Understanding the symptoms of embryo implantation during IVF. Does bleeding during embryo implantation indicate failure?

Many patients undergoing IVF anxiously await the day of embryo implantation, hoping for a successful outcome. However, they often have a limited understanding of implantation symptoms, which can result in various concerns and anxieties regarding the success or failure of the procedure.

What should they do during the waiting period of implantation? What happens if there is bleeding, spotting or secretions after embryo transfer? Does it mean the symptoms of failed? Let this article guide you through the essential aspects of embryo implantation.

4 Factors for Successful Embryo Implantation

The embryo is like a seed, while the uterine endometrium is like soil. The process of implantation can be compared to planting a seed in the soil, but embryo implantation is much more complex.

The following 4 factors are crucial for successful embryo implantation

Success rate of embryo transfer

According to the latest The Assisted Reproductive Technology Summary 2020 National Report of Taiwan provided by Taiwan's Health Promotion Administration, the success rates of in vitro fertilization with single embryo transfer vary across different age groups. For individuals aged 38 and above, the success rate of IVF drops to below 50%.

Age will have a big impact on whether you transfer fresh or frozen embryos and whether the resulting embryos are of high to good quality.
 

What are the Symptoms of Embryo Implantation?

Due to the continuous increase in hormones and trophoblastic secretion in the body, females may experience breast swelling, fatigue, and even nausea after embryo implantation. A small number of women may also experience bleeding. Symptoms vary from person to person.

The following symptoms may occur after embryo implantation:

• Implantation bleeding: A small amount of bleeding or spotting, often accompanied by blood streaks in the discharge. This usually occurs 10-14 days after conception.
• Lower abdominal pain (implantation cramps): Sharp, stabbing pain in the lower abdominal that can occur at different locations or times. If the pain is severe, medical attention should be sought.
• Increased vaginal discharge: To protect the newly implanted embryo and prevent bacterial invasion, vaginal discharge may increase.
• Frequent urination: Increased production of trophoblastic hormones can lead to more frequent use of the bathroom.
• Breast swelling: Soft and swollen breasts with occasional sharp pains can be a result of implantation.
• Heightened sense of sensation: A diminished taste sensation, craving for particular flavored foods, and frequent nausea or vomiting may be experienced.

How Long Does Embryo Implantation Take?

The timing of embryo implantation does not begin immediately after the union of ovulation and sperm. The embryo needs to undergo development before implantation. The embryo has to travel from the fallopian tube for several days before it reaches the uterine endometrium for implantation.

After fertilization, zygote will initially stay in the fallopian tube for 72 hours. During this time, the zygote will undergo division and development into embryos. Subsequently, the embryo will move toward the uterine cavity through ciliary movement. It will then stay for another 72 hours, which is known as the “window of implantation”. During this period, the embryo will hatches, attaches, adheres, and finally invades into uterine endometrium, completing the process of implantation.

The highest chances of conception occur within the 3-day window before and after ovulation. In a woman’s menstrual cycle, there are only 3-5 critical days for successful implantation. In natural conception, it typically happens on the 5th to 9th day after ovulation, which is around the 19th to 23rd day after menstruation. In IUI cycles, it occurs on the 5th to 9th day after taking progesterone. For IVF, it occurs on the 6th to 10th after the ovulation trigger shot.

3 days after embryo transfer

Some individuals may experience early signs of pregnancy, such as nausea, weakness in the body, change in appetite, dizziness, etc. We do not recommend relying on sensation as an indicator of pregnancy during this period.

8 days after embryo transfer

Some individuals may experience breast tenderness, headaches or changes in appetite as their bodies produce more progesterone. However, the symptoms could  be caused by the medications used for IVF treatment. Day 8 after embryo transfer is still a little too soon for an hCG pregnancy test.

10 days after embryo transfer

With an increase of hCG, the early signs of pregnancy may or may not appear, and a negative result from a home pregnancy kit still does not necessarily indicate a failed IVF procedure. We recommend that IVF patients undergo an hCG analysis, which is performed by the hospital on the 14th day after embryo transfer.
 

If bleeding after embryo implantation indicates implantation failure?

Bleeding during the waiting period for embryo implantation can occur when the embryo has just implanted into the uterine endometrium and has not yet stabilized, or it may be due to insufficient progesterone in the early stages of pregnancy. The only defining symptom indicating implantation failure is menstrual bleeding.

Unsuccessful implantation symptoms：

• Menstrual bleeding or severe vaginal bleeding
• Severe abdominal cramping
• Negative pregnancy test result after day 14th

How to differentiate between menstrual bleeding and implantation bleeding?

3 Tips to Prevent Failed Implantation

• Try to avoid irritating foods and maintain a healthy diet.
• Avoid full bed rest.
• Maintain moderate physical activity.