Bed rest immediately after an in vitro fertilization (IVF)
procedure, despite being common practice, did not help women ultimately have a
baby in a new study."The old wives' tale of bed rest should be debunked
once and for all, that you don't need bed rest in any way, shape or form,"
said Dr Jani Jensen, a fertility expert at the Mayo Clinic, who was not part of
The researchers found that women who continued to lie down
for 10 minutes after embryos were transferred to their uterus were actually
less likely to have a baby than women who got up and walked around right
away."It demonstrates that there is no need to keep patients at bed rest
after a transfer.
They can immediately get up and leave," said Dr Richard
Reindollar, the chair of the department of obstetrics and gynaecology at Geisel
School of Medicine at Dartmouth. IVF involves inserting fertilized embryos into
a woman's uterus using a thin catheter.
Women lie down and prop their feet in footrests, and the
procedure takes about five to 10 minutes, said Jensen. Following the procedure,
women are sometimes wheeled on a gurney to a recovery room, where they rest for
several minutes, up to several hours.
Bed rest no good
Other times, women are asked to stand and walk out of the
room on their own."In the past there were a number of people who felt
strongly that patients have bed rest. Some had patients go to bed for five days,"
said Reindollar, who did not participate in the study. Some previous research
has suggested that bed rest actually does no good, and could harm women's
chances for getting pregnant.
In the latest study, researchers in Spain, led by Dr Jose
Remohi at the Instituto Valenciano de Infertilidad, Valencia, and the
Universidad de Valencia, randomly assigned patients to bed rest or to get up
immediately following the procedure. Half of the women in the study, 120 of
them, stayed on the bed for 10 minutes after the embryos were transferred,
while the other 120 women got up and walked out of the room.
Fifty women in the bed rest group went on to have babies,
while 68 women in the other group delivered a baby. "It's not clear
why," said Jensen. The pregnancy rates were similar in both groups, but
miscarriage rates in the bed rest group were 27.5% compared to 18% in the other
group. Statistically, though, that difference could have been due to chance,
the researchers noted.
The authors point out that when a woman is standing, her
uterus is in a horizontal position and speculate that may be better for
successful embryo transfer. They also propose that stress reduction from
walking around after the procedure might play a role in the differing birth
Coping with anxiety
"We believe that encouraging patients to follow their
daily routine immediately after (embryo transfer) may help them to cope with
anxiety during treatment and thereafter to increase their skills in maintaining
relaxation throughout the treatment, and this may be one possible reason behind
our obtained results," they write in the journal Fertility and Sterility.
Jensen agreed that stress reduction is important for
would-be mothers."But I think that the intervention is too small to say
that the 10 minutes of bed rest was detrimental," said Jensen. "The
better message is probably that you really don't need any bed rest at all to
still have good outcomes."Reindollar, who is also the president-elect of
the American Society for Reproductive Medicine, said the study is important in
developing a cache of evidence about the benefits and harms of bed rest He said
that with enough data the Society might consider issuing practice guidelines
that recommend physicians to discourage bed rest."This paper showed that it
certainly does not hurt patients to get up and walk away, and it suggests that
it might hurt to keep them there," Reindollar told Reuters Health.