PREGNANCY AFTER IVF

Finally, after treatment with IVF, pregnancy has blessed your family. Congratulations! Here’s what to expect during the early stages of an IVF pregnancy.

Feeling Excited, But Also Scared?

You’ve most likely been trying to get pregnant for years, and you may have even gone through many cycles of fertility treatments. Finally, you’ve achieved a pregnancy. While you think that you should be happy, instead, you may be feeling scared.

This is completely normal. Especially if you’ve lost previous pregnancies through miscarriage, feeling nervous and not too hopeful about the pregnancy is understandable. Don’t feel guilty for feeling scared, but do find someone to talk to about your feelings. It will help.

Continued Progesterone Support

Your doctor may keep you on progesterone hormone support if pregnancy is confirmed. 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. You can ask your doctor about your options.

Continued Blood Tests for Monitoring

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

• to look for rising hCG hormone levels (pregnancy hormones), in order to ensure the pregnancy is healthy and to look out for very high levels (which may indicate a multiple pregnancy)
• to monitor estrogen levels, especially if symptoms of ovarian hyperstimulation syndrome(OHSS) are present
• to monitor progesterone levels

Ultrasound Follow-up

Before releasing you to a regular obstetrician, your 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.

Release to a Regular Obstetrician

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

You may feel excited to be going to a “normal” doctor – finally! But you may also feel nervous, going from the intense monitoring of your doctor to the more laid back, once-a-month visits of a regular OB/GYN.

If you’re feeling extra nervous, 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, and feeling nervous is completely normal and understandable.

Is my pregnancy at higher risk because it is as a result of fertility treatment?

The statistics show that spontaneous miscarriages are higher in IVF pregnancies compared to naturally conceived pregnancies, although this is strongly linked to the age of the women. Complications later in pregnancy associated with assisted reproduction include gestational diabetes, hypertension, placenta praevia (low lying placenta), abruption, and caesarean section deliveries, mothers with multiple pregnancies being at particular risk. Studies suggest that an IVF pregnancy does increase the risk of pre-term delivery, small birth weight babies and admission of baby to the neonatal unit. But is it important to state that the absolute risk for these complications is small and it is generally considered that the initial causes of infertility may have a higher affect than assisted reproductive techniques themselves. For example, polycystic ovarian syndrome, which is a common cause of infertility, is in itself linked to the development of gestational diabetes. Additionally, pregnancy complications including placenta praevia, prolonged labour, hypertension, and caesarean delivery are associated with older women. Therefore the older you are, the greater your risk of obstetric complications.

Will my care during pregnancy be different?

You should book early in your pregnancy and will be offered consultant led care. You may have to make more frequent visits to your doctor and midwife to check your blood pressure and dip your urine. You are also likely to have more frequent blood tests looking for diabetes and an extra ultrasound scan if there are any concerns about the baby’s growth. You will also be advised to deliver your baby in the hospital rather than at home or in a low risk birth unit. You may be offered induction of labour around 40 weeks of gestation due to the small increased risk of still birth if pregnancy continues beyond that.

If I have any further questions?

You can always ask your midwife or obstetrician any further questions you may have.

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