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The two-week wait (TWW) after an embryo transfer can feel like forever. If you’re sitting there antsy wondering if the transfer was a success, that’s totally normal. And if you’re looking for any clues your body might be giving, that’s normal too.
But here’s the issue with reading into signs: everybody is different. Some women experience symptoms after an embryo transfer, while others have none. This can make things stressful when you’re looking at every shift in your body under a microscope.
To help ease your worries, we are diving into some common symptoms that can surface after an embryo transfer and what they could mean. But first, let’s discuss why pregnancy signs after IVF can be difficult to identify.
Why is it harder to interpret pregnancy symptoms after IVF?
While the two-week wait may have you on the lookout for pregnancy symptoms, you can’t rely on them entirely during your fertility journey.
It’s hard enough to distinguish between pregnancy and PMS symptoms. And when you add IVF meds into the mix, it makes it even harder.
That’s because IVF medication is tricky. It’s made of the same hormones that increase during pregnancy (progesterone and estrogen). So the medicines themselves can make you feel tired, bloated, or have tender breasts and leave you asking: is it the medication or implantation?
Another thing: there is no one single symptom that confirms pregnancy. Some women may have all the symptoms, others may have none. So the only way to know for sure whether you’re pregnant is a positive pregnancy test.
But a little hope never hurt anyone! Just remember that these symptoms don’t guarantee a successful transfer. They are just potential indicators.
What are positive signs to look out for after an embryo transfer?
We know that a positive sign can’t confirm pregnancy. But it’s good to understand some of the symptoms you may experience after an embryo transfer.
I’m noticing … | Because … | How reliable is this symptom for indicating early pregnancy? |
Implantation bleeding | The embryo attaching to your uterus during implantation can cause some bleeding. | Reliable, but not super common. Only 15-25% of women experience this.
Moreover, if the bleeding is heavy with clots, that could signal an unsuccessful implantation. |
Fatigue | Progesterone is rising. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Cramps | Progesterone is rising. Or it could be implantation cramps. Or, in some people, mild cramping can also occur immediately following any pelvic procedure (in this case, embryo transfer). | Not very reliable because there are multiple potential reasons for the cramps.
Note that implantation cramps are dull, mild, and last only for 1-2 days.
Pre-menstrual cramps are more intense and last longer. |
Mood swings | Progesterone and hCG (human chorionic gonadotropin) levels are rising. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Breast tenderness | Progesterone is rising, causing an increase in blood flow to the breasts. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Nausea | hCG levels are rising. | Not really reliable. Mild nausea is typical at 6 weeks (about 2 weeks after a missed period). |
Increased urination | Higher progesterone levels make your bladder contract more. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Bloating and constipation | Rising progesterone levels relax your sphincter and gut muscles. This slows down digestion. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Backache | Rising progesterone causes your ligaments to relax. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Vaginal discharge | An increase in estrogen levels paired with changes to the vaginal wall can cause your vaginal discharge to look and feel different. | Not reliable. It could be due to medication or pregnancy – it’s hard to tell. |
Missed period | Pregnancy | Reliable. Take a pregnancy test to confirm! |
Implantation bleeding
Spot some blood after an embryo transfer? This may be something called implantation bleeding. This can happen when the embryo implants and establishes contact with the maternal blood network. It can lead to light spotting that looks different than your menstrual blood.
This type of bleeding is light and pink or brown in color, and only sticks around for a day or two. It happens in just 15-25% of women during the early stages of pregnancy, so don’t worry if you don’t see it.
Know more: Implantation bleeding Vs Periods | What Does Implantation Bleeding Look Like?
Fatigue
Can’t seem to shake the exhaustion no matter how much you sleep? This is due to rising progesterone levels after ovulation.
It’s hard to tell whether this fatigue from the progesterone is a result of pregnancy or fertility drugs from your embryo transfer.
Cramps
This probably isn’t your first rodeo with cramps. And when they come after an embryo transfer, they could mean pregnancy. But it’s hard to tell. There are multiple reasons you could be having this mild cramping.
They happen due to rising progesterone that either marks early pregnancy or that Aunt Flow is on her way. Cramps may also happen due to the pelvic procedure you just underwent.
Note that implantation cramps are usually milder and duller compared to period cramps. They show up around 6-12 DPO in natural cycles and usually only stick around for 1-2 days.
Know more: What do implantation cramps feel like?
Mood swings
Post-embryo transfer, both pregnancy hormone hCG (human chorionic gonadotropin) and progesterone are rising. This can make for some more frequent and intense mood swings.
But these swings are not an automatic indicator of a successful implantation. They could also be a result of the fertility drugs from your embryo transfer.
Breast tenderness
Are your breasts tender to the touch? That’s normal during fertility treatment. It’s the rising progesterone that causes an increase in blood flow to this area.
This tenderness could be a sign of the early stages of pregnancy or the medication you’ve been taking for IVF. It’s hard to say for sure which.
Nausea
If you can’t seem to keep a meal down, then you may assume you’re pregnant. But nausea is not a reliable symptom of early pregnancy.
This sickness can happen after an embryo transfer due to rising hCG levels. This can be attributed to either your hormone medication or pregnancy hormones. However, it’s important to note that pregnancy nausea due to hCG typically happens at about 4-6 weeks of pregnancy.
If the nausea becomes severe, talk to your doctor.
Increased urination
Are you heading to the bathroom more than usual? This is normal at this time. The higher amount of progesterone in your body makes your bladder contract more.
Just don’t assume this means you’re pregnant. More frequent urination could also be from your fertility drugs.
Bloating and constipation
“I love being bloated,” said no woman ever. But if it’s a symptom of pregnancy, you’ll likely welcome it. The truth is that bloating does not always equate to pregnancy. The fertility medications from your IVF cycles could be the culprit, too.
The bloating happens because rising progesterone relaxes your sphincter and gut muscles. And this slows down digestion. It’s totally normal unless things get severe. Then it could be a telltale sign of OHSS.
Backache
Feel like your back needs a reset? You’re not alone. This is common after an embryo transfer. Rising progesterone leads to some achiness.
Whether this is a sign of the early stages of pregnancy or just a symptom of the fertility medications is TBD.
Vaginal discharge
Your vaginal discharge can sometimes say a lot about what’s going on in your body. But at this time, it could be giving you mixed signals.
Your increasing estrogen levels and changes to the vaginal wall can make your discharge look and feel different. It could be a sign of early pregnancy. Discharge in this situation helps keep infections out of the uterus.
But this could also be a symptom of the hormones you’ve been taking for your IVF cycle. It’s especially common to notice some whitish discharge if you’re on progesterone suppositories.
Know more: Luteal Phase Discharge: What It’s Telling You
Missed period
A missed period isn’t a 100% guarantee that you’re pregnant. But if you’re someone with a regular menstrual cycle, it’s a pretty reliable hint.
If you missed yours, wait to take a pregnancy test.
What if you experience no symptoms at all?
Are none of these signs above ringing a bell for you? Don’t stress!
As we discussed, these signs after embryo transfer are not entirely reliable, especially when doing fertility treatment.
Just because you don’t have any symptoms does not mean your frozen embryo transfer failed.
The only way to know for sure, without a doubt that you’re pregnant? Blood hCG testing.
When should you take a pregnancy test after an embryo transfer?
Your pregnancy test timeline depends on what kind of transfer you did.
For a day 3 embryo transfer, you’ll take a blood test (hCG) 14 days after embryo transfer. For a day 5 embryo transfer, the test happens 12 days after the transfer.
Why do you have to wait so long? Because here’s what’s going on inside your body.
STEP 1: The embryo transfer happens.
STEP 2: If the embryo transfer is successful the embryo will attach to the uterus after 48-72 hours.
STEP 3: Once attached, the embryo increases in size and metabolic activity. This produces more hCG.
STEP 4: After about two weeks, the hCG levels will be high enough to be reliably detected. This is when your doctor or the fertility clinic will call you for blood tests.
How can I improve my chances of implantation?
Implantation is no easy feat. Research says that 75% of failed pregnancies happen due to implantation failure.
So how can you boost your chances of having a successful implantation?
There is no way to guarantee a successful embryo implantation. But here are some things you can do to create an environment that supports implantation.
Get enough sleep
The frozen embryo transfer process is taxing, both mentally and physically. The best thing to increase your chances of implantation post-embryo transfer? Sleep.
Eat a healthy diet
Focus on whole, natural foods and minimize processed ones.
Studies agree that diets rich in fruits and vegetables help with IVF outcomes. You have their antioxidant properties to thank.
You also want to reach for omega-3s and fiber-rich foods. These reduce inflammation and regulate your hormones. This means eating more fish, nuts, seeds, and legumes.
Steer clear of processed sugar and other processed foods. They’re filled with endocrine-disrupting chemicals.
Know more: Diet & Fertility: Eat Your Way to Better Baby Odds!
Take prenatal vitamins
Getting your vitamins via food is ideal. But creating a healthy environment for another human is hard work. So make prenatal vitamins your BFF. Start taking them at least a month before your frozen embryo transfer. Be sure to chat with your doctor before doing so.
Focus on mental health
Stress and early pregnancy loss go hand-in-hand. So boost your chances of implantation by managing your stress.
This could look like light exercise, yoga, walks, journaling, meditation, time with loved ones – really anything that makes you feel relaxed.
Know more: How to Make Implantation Successful: What You Need to Know
In Review
- It’s difficult to wait to find out if your embryo transfer was successful or not.
- Symptoms during the TWW can be caused either by pregnancy or IVF medication. Which means they are not necessarily positive signs to rely on.
- Some symptoms you may experience after an embryo transfer include fatigue, cramps, mood swings, breast tenderness, nausea, and more.
- Implantation bleeding can also happen during early pregnancy when an embryo implants. It looks like light pink or brown spotting.
- Missing your period is a more positive sign of pregnancy, and a reliable one, too. But there’s part two – getting a positive pregnancy test. This is the only way to confirm a successful embryo transfer and pregnancy.
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- Final National Summary Report | SART
- Bleeding During Pregnancy | ACOG
- Predictive value of serum β-human chorionic gonadotropin for early pregnancy outcomes | Springer Link
- Day-3 vs. Day-5 fresh embryo transfer | NIH
- Mechanisms of implantation: strategies for successful pregnancy | NIH
- How to Make Implantation Successful: What You Need to Know | Inito
- The effect of cigarette smoking, alcohol consumption and fruit and vegetable consumption on IVF outcomes: a review and presentation of original data | BMC
