How important is bed rest after embryo transfer?

This study investigated if bed rest after embryo transfer (ET) improves fertility outcomes. 

They found that bed rest after ET did not affect clinical pregnancy (CP) and live birth rate (LBR).

Embryo transfer (ET) is the final step of assisted reproduction. Embryos are formed in a laboratory using in vitro fertilization (IVF). Embryos can be transferred into the uterus (womb) shortly after IVF. They can also be frozen and transferred at a later stage. Improving fertility outcomes after ET is the focus of much research. It is not always clear why IVF/ET is not successful.

Standard protocols recommend bed rest after ET. This is to reduce the risk of the embryo being expelled from the uterus. There are no studies to support this theory. Some doctors believe that moderate activity after ET might be helpful. Stress and anxiety are two factors that might have a negative effect on fertility outcomes. Patients may have increased stress and anxiety if they believe they must adhere to bed rest. This could lead to a greater risk of IVF/ET failure. It is unclear if bed rest has an impact on fertility outcomes. 

This study analyzed 5 other studies with 1002 participants. 3 of these studies compared 20 minutes – 1 hour of bed rest to 24 hours of bed rest. 2 studies compared 10-30 minutes of bed rest to immediate discharge. The fertility outcomes measured included clinical pregnancy (CP), miscarriage rate (MR) and live birth rate (LBR). Other fertility outcomes included implantation rate (IR), ongoing pregnancy (OP) and multiple pregnancies (MP). 

The CP, LBR, IR and OP rates were similar in both groups. There was no difference in the MP rate between the groups. Miscarriage rates were also similar in both groups. 

The authors concluded that bed rest after ET did not affect fertility outcomes.

The number of patients in these studies was low. The cause of infertility was not taken into account in this analysis. The types of patients in the studies varied. More investigation is needed on bed rest before protocols are adjusted. 

If you have any concerns regarding fertility, please consult with your physician.