Bed rest after embryo transfer

In in vitro fertilization (IVF), embryo implantation is a very complex event influenced by embryo quality and endometrial receptivity. Many interventions have been used to increase the implantation rate, but bed rest is probably the most commonly prescribed. Since the etiology of implantation failure in most cases is not related to an excess of activity, however, it is unlikely that bed rest could be an effective strategy to improve pregnancy outcome. We performed a systematic review to evaluate the effect of prescription of bed rest to increase pregnancy rate. A systematic literature search in MEDLINE, EMBASE, and the Chinese Biomedical Database (CBM) was performed to identify articles reporting randomized controlled trials (RCTs) which compared different time length of bed rest in infertile women undergoing embryo transfer (ET). Two authors independently searched the abstracts, identified relevant papers, assessed inclusion and trial quality, and extracted the relevant data. Three trials involving three different comparison groups were included in the review and enrolled a total of 724 randomized subjects. The quality of the included studies was high. The conclusion was that there was insufficient evidence to support the routine use of bed rest to improve pregnancy outcome in women undergoing ET in IVF cycles.