Fertility cycle outcome
Blood Pregnancy Test
The outcome of your cycle will be known for sure with your blood pregnancy test 11 to 12 days after your day 5 transfer or 13 to 14 days after a day 3 transfer. Urine pregnancy tests are discouraged because of the possibility of a false positive and much more commonly, a false negative. Bleeding before your pregnancy test doesn’t mean you are not pregnant, if this happens to you please let your nurse know. You should stay on your meds and keep your blood draw appointment as scheduled.
If your blood pregnancy test is negative, you may stop your medications and expect your period to start within the next few days, but it may not come for two weeks. If it doesn’t come after 2 weeks, please call your nurse. This period may be a heavier one than normal for you. This is a very disappointing time and emotionally difficult, please be sure you have good support and if you need resources, call your nurse.
If your first pregnancy test is positive, you will have approximately 2 more blood draws to follow the level. We look for doubling every 48 hours as reassurance that the embryo is developing well. A level that does not double may warn us of a potential ectopic pregnancy or miscarriage so you may be followed more closely after that. This does not necessarily mean a miscarriage is happening, many of our patients have had less than ideal blood levels and have gone on to have a healthy pregnancy. The implications of your levels will be discussed thoroughly with you by your nurse.
Calculating your Gestational Age
Gestational age is normally calculated by a woman’s Last Menstrual Period (LMP). That means that she is considered 2 weeks pregnant at ovulation (which is the same time as your egg retrieval). So to calculate your gestational age, know that you are 2 weeks pregnant at your egg retrieval. For example, if your retrieval happens on a Wednesday, you are 2 weeks pregnant that day, and the Wednesday 2 weeks later you are 4 weeks pregnant and would have your pregnancy test after that. If your pregnancy test is positive, we would look for fetal heart motion after 6 weeks gestation, or one month after your egg retrieval. Think of it as 2 bonus weeks of pregnancy! Interestingly, if your retrieval falls on a Wednesday, so would your due date be on a Wednesday!
Bleeding in early pregnancy
Bleeding in early pregnancy is very common. Many of our patients report this. In general, brown spotting means the blood is ‘old’ and is less worrisome than bright red blood. Also, the more bleeding there is, the more we worry. This is not exact however, some individuals have had terrible bleeding and go on to have a healthy pregnancy. At the same time, the embryo can stop developing with no bleeding at all. Spotting in early pregnancy is a very common reason our patients call their IVF nurse. Bleeding can be a very scary sight, but try to remember that bleeding alone does not mean you are miscarrying. Please call your nurse to discuss it further and to get a plan for what to do if it worsens. Sometimes your doctor may recommend another blood draw or early ultrasound if appropriate. Sometimes the best thing to do is wait and see.
Miscarriage after IVF
Miscarriage rates are the highest before 8-10 weeks gestation, and are based on the age of the female or the egg donor. 20% of all pregnancies in woman under 35 will miscarry. That number may be as high as 40% in women over age 40 (unless she uses an egg donor), so it is a very real risk. Once fetal heart motion is seen at 6 weeks, the chance of miscarriage starts to drop, and as each week passes the miscarriage risk drops a little more, until by 12 weeks the chance of loss is 3% or less. Your particular circumstances may vary, please consult with your doctor for information specific to your situation.
When to see your OB
We usually advise that you start prenatal care with your Obstetrician when you are between 10 and 12 weeks pregnant. Normally we do ultrasounds at 6 and 8 weeks gestation. We will forward the ultrasound and blood work reports to your Obstetrician with a letter about your pregnancy. Please make sure we know who your Obstetrician is so that they may receive this information in a timely manner. Most of our patients schedule their first obstetric appointment a month ahead, so call your doctors office after fetal heart motion is seen at your first or second ultrasound at NFC. Prenatal care typically follows the normal schedule for IVF pregnancies, and you will receive instructions on weaning off your IVF meds about a week after your last ultrasound and blood work at NFC. We wish you all the best and look forward to receiving your delivery information after you have your baby.
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