Nowadays, IVF is a common medical term. Especially among women in their reproductive years. With the advances in reproductive medicine and the increased success rates of IVF, this fertility technique is no longer a hopeless option for infertility patients, but an active treatment. There are three parts of the IVF treatment process that are often of more concern: selection of the protocol, egg retrieval and transfer, and post-transplant recuperation. The first two processes are the doctor’s job, and the patient is often passive and has little involvement; while the last process is patient-led and involves the whole process, with much room for maneuver. It is precisely in this process that patients have a lot of confusion, a lot of excesses and deficiencies. To this end, a few suggestions for reference. Attention to rest, do not stay in bed Bed rest may be a common obstetrics and gynecology “medical advice”. Such as miscarriage, premature labor, bleeding, prenatal and postpartum. But is bed rest really necessary? It really depends. The correct answer to the question of whether bed rest is necessary after IVF is “no”. Reproductive medicine experts at home and abroad have studied this issue and concluded that the success of IVF is related to the technique of transfer, endometrial tolerance, and the quality of the embryo, but not related to whether or not to stay in bed after transfer. The common view is that prolonged bed rest after transplantation will first disrupt the daily routine, affect work, aggravate the psychological burden, cause patients to be nervous and disturbed, affect the regulation of the neuroendocrine system, and ultimately affect the outcome of pregnancy, which is detrimental and not beneficial. There are also studies that point out that prolonged bed rest is not conducive to blood circulation in the pelvis and lower limbs, and in addition to not being conducive to embryo implantation will also cause lumbosacral discomfort, loss of appetite, indigestion, constipation and abdominal distension, etc., and there is also the possibility of venous thrombosis of the lower limbs. Therefore, in the post-transfer precautions of major fertility centers, there is no medical advice for long-term bed rest. As for the attention to rest, it varies from person to person and is individualized. The general principle is to avoid overwork and be mentally happy. In my patient group, there are those who go home to work immediately, those who buy food and cook at home, those who rent a room in Jinan to avoid their in-laws and friends to enjoy the world of the two of them, and those who booked a VIP room to communicate with their fellow transplant recipients and wait for the results. The list goes on and on. My advice to patients is: the best is the one that suits you. Be aware of abnormalities, don’t be rash You should still be aware of abnormalities after IVF transfer. The most common abnormalities after embryo transfer are: 1. Post-transfer abdominal pain It is common to hear some patients complain of abdominal discomfort and pain after the transfer, and as a result, they are highly nervous and have trouble sleeping and eating. To say, abdominal discomfort, there are true and false. False, may stem from excessive stress, nervousness, excessive attention. Compared to a normal natural pregnancy, IVF patients pay too much. After embryo transfer, they don’t know how to treat this belly well, and they can’t wait to put it in a safe. Occasional abdominal discomfort, a transient pins and needles feeling, there is no need to be alarmed. It can be observed for the time being. The organs in the “stomach” are not only the uterus, ovaries, fallopian tubes, but also its neighbors. For example, there is the bladder in the front, the rectum in the back, and the small intestine and colon around the left and right sides. Occasional intestinal spasms can also cause transient pain in the lower abdomen. However, if the pain persists and gets progressively worse, it is time to see a doctor. For real people, if severe abdominal pain occurs suddenly, you should go to the hospital promptly. Sudden abdominal pain after egg retrieval and transplantation should be alerted to the presence of internal bleeding, and may also be related to ovarian impaction and torsion. It is common in patients with more egg retrieval and ascites. I suggest you to refer to my other article “Ovarian torsion, an acute abdominal condition prone to occur before and after IVF egg retrieval”. In addition, the appendix is also considered a close neighbor of the uterus, and attention should be paid to the abdominal pain caused by acute and chronic appendicitis. 2, bleeding after transplantation Bleeding after transplantation is a relatively common symptom. It should also be treated differently. Common cases are: cervical inflammation, cervical polyps. Generally, the bleeding will not be too much, and there can be a small amount of bloody secretion. If the bleeding is heavy and lasts for a long time, you should go to the hospital to find out where the bleeding is, and if necessary, perform gynecological examination and ultrasound to see if there is intrauterine bleeding. If it is intrauterine bleeding, there is no need to be nervous. The cause of the bleeding is not always easy to find, but it does not mean that the bleeding is necessarily unsuccessful and that you will have a miscarriage. Small amounts of bleeding should be communicated with your primary care physician for counseling and, if necessary, hospitalization for observation. If the bleeding is heavy, such as the amount of menstruation, or more than the amount of menstruation then the nearest doctor should be consulted immediately. If the embryo transfer is unsuccessful, even if the bleeding does occur, it usually does not exceed the amount of a menstrual period. Some patients are concerned that bleeding after transfer is an ectopic pregnancy. It is important to note that there is no need to consider this issue between the time of transfer and the date of the blood HCG test. Even if an ectopic pregnancy occurs later, there is no way to check, diagnose, or prevent it at this time, and there is no way to talk about treating it. Bleeding close to the date of the blood HCG check may be related to the early onset of an unsuccessful menstrual period. However, it is still recommended to check the blood HCG on time to avoid missing the diagnosis of ectopic pregnancy and other abnormalities. A small amount of bleeding about one week after transplantation may be related to the bleeding of implantation, no need to be nervous, maintain the original medication program can be. 3, abdominal distension and chest tightness after transplantation Abdominal distension after transplantation is mostly related to the application of progesterone drugs and excessive rest. In general, after the transplantation of appropriate rest for 2-3 days, you can go to work, as long as you do not do heavy labor, to avoid activities that increase abdominal pressure can be. However, if the patient’s estrogen is too high during ovulation promotion and after egg retrieval, and too many eggs are retrieved, more attention should be paid. One should be alert to the development of ovarian hyperstimulation syndrome (OHSS). It is mainly manifested as abdominal distension, stomach discomfort, and low urine output, etc. If it gradually worsens, patients should go to the hospital immediately. Patients with more egg collection who have chest tightness, aggravated by lying down may be related to pleural effusion caused by OHSS, at this time should also go to the hospital immediately. 4, about vaginitis Patients receiving a large number of estrogen treatment will cause an increase in glycogen in the vagina, acidity is high, the local cellular immunity decreases, suitable for the reproduction of pseudomyces yeast, also known as Candida, causing inflammation. This inflammation is also known as vulvovaginal pseudomycosis (previously known as moldy vaginitis). Patients undergoing IVF are prone to it because of the high estrogen environment present in their bodies. The main symptoms are vulvar itching, burning pain, and curd-like or caseous leukorrhea. If there is any discomfort, you should go to the hospital for laboratory tests and, if necessary, choose azole-based vaginal medication that is not harmful to the fetus for treatment. Hold a normal mind and eat home cooked meals Regarding the diet after embryo transfer, I advocate adopting a consistent approach and not making too many changes. Neither should there be a lot of tonic and nourishment, nor should there be excessive hunger and satiety, hot and cold. The mental state and progesterone medications at this stage often affect the digestive function first. In terms of three meals a day, it is important to eat regularly and to be refined. Due to the need for progesterone drugs to protect the fetus after IVF transplantation, coupled with the patient’s less movement and more quiet, the diet is more detailed, intestinal peristalsis is reduced, and sometimes constipation occurs. When it is light, it can be corrected by adjusting the diet structure, such as eating more vegetables and fruits, high-fiber diet, moderate exercise, and avoid excessive bed rest. If constipation for a long time, the above methods can not reduce the symptoms, can be appropriate to take laxatives, before taking attention to read the instructions, whether there are pregnant women contraindicated. On the issue of nutrition, in 2007, the Chinese Nutrition Society issued the “Dietary Guidelines for Chinese Residents” in the dietary guidance during pregnancy, divided into three stages: pre-pregnancy, early pregnancy, and mid- and late-pregnancy. If this stage after embryo transfer is categorized as pre-pregnancy, the dietary guidance should include the following aspects: 1, more intake of folic acid-rich foods or supplemental folic acid. Such as animal liver, dark green leafy vegetables (such as kale, turnip, long leaf lettuce), broccoli, asparagus, citrus fruits and juices, beans. 2, often eat iron-rich foods. Such as animal liver, lean meat. Other foods in the black fungus, jujube, cauliflower and other iron content is not small. 3, ensure that the intake of iodized salt, appropriate to eat more seafood. Such as fish, shrimp and shellfish kelp, seaweed and so on. 4, quit smoking and alcohol in order to achieve the above requirements, the above beneficial ingredients, organic collocation, frying and frying, fancy new, fine work, both for my patients and her family, is a very interesting thing, than every day to think about “into” and “no “It’s a lot better than trying to figure out what’s going to work and what’s not going to work. Follow the doctor’s advice, don’t fool around After IVF, most of the patients, who are actually healthy people, have two tendencies when they go home. One is to do nothing, spend their days as if they were years old, and have a hard time sleeping and eating; the other is to have nothing to do, to hear hearsay, and to fool around. I say this without too much blame, just hope that we can get through this period of time after embryo transfer. 1.About complying with the doctor’s advice After embryo transfer, patients have a doctor’s advice list in their hands, which should have the details of medication and follow-up time. They should remember to follow them. Don’t compare with others, each person’s specific situation is different, the medication program is also different. However, if in doubt, always go back to the doctor. The most important follow-up appointment is when blood is drawn to pick up to see if you are pregnant, and it is best to do so on time. Too early or late will affect the doctor’s correct judgment of the condition. 2.About other medication We are often asked about medication before and after transplantation. In fact, we should be careful about the use of medication, and should not be afraid of “medicine”, we should weigh the pros and cons, reasonable use of medication. If you have a mild cold, you can drink plenty of water and rest to relieve the symptoms. If there is a high fever, severe cough, tonsil inflammation, lung infection, only through rest is not “through” the past. The absence of medication at this time will also have an impact on the whole process after transplantation. If you have vaginal itching, you should go to the hospital for a vaginal secretion test and use medication according to the test results. In short, the key to whether or not to use medication after transplantation is whether or not it is “needed”. In addition, there is also a need to “keep two good passes”. Doctors to put the first gate Any application of drugs should be taken under the guidance of the doctor. When prescribing medication to the doctor first, it may be worthwhile to make an advance, say I am pregnant or I am “doing IVF”, so that the doctor has to take into account. It is a good idea to say that I am pregnant or I am “doing IVF” so that the doctor can take it into consideration. When taking medications, pay attention to the words “caution, contraindication, prohibited for pregnant women” on the package. Doctors can not know all the drugs, such as the above words, should remind the doctor whether it can be used. 3, about the hormone check This is a big topic. Many patients are obsessed with the hormone level after embryo transfer and the dose of progesterone application. Any one of these taken out would make up a large chunk of an article. Here, I will just generalize: Progesterone Screening There are a large variety of progesterone analogs for luteal support after embryo transfer. In terms of their routes of application, there are intramuscular, oral, and vaginal. Nowadays, major fertility centers tend to prefer oral and vaginal application, or a combination of drugs. Some oral drugs are not detected in the blood; the local drug concentration of vaginal drugs is significantly greater than that of peripheral blood. Therefore, there is no need to repeatedly draw blood to check the level of progesterone. The best thing is to follow the doctor’s advice and take the medication on time. HCG test Many patients want to know whether they are pregnant as soon as possible after transplantation, and this feeling is understandable. HCG is secreted by the trophoblast cells of the placenta as soon as the fertilized egg implants in the uterine wall. Due to the sensitive and effective detection of HCG, HCG concentration has become a commonly used test for predicting early pregnancy and miscarriage, and to aid in the diagnosis of ectopic and multiple pregnancies and related disorders. The concentration of HCG in a healthy, non-pregnant individual should be so low that it may be undetectable, at which point the serum concentration of beta-hCG should be less than 3-5 mIU/ml (depending on each laboratory). In intrauterine pregnancy, blood β-HCG can be detected 2 to 3 days after the fertilized egg is laid (about 24 days into the menstrual cycle.) The earliest day on which pregnancy can be detected also depends on which test is used and the sensitivity of the test method. Urine test has more influencing factors, and sometimes there are false positives or false negatives that affect the judgment. The results of blood tests are more accurate. In order to diagnose accurately, blood tests are usually scheduled 14 days after ovulation. Positive results too early in the test may be affected by the injection of HCG drugs before egg collection. The timing of blood tests for IVF patients has been prescribed by the doctor according to the dates of egg collection and transplantation. Therefore, it is best to follow your doctor’s instructions to check your blood on time.