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Spotting after Embryo Transfer; am I going to Miscarry?

Author Name: Dr. Ankita Khandelwal || Mentor Name: Dr. Yogita Parihar on April 27, 2020

Infertility is a condition that affects one in ten couples who are trying to conceive. One of the most common treatments offered is IN VITRO FERTILIZATION.It has helped many couples to achieve their dream of parenthood. Although ivf has such a high success rate,it can be anxious process to go through.Even more nerve-wracking is the 15 days waiting period after the embryo transfer till the time result is obtained. Patients often become overtly focused on any symptoms they experience.A common cause for concern for many women who undergo ivf is spotting after embryo transfer. When a woman is trying to become pregnant, even smallest amount of bleeding tends to cause concern. So is spotting always BAD?To understand this,let us understand the normal physiology first…

Normally during the menstrual cycle,egg is released from the ovary and is picked up by the adjacent fallopian tube. At the same time if partners sperm reaches the fallopian tube through cervix and uterus, fertilization takes place and embryo is formed. This embryo after 4-5 days is propelled towards uterus where it makes connection with inner layer of uterus. This process is called as implantation.This is sometimes experienced by the woman as slight spotting or bleeding called as IMPLANTATION SPOTTING OR BLEEDING.

During IVF, eggs are retrieved from the ovaries and fertilization with sperm takes place in the laboratories. The resultant embryo formed is then inserted in the uterus, where it implants and creates pregnancy.The implantation of the embryo into the wall of the uterus is not a part of assisted reproduction process;it is something that occurs naturally in exactly the same way as in normal sexual conception.This explains how in terms of the symptoms including implantation spotting or bleeding,they are exactly the same in the case of IVF,

Such spotting after embryo transfer usually occurs 7-10 days post transfer. This is usually self-limiting, lasts for 3-5 days..This is an early sign of pregnancy. This is sometimes associated with slight cramping, nausea , breast tenderness.There is no set pattern ,it may or may not occur in all patients. Pregnancies obtained through ivf have a higher rate of bleeding than a spontaneously conceived pregnancy.Roughly 40% of women conceived through ivf experience bleeding or spotting post-transfer.

Spotting immediately after ET can occur if doctor had technical difficulty during transfer and had to manipulate the cervix. Spotting after the use of vaginal suppositories may be another cause of spotting during IVF cycle.The vaginal suppositories that are given to prepare the uterus to receive embryo could cause cervix to become very sensitive which may result in bleeding especially after sexual intercourse.Patients are advised to abstain from sexual intercourse during part or all of an ivf treatment cycle.
So when should you need to consult a doctor?If bleeding is heavy or painful with cramps and vomiting,one should always consult the doctor and needs to rule out complications like miscarriage or ectopic pregnancy.

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