The Poppy Seed Sandwich

After an embryo transfer, patients often wonder the following: Is my embryo going to fall out?

I think it’s a natural fear, especially since so many hopes and dreams are riding on the outcome of the embryo transfer.

Even though an embryo transfer is a highly technical procedure, one thing is certain: You can’t cough/pee/sneeze/squeeze/jostle an embryo out of the uterus.

Nearly fifteen years ago, when I was a new Reproductive Endocrinology fellow, someone explained an embryo transfer as “Throwing a velcro ball into a shag carpet.”

While I got the analogy because I’m old enough to remember the 1970s, it didn’t resonate with me.

So I thought of my own: Placing an embryo in the uterus is like putting a poppy seed in a peanut butter sandwich.

The embryo is tiny. The lining is thick and sticky. There’s no way that poppy seed is coming out.

Over the years I’ve explained an embryo transfer this way thousands of times. If you’ve ever worked with me, heard me lecture or been a patient or trainee, you’re probably sick of hearing it.

To wit: a patient told me about a year ago that she shared this on a huge fertility support group site and now I was famous as the Peanut Butter and Poppy Seed Doctor.

I can live with that.

Stick and grow embryo.

Stick and grow.

Why the Pineapple?

To many, the pineapple has become symbolic of the fertility journey.

Why?

Here’s the science: For centuries, pineapple (Ananas comosus) has been used as a folk medicine by indigenous peoples of Central and South America.

Pineapple fruit, skin and stems can be extracted to yield bromelain, a mixture of proteolytic enzymes that can interact with pathways in the body involved in inflammation, blood clotting and the immune response.

Bromelain supplements have been commercially available since the 1950s and it has been studied as an anti-cancer agent.

But the link to fertility treatment – and specifically IVF – is weak.

The theory is that by ingesting pineapple – and hence its proteolytic enzymes – the uterine environment may have less inflammation, better blood flow and an altered immune response, one that favors implantation of an embryo.

The bottom line: Pineapple is unlikely to be harmful to an IVF cycle, but it’s also not likely to be the deciding factor for its success.

But patients, please keep wearing your lucky pineapple socks when you come for a transfer!

While I’m 99.999% Science, I’m also 0.001% Faith, Hope, Trust and Pixie Dust, and I still believe in the power of good luck – and good vibes.

So don’t worry, if you forget your lucky pineapple socks, I’ll probably still be wearing mine.

Image via Amazon