Bleeding After Embryo Transfer

Observed in 7-42% of in-vitro fertilization treatments, luteal phase bleeding occurs in slight bleeding 7-8 days after egg collection.

The bleedings observed between the embryo transfer and pregnancy test can be too worrying for the patient. These bleedings make the patient feel that the treatment has failed. The bleeding during this period and the failure of the treatment are found to be related, however, there are many cases that result in pregnancy.

What is luteal phase in the woman’s natural cycle?

The structure called corpus luteum which develops in the woman’s ovary after ovulation during the natural monthly cycle secretes progesterone and estradiol hormones and prepares the uterus for the implementation for the embryo’s adherence. This period is called ‘luteal phase”.

The hormones secreted by the corpus luteum enable the continuation of the pregnancy until the hormones produced by the placenta at early pregnancy, that is to say, until the 7th week of the pregnancy. All pregnancies would be with abortive outcome if the corpus luteum structure did not exist.

Why is medication used to promote luteal phase at in-vitro fertilization treatment?

The stimulation of the ovaries by medication is the first phase in in-vitro fertilization treatments. It is known that the stimulation of the ovaries by medications disrupts the function of the corpus luteum. The hormone levels above normal create adverse effect on the brain and lead to the shortening of the abovementioned luteal phase and also particularly result in luteal phase bleeding due to the sudden decrease in progesterone hormone.

Therefore, luteal phase promoting medications should absolutely be used to increase success in in-vitro fertilization so as to prevent the sudden hormone reduction. The only way to prevent luteal phase bleedings is to use sufficient amount of luteal phase promoting medications. Luteal phase being too short due to the stimulation of the ovaries might result in the failure of the IVF treatment.

How to use the progesterone hormone, which is given as luteal phase promotion? What side effects does it have?

Studies have shown that the most ideal time to start progesterone hormone is immediately after the egg collection. Progesterone has types suitable for oral, vaginal, rectal and intramuscular use. Vaginal or intramuscular use is usually preferred in today’s IVF treatments. Studies have shown that the use of oral progesterone leads to lower rates of pregnancy and implementation when compared to the other methods.

The use of vaginal progesterone enables reaching higher levels in the uterus and it is preferred by the patients due to ease of use. At our center, the use of vaginal progesterone is recommended to the patients as a routine. Vaginal use is well tolerated by the patients except for vaginal discharge and irritation in the vagina. Vaginal application does not involve the pain caused by the injection in the intramuscular application, though rare, the allergic reaction and potential abscess forming in the area of application.

What should be done in case of bleeding after embryo transfer?

The patients who experience bleeding after embryo transfer tend to think the treatment has failed and discontinue medications. However, the probability of pregnancy is still resumed. Therefore, the medications should not be discontinued. You should absolutely contact your physician or IVF coordinator if you experience bleeding after the transfer.