes.
Food to avoid during first trimester:
忌吃食物：

1. 山楂――会刺激子宫收缩。 Hawthorn (shan zha) - will stimulate uterus contraction.

2. 西瓜――会刺激子宫收缩，高糖分，糖尿病者禁食。 Watermelon - will stimulate the uterus to contract, high-sugar, not suitable for diabetes.

3. 龙眼――会导致漏红或先兆流产 Longan - would lead to spotting and threatened abortion.

4. 益母草――会使子宫收缩，对胎儿危害十分大。做月子时才吃。 Motherwort(yi mu cao) - cause the uterus to contract, to the great harm to the fetus.

Tips

The following is a list of tips that I got from Singapore motherhood IVF/ICSI support group:-

1. Place the raw egg white in a cup, pour boiling water on the egg white and stir, add ensure milk powder after 10-15 min. Cooking the eggs even for a short while over the stove destroys the albumin protein which we need. U must eat betw 4-8 egg whites after your ER op as the onset of OHSS is most severe after ER op.

2. Take 3 to 4 egg whites every morning during lucrin and puregon injections. Then took about 7 egg whites after ER. But reduced to 3 egg whites again after ET. Drink milk daily too.

3. Drink red dates help implantation.

4. Things you should DO before ER:
- Eat an egg or two each day or other protein rich foods
- Acupuncture (if possible)
- Massage
- Drink lots of water
- Exercise (only light exercise when stimming and after ER/ET like walking,. This increases blood flow to the uterus) Don’t get heart-rate over 140
- Eat lots of protein and high-quality fats. Nuts, seeds, eggs, meats, beans etc
- Eat lots of fiber as well. This helps PCOS women with IR to regulate insulin better
- Get at least 8 hours of sleep each night. Take frequent naps

5. Things you should AVOID before ER:
- DH should not expose himself to sauna/hottub
- Avoid cold/iced food
- Avoid excess amounts of red meats
- Don’t eat sugar or sugar substitutes! Sugar negatively effects egg quality.
- No alcohol for either partner for at least 1 month before ER
- Reduce or eliminate caffeine intake
- Avoid eating fish due to mercury content

6. Things you should DO after ER:
- Relax
- Drink plenty of Gatorade
- Drink Pedialyte(isotonic rehydration drink) and water to avoid OHSS. 3-5 liters a day!

7. Things you should AVOID after ER:
- Exposure to sun

8. After ET care:
- No heavy lifting! Anything over 5 lbs is too much
- Rest, rest, rest!!!!!

9. Avoid using Cologne, hairspray, aftershave etc during ER

10. Activity restrictions after IVF transfer
- lie on back for 1 hour after embryo transfer before going home
- limit physical activity for the remainder of that day. This means hang out on the couch or in the Lazy-boy recliner - watch videos, read, boss hubby around, etc
- allow "normal activity" beginning the morning after embryo transfer - but heavy bouncing of the uterus is restricted until after the pregnancy test. Therefore, water skiing, jogging, "uterus bouncing sex", etc. are probably not a good idea until after the pregnancy test

11. IVF embryo transfer and travel
- do not fly out on the day of the transfer, but wait until the next day

Yoga Postures for Infertility

1. Supported Bridge Pose :
- Lie on the back and bent your knees with feet flat on the floor ,
- Move your feet to your bottom as close as possible,
-Inhale and exhale deeply 4 times, then slowly lift your pelvis and buttocks off the floor while keeping your feet flat on the floor,
-Clasp your hands behind your back,
-Stay in this pose for a minute or two while breathing deeply.

2. Legs up on the wall pose:
-Lie on your side with your buttocks close to wall,
-Slowly inhale and exhale, then when you are exhaling turn your body and move your legs up to the wall at the same time so that you create a 90-degree angle at your pelvis between your legs and body,
-Stay in this pose for a few minutes inhaling and exhaling slowly.

3. Cobbler's pose:
-Sit on the floor with your legs stretched out,
-Inhale and exhale then while exhaling bring your feet close to your groin and push the sole of your feet against each other,
-Hold to your toes and when exhaling try to lower your knees to the ground as much as you can,
-Hold this pose for about 3-5 minutes while slowly inhaling and exhaling.