11 December 2020

What is implantation bleeding?

Professional doctor screening of pregnant woman by ultrasound.
Consultant Gynaecologist
Dr Mireia Galian

IVI London


Implantation bleeding can happen in early pregnancy. It can also be accompanied by mild implantation pain. If you’re not expecting to be pregnant, it could pass you by without you noticing.  You might even mistake it for early spotting ahead of your next period. But if you’re trying to get pregnant, it’s natural that you might be more alert to the signs that something feels different. It is also natural to worry about whether something is wrong, or if it’s just normal. To put your mind at ease right from the beginning: implantation bleeding is totally normal. 1 in 4 pregnant women experience implantation bleeding, so if you don’t notice anything, there’s nothing to worry about either. Here’s a helpful guide that tells you all you need to know about implantation bleeding.


What is implantation bleeding?

You may think of the moment of conception as the moment when the sperm meets the egg. Once they merge to become a single cell, life begins. However, it’s also helpful to view pregnancy as a process, rather than a single event.

The process begins when the egg is fertilised. This normally happens as the egg makes its way along the fallopian tube. Once fertilised, it will rapidly divide to become an embryo called a blastocyst. It is at this stage that the embryo reaches the uterus to start the implantation process.

Before implantation, the uterus will have already prepared itself for the embryo by getting thicker, which helps the embryo to implant. When implantation takes place, it is possible for some small blood vessels to capture as the embryo settles into the womb lining. This is what sometimes leads to an implantation bleed.


What is implantation bleeding like?

Implantation bleeding is normally noticeable as a small amount of spotting or light bleeding that happens around 10 to 14 days after conception. It is light, stops by itself and does not require any treatment. Because of the timing, it is easy to confuse it with the onset of your next period, but there are some key differences. Let’s have a look at them:


A normal period usually lasts between three to seven days, with the first couple of days usually being a flow of bright red blood.

Implantation bleeding generally only lasts no longer than 24 to 48 hours. It is either brown, pinkish or black.

Intensity of bleeding

Period bleeding is heavy at the beginning and lightens up towards the end.

Implantation bleeding tends to be very light or consist only of light spots of blood, and it should not be heavy.

Amount of cramping

For those who normally experience period cramping, it often occurs before the bleeding starts and lasts for two to three days. During this time, it can be quite severe.

If any cramping occurs during the implantation of an embryo, it is usually very mild.


Is implantation pain normal in early pregnancy?

Even though only 25% of women experience implantation pain or cramping, it is a perfectly normal part of pregnancy. Here’s how you can recognise implantation pain as opposed to menstrual cramps:

  • When? If you do have some implantation cramping, it occurs between 10 and 14 days after ovulation, which is usually around two to seven days before your next period is due. This is why it’s so easily confused with menstrual cramps.
  • What does it feel like? Implantation cramps feel quite similar to menstrual cramps, but they are milder in intensity. Some women say that it feels like a sensation of light pulling, pricking or tingling.
  • Where? The cramping or tingling feeling is in the lower abdomen and lower back. Sometimes it is only felt on one side of the body.
  • How long? The duration can vary between individuals. It could be just a few isolated twinges or occasionally it could last between one and three days.


Is implantation bleeding a sign of early pregnancy?

One in every four pregnant women experience implantation bleeding or implantation pain, so it is only a sign of pregnancy in a minority of cases. There are also more common signs of early pregnancy which are both easier to recognise and easier to read:

  • Breast tenderness: Breasts can feel tender as early as a week or two after conception. The circulation of extra oestrogen and progesterone makes the breast glands start to grow and they retain extra fluid, making them feel full, sore or unusually sensitive. Your nipples may also look darker, although this change is not noticeable until about week 10 of pregnancy.
  • Fatigue: Tiredness is a normal response to all the hormonal changes happening within your body. The extra progesterone triggers a rise in basal body temperature and your heart starts to pump faster to deliver extra oxygen to the uterus, which can be exhausting!
  • Morning sickness: Morning sickness affects the majority of pregnant women at around six weeks. For some, subtler feelings of nausea (which feels like mild travel sickness) can start after only two weeks.
  • Frequently needing the loo: The need to urinate more often will increase as the pregnancy progresses, but it can also be a sign of early pregnancy. The extra blood flow to the kidneys starts early on, causing increased urine production.


Does implantation bleeding happen with IVF?

Yes. If you have a fertility treatment such as IVF, all the signs of early pregnancy are exactly the same. Whether the egg meets the sperm in the fallopian tube or in the laboratory, it still takes the same amount of time for the embryo to implant. If this does happen, the likelihood of implantation bleeding is still around 25%. All of the other signs of early pregnancy remain the same, too.


Getting in touch with us at IVI London

If you do have any questions or concerns about your fertility, and would like to know more about assisted fertility treatments such as IUI, IVF or egg donation, do not hesitate to get in touch with us. You can even take a virtual visit by reserving a place at our free Online Open Evening. We’d love to hear from you.

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