Received September 19, 2021
Accepted January 31, 2022

The embryo transfer (ET) procedure is the final step of an in vitro fertilization (IVF) cycle. Different strategies have been proposed to increase the possibility of implantation, such as post-transfer bed rest. The objective of this manuscript is to compare clinical outcomes of embryo transfer after an IVF cycle comparing rest vs. early ambulation. The patients, intervention, comparison, outcomes (PICO) model was used to select the study population: women/couples who underwent an IVF cycle were included in which it was decided to compare the clinical results in patients who underwent bed rest versus early ambulation. Only studies which included live birth (LB) as outcome were included (www.crd.york.ac.uk/PROSPERO/CRD42020188716). A systematic search for studies was conducted in MEDLINE, ClinicalTrials.gov, PubMed, and Cochrane Library. The searches were coordinated by a librarian in May’20, and searches were filtered from 1995 to date. All original peer-reviewed articles in English were included, regardless of study design. The search retrieved 27 citations, from which 14 were eligible for full-text analysis, and 4 were accepted for inclusion. The studies included data on 21,598 patients / cycles (rest: 20,138; early ambulation: 1,460). In patients who underwent bed rest, a LB rate of 43.6% was observed vs. 52.5% in those who did not. The meta-analysis showed an odds ratio of 0.77 (95% CI 0.5–1.2), which is interpreted as 23% less likely to have a LB by undergoing bed rest, however, this was not statistically significant. Considering that there is no difference between the two strategies, there is no evidence to recommend bed rest after an embryo transfer procedure.