Q. Why am I bleeding one day after testing positive for pregnancy by frozen embryo transfer?

Answered by
Dr. Sameer Kumar
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Sep 15, 2021

Hello doctor,

I had a frozen embryo transfer on the eleventh of this month of a genetically tested 5AA embryo. I got my first positive pregnancy test on the sixteenth of this month. Yesterday, I had red blood when I wiped it for a few hours. Today I had more blood when I wiped. I am on Estrogen and Progesterone supplements. What should I do, and what could be causing this? I bled with my past two pregnancies, which were successful, however, not until later in the first trimester. I am taking Aspirin, Vitamin D, and prenatal Vitamin tablets. Kindly give your opinion.



Welcome to

If you have been offered a frozen embryo transfer on the eleventh of this month, and the test is positive after five days, then the present bleed is likely to be an implantation bleed. However, the color of the blood is an important indicator of implantation. Also important is the total dosage of Progesterone being taken during the day.

Please share the complete detail of the prescription you are presently on to check on dosages. Progesterone is the key to support pregnancy during the primary and secondary city-trophoblastic invasion of embryonic villi into the uterine mucosa and myometrium to ensure implantation.

The implantation bleed can last for two to three days, but if the color of the bleed is bright red as of today, then Progesterone supplementation needs to be readjusted.

Please share the prescription as an attachment for review. Aspirin 75 mg once a day is to be continued. The bleeding is not because of the antiplatelet action of aspirin.

Hi doctor,

Thank you.

I am on 1 ml daily by IM progesterone injection (50 mg/ml MDV 10 ml). Kindly give your opinion.



Welcome back to

I am afraid you are on a very low dose of Progesterone. At your age and with frozen embryo transfer, the requirement is 400 to 600 mg daily during the transfer and for the next ten days when implantation completes and to avoid such bleeding episodes.

We offer the following progesterone regimen:

1) Tablet Duphaston (Dydrogesterone) 10 mg twice a day.

2) Tablet Susten 400 SR (sustained-release) (Progesterone) orally at night (an hour before sleep).

3) Tablet Progynova (Estradiol Valerate) 1 mg thrice a day.

4) Aspirin 75 mg once a day to continue till fetal heart rate is achieved.

Your Progesterone has to be increased if it is only injectable 1 ml (50 mg) is being taken IM (intramuscular). The restricted activity also needs to be followed. You may discuss this with your doctor and make an informed decision.

I hope this was helpful.

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