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Bed rest after IVF doesn't help
Friday, June 28, 2013
By Kerry Grens
NEW YORK (Reuters Health) - 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 study.
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 gynecology 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. 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. José 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 percent compared to 18 percent 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 rates.
"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 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.
SOURCE: http://bit.ly/17kpqLI Fertility and Sterility, online June 10, 2013.
NEW YORK (Reuters Health) - 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 study.
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 gynecology 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. 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. José 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 percent compared to 18 percent 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 rates.
"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 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.
SOURCE: http://bit.ly/17kpqLI Fertility and Sterility, online June 10, 2013.
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