Bleeding! Will the transferred embryos still be preserved?

The article is reproduced from: Fertility Center of Yichang Central Hospital

"IVF" technology has helped many women of childbearing age realize their aspirations to become mothers. Embryo transfer is a key step, and women occasionally experience vaginal bleeding after a fertilized egg transfer.

Nervous mother-to-be worries: Will the transferred embryos still be preserved?

【Within 3 days after transplantation】

During the embryo transfer process, a speculum needs to be placed in the vagina and the transfer tube extended into the cervix in order to place the fertilized egg in the uterus.

If there is cervical erosion, excessive curvature of the cervical canal, etc., when disinfecting, placing a speculum, or transplanting a tube through the cervix, the instrument is likely to touch the erosion surface, irritate the cervical mucosa, and cause a small amount of bleeding from the cervix.

The amount of bleeding caused by this factor is small and can be stopped in 1-2 days. There may be a small amount of bloody discharge, generally no symptoms of abdominal pain, and no effect on transplant outcomes. So relax your mood, continue to observe, if you are nervous, it is recommended to communicate with the attending doctor in time.

When bleeding exceeds 1 week, please visit the clinic in time to rule out other problems.

【7-14 days after transplantation】

This period is the embryo implantation stage, i.e. the embryo implantation into the endometrium, which is the first step in pregnancy. The capillaries of the endometrium are dense, the blood supply is relatively rich, if the position of the embryo implantation is near the blood vessel, the trophoblastic layer of the embryo invades the blood vessel, which will cause the small blood vessel to rupture and bleed.

Due to the long duration of time that blood stays in the uterine cavity, the blood that flows out is dark red. Fetal protection medications should continue to be used at this time, and 10 to 14 days after transplantation, blood should be drawn to confirm pregnancy. If you are nervous and not very at ease, you can return to the central hospital in advance for examination, and the doctor will arrange a follow-up treatment plan according to the results of the examination.

【14-28 days after transplantation】

After the embryo implantation stage, the HCG value of the blood draw has confirmed the pregnancy, and the doctor will continue to give corpus luteal support and instruct the ultrasound to check the fetal heart rate after two weeks.

During this 2-week wait, if there is vaginal bleeding, it is roughly divided into two situations:

If there is only a small amount of transient bleeding, with or without mild abdominal pain, there is no need to be too nervous at this time, proper rest, and regular examination.

If vaginal bleeding is bright red, more bleeding or persistent bleeding, accompanied by more severe abdominal pain, indicating that there may be a threatened miscarriage or ectopic pregnancy, you need to go to the hospital in time.

The results of the blood hCG examination cannot determine the location of the gestational sac and the development of the embryo cannot be assessed. Ultrasound examination is required to understand the implant location and development of the embryo.

If the embryo is indeed intrauterine, the pregnancy can be continued after the drug adjustment and regular ultrasound follow-up can be carried out.

If the embryo implants outside the uterus, an ectopic pregnancy, known as an ectopic pregnancy, is "ectopic pregnancy" and requires immediate hospitalization for further treatment.

【28 days after transplantation - 12 weeks pregnant】

After ultrasound B determines intrauterine pregnancy, this stage is the first trimester, in the early pregnancy stage, the embryo develops in the mother's uterus, erodes the uterine blood vessels, and establishes blood circulation with the mother, at this time, 30% to 50% of pregnant women may have vaginal bleeding.

If the vagina has only a small amount of brown or pink discharge, the bleeding time is short, at this time dynamic observation can be, appropriate rest, relax the mood, do not need too much anxiety, continue fetal protection treatment, and recheck B ultrasound after 1-2 weeks.

If there is a history of embryo cessation, B-ultrasound review needs to be more frequent when vaginal bleeding occurs.

If the vagina has more bleeding, bright red or dark red color, then there is a possibility of threatened miscarriage. It is necessary to go to the hospital for ultrasound examination to determine whether there is blood accumulation in the uterine cavity.

In the B ultrasound review, if you see that the embryo is developing normally, you do not have to be too anxious, follow the doctor's advice, and adjust the medication in time to protect the fetus. Of course, there are also some cases where embryos are stopped in the first trimester. But in most cases, it is the problem of the embryo itself that causes it, and do not blame yourself too much.

Expert introduction

Professor Ye Hong

Grade II Chief Physician, Master Supervisor, Visiting Scholar in the United States

Director of the Department of Obstetrics and Gynecology, Director of the Department of Obstetrics and Gynecology, Director of the Department of Obstetrics and Gynecology, director of the Reproductive Center of the First Clinical Medical College of China Three Gorges University & Yichang Central People's Hospital. Member of the Standing Committee of the Obstetrics and Gynecology Branch of the Chinese Endoscopic Association, Vice Chairman of the Reproductive Medicine Branch of the Hubei Medical Association, and Vice Chairman of the Hubei Women Physicians Association. The current chairman of the Obstetrics and Gynecology Branch of Yichang Medical Association is the director of Yichang Obstetrics and Gynecology Quality Control Center. He was awarded the title of "Ye Hong Famous Doctor Studio" by Yichang Municipal Government and "Municipal Management Expert" by Yichang Municipal Government.

He has extensive experience in the diagnosis and treatment of obstetrics and gynecology diseases, female reproductive endocrine diseases and infertility, and specializes in uterine and laparoscopic surgery and various assisted reproductive fertility techniques. He has successively led the departments of obstetrics, reproductive medicine and gynecology of the hospital to obtain the "Hubei Provincial Clinical Key Specialties", and led the department to obtain the 48th place in the national scientific and technological volume and value in 2018. He has published more than 60 academic papers in authoritative journals at home and abroad, including many SCI records. As the first person in charge, he has won a number of provincial and municipal scientific and technological progress awards, won a number of national and provincial scientific research projects, and edited two professional papers in Chinese and English.