What are the Causes of Cramping After IVF?

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  • Written By: Christine Hudson
  • Edited By: Lauren Fritsky
  • Last Modified Date: 13 September 2019
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In vitro fertilization (IVF) cramping is not uncommon, and some women experience it for one to four days after the implantation procedure. This cramping is usually felt because of the embryo embedding itself into the wall of the uterus — just the symptom of cramping after IVF does not necessarily indicate the success of the procedure, however. Some women also feel cramping after the procedure due to excess hormones and chemicals in the body, such as human chorionic gonadotropin. Or the cramping may be due to an underlying medical problem or even a issue with the procedure.

It is common for most pregnancies, clinical or not, to cause some discomfort and side effects. Many women experience menstrual-like cramps and even some spotting as the embryo attaches to the uterus wall. In this instance, cramping is a good sign after IVF. The symptoms, however, are so close to those caused by medications or increased hormones that it is often impossible to know for sure whether implantation has occurred until a clinical pregnancy test is performed.


IVF refers to manually combining a sperm and an egg in a laboratory and then transferring the embryo to the woman's uterus. Medications are generally prescribed to control the speed at which the eggs ripen and increase the chance of being able to retrieve more than one egg at a time. This process increases hormones in the body, which may cause symptoms similar to menstrual cramping as well as moodiness and breast tenderness. The medications themselves, progesterone especially, may also cause abdominal cramping and headaches.

Ectopic pregnancy is rare after IVF and occurs in about 2 to 5% of cases. Cramping can be a sign of the embryo implanting in the wrong place, although this is more common in women who have a history of pelvic inflammatory disease or who have had prior ectopic pregnancies with or without IVF. The cramping associated with ectopic pregnancy is generally more of a sharp and constant pain in one area of the abdomen rather than a more generalized cramp throughout. If an ectopic pregnancy is suspected, the patient contact her healthcare provider immediately to explain symptoms and get help.

While cramping after IVF is very common and may even be a good sign, it is important for a woman to note her particular symptoms and discuss them with a medical professional. Most will suggest over-the-counter painkillers to offset “normal” cramping pain. Prescription painkillers are usually not prescribed because they could be potentially harmful to the unborn child if the procedure was successful. Some women also find that using a heating pad or hot water bottle is extremely helpful to relieve discomfort.


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Post 5

Progesterone does not cause cramps. It actually calms the uterus. I'm not sure why I keep seeing people post this.

Post 4

It's so difficult to analyze cramps after IVF. I was told that if I get pregnant after IVF, I will have very painful cramps. I had very light ones so I thought that it did not work, but it turned out I was pregnant!

Post 3

@literally45-- It's a good idea not to get hopes high after IVF because of cramps. If implantation doesn't occur after IVF, menstruation follows which naturally causes cramps. After my first IVF, I thought I was having implantation cramps only to discover that I was having my period. It was a huge disappointment.

Post 2

Progesterone also causes cramping, which many women take before their IVF to make implantation successful.

My sister was on progesterone therapy for a long time before IVF. She had difficulty getting pregnant because of a progesterone deficiency. Progesterone is responsible for preparing the endometrium for the fetus to attach to. The downside to progesterone therapy is that the hormone causes cramping. My sister had cramps all throughout the therapy as well as cramps right after IVF.

She wasn't sure if it was implantation or regular cramping but didn't want to get her hopes high. It turned out to be regular cramping but the fetus did implant successfully. I have a gorgeous, one year old niece now.

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