Nutrition is like life in general, you have to keep a healthy fashion of behaving, of eating, of performing some exercise in your life. Do not expose yourself and your embryo and possible baby to tobacco, alcohol, drugs, medications that are not prescribed by your doctor. So that’s the main important things that you have to have in mind related to your normal life around an embryo transfer and treatment.
Years ago we used to tell our patients not to take any carbohydrates or to lower the ingestion of carbohydrates. Nowadays, we sort of see that there was no change in that. So, again, a healthy lifestyle with a healthy diet and some healthy habits like walking, doing some exercises and of course no smoking or drinking too much would be the best.
At least up until the pregnancy test, you may be advised to avoid activities that may pose a risk of infection such as swimming and sexual intercourse. Avoid foods not recommended during pregnancy such as raw or under-cooked meat and seafood, unpasteurised dairy products and excessive caffeine consumption. Avoid hot baths/hot showers and anything which will put stress or strain on your body and mind, but also avoid sitting still for long periods of time – you can maintain gentle activity, which helps to keep blood circulating around your body well.
I always say you have to consider yourself potentially pregnant. Actually, we call it pregnant until proven otherwise, PUPO, it’s a very popular term that the patients actually introduced in our clinical work. That means just follow the same recommendations you would follow if you were pregnant. In terms of diet, obviously, it’s very important to avoid any raw food. So no raw meat or raw fish, sushi, Parma ham, any unpasteurized cheese, or any raw eggs.
It is very important to wash your hands carefully all the time. Don’t eat fresh unwashed salads or vegetables, wash the fruit you eat. So these are the recommendations that you would follow anyway in pregnancy. In terms of what we should avoid I always say to be careful with exercise and baths, and going to the spa and having hot tubs and things like that. It is because when we do the embryo transfer, we remove the cervical mucus from the neck of the womb, and that might, in theory, increase the risk of catching infections. So it is better to avoid swimming and baths, and have a shower instead, obviously, for some period of time after transfer.
Gentle exercise is OK if you have had a fresh transfer. Remember that your ovaries are still swollen and you have had a small surgical operation. Do not go for strenuous exercises, like horse riding competition and things like that should be avoided.
After embryo transfer, it’s better to be calm, but don’t stay in a bed. It’s better to avoid swimming, having a bath (you can have a shower), intercourse and sports. I usually recommend these precautions for 5 days and after 5days, it is possible to do everything. With sports activities, it’s better to be a little bit careful and not to push to the maximum. I think in the last two years, I recommend avoiding Google because patients tend to look for some things which they can do after the transfer, more medication, etc. It’s only stressful, but it doesn’t help the implantation.
From the nutrition side, raw red meat and raw sausage are forbidden. You can eat red meat cooked. Foods like liver, brain, or kidney even if cooked it is forbidden because of the risk of toxoplasmosis infection. Raw milk is also forbidden – this is very important.
After the embryo transfer, do not change any dosage of the medication. You might have some side effects from the medication but always ask the doctor, don’t change anything yourself – this is very important. Especially, progesterone is crucial to keep the pregnancy safe for the first eight weeks of pregnancy. If you accidentally change the dosage or you stop taking the progesterone, you can lose the pregnancy. It is very important not to alter the dosage of the medication.
Sexual intercourse is forbidden until the blood test is done 10-12 days after the embryo transfer. Otherwise, normal physical activity is good. We always tell patients to go outside for a walk because progesterone can cause a little bit of depression. We always encourage patients to go outside and keep in touch with people, have a normal life. It is very important for us not to change the psychology of the patient and otherwise, you can do everything normally. As for physical exercise, walking is good but do not go swimming or do very heavy exercise.
What should you avoid after the embryo transfer? The time between the embryo transfer and the pregnancy test is two weeks. That’s a rather long wait. Some people get very stressed about it and I really advise my patients to do all their best to have this period as peaceful and as relaxing as it could be. The one thing you should avoid is bed rest. We used to recommend bed rest but it was years and years ago. Nowadays it is definitely not recommended. You just act with completely normal activities in the day. Obviously, what I really recommend avoiding is e.g. sitting in a bath for long hours – this is not recommended. So basically, if you can have a shower rather than a long bath, that’s advisable. The second thing is sitting in a pool for long hours, especially in public pools – it is also not recommended. Obviously, alcohol is not recommended, as we know. You can have straightforward activities, like you can do walking, yoga and a little bit of pilates. Obviously, no heavy sort of activities, like heavy gym or serious running or jumping – it is not recommended. Just basically trying to take it easy. As I said, maintaining a healthy diet is always recommended. There are some clinics offering acupuncture, just before and after the embryo transfer. This is to have as a relaxation technique rather than an evidence=based effect on increasing the success of the embryo transfer. So whatever makes you comfortable, just do it, avoid bed rest and avoid very stressful exercises.
I would recommend you avoid toxins like alcohol, smoking, and other drugs. Especially because it is important for the pregnancy, not because it has been demonstrated clearly that it can have an impact on the implantation rates but what we try to recommend for patients is to have a healthy lifestyle, as healthy as possible, and that is avoiding drugs, avoiding smoking, and avoiding an excessive intake of alcohol.
I would say that not that many things. I would say that if you have some common sense, you are going to avoid strong physical efforts, risky situations, or those that may lead you to have a big impact like climbing or things like that. Other than that, you can lead a pretty normal life, of course, we recommend avoiding toxins like drinking alcohol and things like that. Though, the potential effect on the embryo is not really that much. In the end, I would probably say that you should avoid anything that may make you feel guilty if the outcome is negative.
In most of the cases of the negative, that’s something that’s going to be due to the embryo, the endometrium, the dialogue between them and there’s nothing we can do to solve that. It’s also important to cope with that situation, and usually, it’s easier if the patient feels that she or they have done their best and in this sense, if you think that you’re going to have this negative feeling if you go to the gym, don’t go to the gym, or try to walk, try to accommodate to what you feel, it’s going to be okay for you.
Sticking to the scientific evidence, there is nothing really that you should avoid other than these situations that I’ve mentioned at the beginning like toxics and strong physical efforts and things like that.
