How pregnant is she?
In the medical world, all pregnancies are dated from the last menstrual period since, in the past, this was the last identifiable event and is a tradition in obstetrics dating back hundreds of years. Most term pregnancies are considered due after the 40th week of gestation after the start of the last menstrual period. After conception via IVF, since we know the date of conception, which is the date of egg retrieval and insemination, we calculate a theoretical last menstrual period by subtracting two weeks from the egg retrieval. For example, when a patient's pregnancy test returns positive, they are already four weeks pregnant.
Early pregnancy monitoring
A positive pregnancy test is a thrilling moment, especially considering all that our patients have undergone to get to this point. We will continue to monitor early pregnancy up until 10 weeks time, when our patients will establish a relationship with their obstetrician and see them from that point forward.
For the first 7 weeks of pregnancy, the patient will continue to take progesterone by intra-vaginal tablets or by injection. After that point, their care is individualized depending on such factors as age, general ovarian health and whether they have multiple embryos.
The first ultrasound exam is to establish the number of embryos that have attached, and the presence of a heartbeat. A second ultrasound checks for good growth and progression of the embryo. Once the second ultrasound is found to be consistent with good viable fetal growth and heart motion, it is with joy (and a little sadness with saying goodbye for now) that we will discharge the patient from our care for the duration of this pregnancy.
If a patient does not already have an obstetrician, we can provide appropriate referrals to any of the excellent obstetricians in our referral network. We can also assist in obtaining further information about pre-natal genetic screening and testing.
Early pregnancy spotting and bleeding
It is very, very common to experience minor spotting, bleeding and even mild cramping within the first trimester of pregnancy. This does not mean that a woman will lose the pregnancy. Mild spotting, bleeding or cramping may be due to the process of the placenta opening small maternal blood vessels in the uterus, which it must do for the placenta and fetus to survive and grow.
The following symptoms may be cause for concern. Please contact our clinic or obstetrician if any of the following occurs:
- Bleeding similar to a menstrual period or heavier
- Significant cramping or pelvic pain
- Significant ovarian pain
- Shoulder pain
- A fainting episode
If our patient does not conceive
A negative pregnancy test can be a heartbreaking experience that every woman and couple may approach differently. As soon as our patient is ready, we encourage them to schedule a follow-up visit with their doctor at the clinic so we can review their cycle and make plans for the future. This follow-up visit is very important to all of us.