How to Help Implantation In The 2WW [A Fertility Dietitian’s Perspective]

Are you in your 2ww and wondering how to help implantation? Keep reading to learn more about foods that help implantation, and how supplements and lifestyle changes can help too.

This information is essential if you’re looking to improve your chances of conception whether you’re trying to conceive naturally or have an embryo transfer coming up.

In this blog post, we’ll dive into the importance of implantation, the reasons for implantation failure, and more importantly, how to help implantation through food choices and lifestyle changes.

Let’s get started! 

What is implantation?

Implantation is a critical step in becoming pregnant; it’s when the fertilized egg attaches itself to the uterine wall. You can have a significant influence on this stage of the reproductive process with your lifestyle choices, including your diet.

Hormones play a pivotal role in this process. Estrogen works to thicken the uterine lining, preparing a nourishing environment for the embryo. This lining serves as the primary source of nutrients for the embryo until the placenta is fully developed. 

On the other hand, progesterone helps the lining remain stable and sticky enough so that the embryo can stick to it. Low levels of progesterone in the 2ww can compromise the implantation process.

When does implantation occur?

Implantation occurs when the embryo attaches itself to the uterine wall, embedding within the nutrient-rich lining of the uterus. Initially, this lining is rather slim, measuring around 2 to 4mm before ovulation. However, during the luteal phase post-ovulation, it thickens considerably to between 7 to 16mm.

Implantation occurs about 6-10 days after ovulation, or 1 to 5 days after embryo transfer. Many factors such as hormone levels and uterine conditions must align for the fertilized egg to successfully implant itself into the uterine wall.

Signs of implantation

Common signs of implantation in the 2 ww post-ovulation or after embryo transfer may include: 

  • Light spotting
  • Cramps
  • Breast tenderness
  • Fatigue
  • Changes in cervical mucus
  • Elevated Basal Body Temperature (BBT)
  • Urinating frequently

Implantation symptoms can vary among individuals, and some may not even experience any at all. It’s always best to consult your healthcare provider if you have any concerns.

Reasons for implantation failure

Reasons for implantation failure include the health of the uterus or the health of the embryo. It’s also important to take advanced maternal age and embryo stage into consideration. 

Now let’s discuss what can hinder implantation of the embryo from a nutrition perspective: 

Uterine Fibroids

Fibroids are non-cancerous lumps of tissue that can grow in the uterus. They are very common and usually don’t cause any problems. However, if they’re in the wrong spot, they can cause implantation to fail. 

Risk factors for developing uterine fibroids include high levels of estrogen, alcohol, caffeine, BPA, higher intake of red meat and ham, too much caffeine, food additives, and not eating enough fruits and vegetables. 

Uterine Polyps

Polyps are usually non-cancerous soft growths of tissue in the lining of the uterus. Women with infertility who had their polyps surgically removed experienced an increase in pregnancies.

Thin endometrium 

Thin endometrium is a known challenge for embryo implantation. The endometrium is the tissue that lines the uterus. The endometrium thickens to create an environment that is ideal for pregnancy and to provide physical support for the placenta to attach to so having a thin uterine lining decreases the chances of implantation. 

Endometriosis

Endometriosis is a condition affecting about 10% of women of reproductive age. It occurs when similar tissues to the uterine lining grow outside of the uterus, causing pain and discomfort. Endometriosis causes implantation failure by decreasing the expression of implantation markers during the window of receptivity.

Endometritis 

Endometritis is an inflammatory condition of the lining of the uterus. It’s commonly caused by an infection such as tuberculosis or a sexually transmitted infection. However, dietary factors such as your dietary fat ratio, may impact inflammation too. 

Autoimmune conditions

Autoimmune conditions such as Hashimoto’s thyroiditis, Celiac Disease, Lupus, Type 1 diabetes, Ankylosing Spondylitis, and Multiple Sclerosis (MS) are associated with chronic inflammation. Markers of autoimmune disorders are common in women with Recurrent Implantation Failure. 

This is why as an integrative and functional fertility dietitian I always work on blood sugar balance and gut health with every client since all the above conditions are associated with either the gut or blood sugar levels. 

Obesity 

Obesity is associated with increased estrogen production due to increased levels of aromatase (the enzyme that converts androgens in fat to estrogen). This study also found that women who had more belly fat, waist circumferences ≥36 inches, or waist-to-hip ratios ≥0.85 had a lower probability of conceiving per cycle. 

Vaginal and endometrial microbial imbalances

Although this area of research is newer, It has been shown that women undergoing IVF have higher pregnancy success rates when they have more lactobacilli bacteria inside their uterus.

Lactobacillus acidophilus KS400 probiotics used vaginally for 6 days before embryo transfer decreased miscarriage rates by almost 10% and increased live birth rates by about 16% compared to controls.

Increase implantation success with these strategies: foods, supplements, and lifestyle

Foods, supplements, and lifestyle changes can go a long way when you need to increase implantation success. Eating certain fertility-friendly foods may help implantation, while other foods may hinder the process.

Proper nutrition can increase implantation success by increasing blood flow to the uterus, thickening the uterine lining, making the uterine environment ideal for pregnancy, optimizing estrogen levels to decrease the risk of tissue growths in the uterus, and supporting progesterone production to help keep the uterine lining stable. 

Foods to eat during the 2-week wait 

There is no specific diet to follow during the two-week wait, but focusing on consuming nutritious foods and including all of the 5 food groups as well as some of the specific foods based on evidence is the best method to follow. Foods to help implantation include: 

examples of implantation foods to eat during the 2 -week wait

Fish is a great source of EPA and DHA omega 3s that our body can use so we really can’t rely on plant sources alone to meet our needs. Omega 3s decrease inflammation helping create an ideal environment for embryo implantation. 

low mercury DHA and EPA rich fish list
  • Whole grains: Whole grains are packed with fertility-friendly nutrients like B vitamins, iron, and fiber. Boosting your consumption of these grains can enhance the thickness of your endometrial lining, potentially improving the chances of successful implantation. Some good choices are quinoa, brown rice, and whole wheat bread. 

Antioxidants help protect against damage from free radicals, which can affect the reproductive system negatively. Eat the rainbow because different colors have different antioxidants. 

  • Cruciferous vegetables like broccoli, kale, cauliflower, and Brussels sprouts can help the body eliminate excess estrogen, a risk factor for abnormal uterine tissue growths like fibroids and polyps that can decrease implantation success. 
  • Probiotic foods: research suggests that the gut, vaginal, and uterine microbiota may affect immune factors essential for implantation. Foods that feed healthy bacteria include fermented foods like kefir, yogurt, sauerkraut, and more.
  • Folate-rich foods: higher folate intake has been associated with higher rates of implantation, clinical pregnancy, and live birth rates. 

High sources of folate include beef liver, cooked spinach, black-eyed peas, rice, asparagus, and Brussels sprouts. Good sources of folate include avocado, romaine lettuce, broccoli, other leafy greens, beans, and lentils.

  • Beetroot: Beetroot is rich in nitric oxide, which can help increase the flow of nutrient-dense blood to the uterus, thereby encouraging successful implantation. 

Drinking a glass of beetroot, watermelon, and ginger juice daily starting on the day of the embryo transfer until the day of the pregnancy test improved the implantation rate by 25.2% vs. 20.5% and the clinical pregnancy rate by 41.0% vs. 22.0% compared to those who didn’t drink the juice. 

image of watermelon, beetroot, and ginger juice for implantation.

Foods to avoid during implantation

Implantation foods to avoid or limit include:

  • Sugary foods: Foods high in sugar can cause a quick increase in blood sugar levels and increase inflammation levels. Frequently eating such foods might disturb our hormone balance, potentially harming fertility. 

Blood sugar levels in the high but normal range, >99 mg/dl at 2 hours after a meal, and fasting levels >88 may decrease the probability of conceiving per cycle. 

  • Alcohol: Alcohol can interfere with your hormone levels, which may negatively affect implantation.
  • Caffeine: It’s best to avoid or limit your caffeine intake during this time because higher intakes of caffeine have been shown to disrupt embryo implantation. Aim for 200mg caffeine or less = 2 cups of coffee or less.
  • Foods that may contain listeria bacteria such as raw seafood, soft cheeses, sandwich meats, and pre-packaged salads). Listeria bacteria can impact your growing embryo and increase the risk of pregnancy complications.
  • High mercury fish king mackerel, Marlin, Orange roughy, Shark, Swordfish, Tuna, bigeye, and Tilefish (Gulf of Mexico).
  • Advanced glycated end products (AGEs): the body makes some AGEs naturally, but others are produced by cooking methods like grilling, frying, and roasting. A high amount of AGEs is also present in processed foods. There is a link between AGEs exposure and inflammation, oxidative stress, and cell damage which can all negatively impact embryo quality and the uterine environment.
examples of foods to avoid or limit during implantation.

Supplements to increase implantation success

  • Probiotics: a vaginal microflora probiotic may be beneficial for implantation given that the vaginal and endometrial microbiomes play a role in implantation. Lactobacilli may be beneficial for implantation because they reduce pathogen growth by making organic acids and hydrogen peroxide, control vaginal pH, and attach to endometrial cells.
  • L-arginine: L-arginine may help enhance implantation by increasing blood flow and thickening the endometrium according to a small study.
  • Vitamin E: One small study of 40 women with implantation failure found that vitamin E in the dose of 400 IU or 268 mg for 12 weeks showed a reduction in inflammation and improved uterine lining thickness. You should discuss extra vitamin E supplementation with your doctor because it’s typically not advised in pregnancy.

Researchers in Turkey found that 500 IU/day of vitamin E supplementation in women with unexplained infertility improved the uterine lining thickness during controlled ovarian stimulation and IUI cycles.

  • Progesterone boosting nutrients: nutrients such as B6, Vitamin C, Selenium, Omega 3, and Vitamin D may help to increase the production of progesterone which is crucial in keeping the uterine lining stable and sticky and therefore aids in implantation success. Read my blog on foods to increase progesterone for more information. 

The US Centers for Disease Control and Prevention (CDC) recommends that women who could become pregnant take 400 micrograms (mcg) of folic acid every day. Women who took a prenatal multivitamin  ≥6 times/week had a lower risk of ovulatory infertility and a shorter time to pregnancy. 

Start taking a prenatal with folate like FullWell at least 3 months before trying to conceive to reduce the risk of major birth defects of the brain or spine. Save 10% off your first purchase with code FUELINGFERTILITY10

Lifestyle Changes

  • Exercise: A small study of women undergoing IVF found that those who were moderately active 3-5 days a week during fertility treatments including after embryo transfer had an increased live birth rate per retrieval 47.6% vs. 22.1% compared to those in the low activity group. 

They also had higher implantation rates 29.6% vs. 19.4%.In addition, vigorous exercise during the implantation window especially in women trying to conceive naturally may cause a shorter luteal phase defined as <10 days from the time between ovulation and the start of the next period. 

When the luteal phase is too short, the lining of the uterus might not be ready for implantation.

  • Circadian rhythm: to improve your circadian rhythm expose your bare eyes to natural sunlight first thing in the morning for 5-10 minutes or more, and block blue light or artificial light exposure at night. Also, try to wake up and go to bed at the same time daily to maximize melatonin production which is our sleep hormone and an antioxidant.
  • Acupuncture: acupuncture before embryo transfer significantly increased the IVF outcomes in women undergoing IVF compared with no acupuncture. Acupuncture can increase implantation success by boosting blood flow to the uterus, which helps create a thick uterine lining. It can also help to reduce stress and prevent uterine contractions, which can interfere with implantation.
  • Stress: A chronically high blood level of adrenaline is closely related to infertility and failed embryo implantation. When we are stressed our adrenal glands release adrenaline.

Frequently Asked Questions

Should I eat pineapple for implantation?

There are currently no studies that recommend eating pineapple for implantation. However, pineapples contain Bromelain, an enzyme that may decrease inflammation in different conditions. Additionally, bromelain may increase the risk of excessive bleeding.

Does pomegranate juice help with implantation?

There is no scientific proof that drinking pomegranate juice helps with implantation. Pomegranate has antioxidants and is also anti-inflammatory. Some studies have shown that consuming pomegranate juice and extract can improve cardiovascular health.

What is the two-week wait?

The two-week wait is the time between ovulation and the day of your expected period. Or the time after your embryo transfer, where you’re waiting to see if you’re pregnant. The luteal phase of your menstrual cycle is the same as the 2ww period. During this phase, your uterine lining gets thicker to prepare for a potential pregnancy.

Why do I need to wait 2 weeks?

You need to wait 2 weeks to make enough hCG (human chorionic gonadotropin) to show up on a blood test. Doctors recommend waiting two weeks before testing for a pregnancy to make sure you get the most accurate results.

What is recurrent implantation failure (RIF)? 

Recurrent implantation failure (RIF) is when embryos don’t stick after the transfer of several good-quality embryos. It affects about 10% of couples undergoing IVF and embryo transfer. There is still no agreed-upon definition or standard protocol for the diagnosis and treatment of RIF. 

Bottom Line

Diet and lifestyle habits play a significant role in the fertility and IVF journey including how to help implantation. Increase implantation success by consuming foods rich in omega-3s, reducing red meat and sugar intake, and nourishing yourself, especially during that crucial 2ww.

And hey, if all this sounds like a lot to digest (pun intended!), I’ve got your back. Learn more about how I can help you get pregnant faster with my “Restore Fertility Roadmap” program.

To your fertility success!

Disclaimer: Please consult your healthcare provider if you have any medical questions or concerns. You should not use this article as a substitute for professional medical advice, nor to diagnose or treat anything.  

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Celine Thompson MS, RDN

I'm Celine, a registered dietitian and a certified fertility nutritionist who has overcome pregnancy losses and now empowers women and couples to take back control of their fertility journey by nourishing their bodies to restore fertility. I love mangoes, avocados, steak, salmon, rice and beans. I can eat these on repeat, Seriously! I love going down the rabbit hole of PubMed doing research with a good reality TV drama as my background noise. I'm a wife, boy mama, and also a dog mom. I'm on the mission to help you eat delicious food that nourishes your soul and body.

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