Can Embryos Fall Out After Transfer?

Embryos are tiny, delicate things. The transfer process is often treated with great caution and preparation. These two things, when considered together, often cause surrogates to be quite concerned about how to best protect the embryo they’ve just been entrusted with carrying. Many surrogates, and occasionally their intended parents, raise the question of how secure the embryo is once placed in the uterus, and if it’s possible that the embryo could, “fall out.”

The overwhelming fear is that walking, jumping, or even urinating could cause the embryo to simply slip out of the uterus. Doctors often prescribe bedrest following the transfer in order to allow the embryo time to “get settled” and implant, so it makes sense that undue movement could cause the embryo to become dislodged and slip out, right? Rest assured that this is highly unlikely. The idea has merit, in theory, but is not plausible in reality.

The uterus is a muscular organ. This means that it stays contracted and tight in its natural state. While the area inside of the uterus is called a “cavity”, it is not a literal empty space. The transferred embryo does not have open space in which to move freely or roll around. Nearly all IVF doctors will require your uterine lining to be thick enough for the walls to touch in the middle before proceeding with a transfer. This creates an environment in which the thick, sticky endometrial lining leaves no empty space. When the embryo is placed between the uterine walls and the muscle contracts, it will create a secure place for the embryo to bury itself deep within that thick lining and begin to grow.

Visualize placing a poppy seed in the crease of your elbow, and then folding your arm shut tightly by using your muscle. Now wiggle that arm as hard as you can. No matter how hard you try, that poppy seed will not fly out. An implanted embryo inside of a flexed uterus is much the same.

No reasonable external physical activity, be it jumping, rolling over in bed, walking, or running can cause a healthy receptive embryo to become dislodged once it has implanted into the endometrial lining. The bedrest period is meant to help you relax and encourage the embryo to implant and bury itself within the endometrial lining. While you should always follow doctor’s orders regarding bedrest, do not be afraid to get out of bed to use the restroom or stretch your legs.

If you have questions about what activities are approved, both during bedrest and once you’re cleared to return to daily life, do not be afraid to ask your nurse or doctor.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 22 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for the last two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society of Reproductive Medicine, the American Fertility Association, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 28 years and their two teenage daughters.