Pregnancy After IVF

Finally, after treatment with IVF, you’re pregnant. Congratulations! Here's what to expect during the early stages of an IVF pregnancy.

IVF Pregnancy Test

When can you take a pregnancy test during an IVF treatment cycle? Your doctor will likely schedule a blood test 10 to 14 days after the egg retrieval. The blood test will detect and measure the hormone hCG, the “pregnancy hormone.”

You should not take an early at-home pregnancy test during IVF treatment. Taking multiple early pregnancy tests is a bad habit many fertility-challenged women struggle with, and it’s one you should try your best to resist if you’re getting fertility treatments.

The reason is that one of the fertility drugs used is the hormone hCG. If you take a pregnancy test the day after receiving this injection, you may get a positive pregnancy test, not because you’re pregnant, but because the test is picking up the hormones from the fertility treatment.

Continued Progesterone Support

Treatment isn’t over the moment you get a positive pregnancy test result. Your doctor may keep you on progesterone hormone support. How long he will continue progesterone treatment will be dependent on your particular situation.

If you're taking progesterone in oil through injections, you may be able to switch to vaginal suppositories or gel. Or, you may be able to discontinue progesterone hormone support as newer research indicates it may not affect the outcome of the pregnancy. Ask your doctor about your options.

Continued Blood Tests for Monitoring

Your fertility doctor will also likely continue to check your hormone levels for at least a few weeks following a positive pregnancy test. There are a few reasons for this:

• Checking for: Rising hCG levels (which may indicate a multiple-pregnancy)
• Monitoring: Estrogen levels, especially if symptoms of ovarian hyperstimulation syndrome (OHSS) are present
• Watching: Progesterone levels for a healthy pregnancy

The Excitement and Fear of Good News

You've most likely been trying to get pregnant for years. You may have even gone through many cycles of fertility treatments. Finally, you've achieved a pregnancy. You’re likely really excited and happy. But you may also feel anxious. You may even wonder if it’s all really happening. If you have friends who are still trying to get pregnant, you may experience some survivor’s guilt. All of this is completely normal.

Feeling nervous and not too hopeful about the pregnancy is understandable. If you’ve experienced miscarriages in the past, this is especially true. Don't feel guilty for feeling the way you do. Do try to find someone, whether a friend or a therapist, to talk to about your feelings. It will help.

Women who have experienced infertility are at-risk for developing pregnancy and postpartum depression. The sooner you talk to someone, the more likely it is you'll feel better.

Deciding When to Tell People

This is a big moment! However, you may or may not be ready to share the news with the world.

If you’ve shared your treatment progress with friends and family, especially if you’ve shared details of this particular cycle, you may be expected to tell them sooner than later. If they knew when you had your embryo transfer, they are naturally going to want to know if the cycle worked!

However, for those who weren’t in the loop, you can choose to wait.

When should you tell? When you see your hCG doubling? After ultrasound confirmation? After you see the heartbeat? After the first trimester? It’s entirely up to you. There is no right or wrong answer.

Ultrasound Follow-up

Before releasing you to a regular obstetrician, your fertility doctor will most likely order an ultrasound or two during early pregnancy. This is mainly to check for a multiple-pregnancy.

Depending on what week the ultrasounds take place, you may even get to see the baby's heartbeat.

If you’re pregnant with twins, when might you find out? The first ultrasound may be too early to really know. By your second (and most certainly by your third), you should find out if you’re expecting one or more than one.

Feeling Better Despite OHSS

If you, unfortunately, developed a case of ovarian hyperstimulation syndrome during treatment, your symptoms may last several weeks. They may even get worse. Be sure to stay in contact with your doctor.

Release to a Regular Obstetrician

Usually, an IVF pregnancy is handled by a regular obstetrician (OB) and not a high-risk obstetrician. Your fertility doctor will transfer you over to the regular OB at about the 8-week mark.

You may be excited to see a "regular" doctor—finally! You may also feel nervous. It can be quite a shock to go from the intense monitoring of IVF to the more laid back, once-a-month visits of a regular OB/GYN. Don’t hesitate to talk to your doctor.

If an extra ultrasound would help calm your nerves, go ahead and ask. Your doctor knows how much you've gone through to get pregnant. Feeling nervous is completely normal and understandable.

Pregnancy Risks After IVF

Pregnancy after IVF conception is associated with some increased risks and complications. These risks don’t seem to be directly caused by the use of fertility treatment. Instead, they are more likely associated with the original reason IVF was needed in the first place—infertility or advanced age.

Some pregnancy risks and complications that are higher after IVF conception include:

• Abnormal bleeding
• Congenital defects
• Gestational diabetes
• Intrauterine growth restriction (IUGR)
• Preeclampsia
• Pregnancy-related hypertension
• Premature labor (even with a singleton pregnancy)

Pregnancy after IVF is also more likely to require induction of labor and have a higher risk of cesarean birth. Prenatal care is always important, but it’s especially important after IVF to hopefully catch these complications early and treat (or prevent) them as soon as possible.