If you’ve just gotten a positive pregnancy test after your embryo transfer, congratulations! Here’s some more background on what you can expect.
hCG level testing
About 10 days after your transfer, your doctor will have you come in for a blood test to check your human chorionic gonadotropin (or hCG) levels. hCG levels rise when an embryo implants in the uterus and a blood test can typically detect the hormone before at-home urine pregnancy tests. hCG levels below 5 mIU/mL are considered negative for pregnancy. Anything between 6-24 mIU/mL is a gray area, which could indicate a biochemical pregnancy, a type of early pregnancy loss.
Research suggests that pregnancies with hCG levels that reach at least 100 mIU/mL within 10 days of a five-day transfer or 12 days following a three-day transfer are the ones most likely to result in a successful pregnancy. Although high hCG levels are typically a more promising sign, rising hCG levels are more important than the initial number. Your fertility clinic will want to check your hCG levels every few days, and then weekly, to make sure the levels continue to double every 48 hours.
You will have your first ultrasound when you are five weeks pregnant to confirm that there is a gestational sac — a fluid-filled body containing the embryo. Then, when you’re six weeks pregnant, you’ll return for another ultrasound, this time where you’ll be able to hear the baby’s heartbeat. Later, toward the end of your second trimester, you’ll have a full anatomy scan, taking a detailed look at baby from head to toe.
Graduating from the fertility clinic
Fertility clinics typically monitor IVF pregnancies up until weeks eight to ten of pregnancy. During this time, you will be prescribed progesterone suppositories or injections. Studies show that progesterone increases the pregnancy rate following IVF and helps decrease the risk of miscarriage. Once you graduate from your fertility clinic, you will see your obstetrician At a traditional schedule with several weeks between appointments. Though this can be nerve-racking, especially considering how closely your fertility clinic monitors you, it’s the normal schedule of appointments. If you have a high-risk pregnancy due to a health condition or a history of pregnancy loss, you may have more frequent appointments.
It can be hard to feel calm after getting pregnant using IVF, even after you reach your second and third trimesters. Your road to parenthood might not look like what you expected, and that’s OK. You worked hard for this pregnancy, so you deserve to enjoy it. If the fear of pregnancy loss feels all-encompassing, try opening up about these complicated feelings to a friend, trusted loved one, or mental health professional. It’s important to take time to celebrate each milestone, no matter how small. The IVF process takes away some of the big firsts, like the randomness of a positive at-home pregnancy test, or, for some, being surprised by the sex of the baby, but that doesn’t mean you can’t make your own unique memories.
Reviewed by the Ovia Health Clinical Team
- American Society for Reproductive Medicine. “Progesterone Supplementation During In Vitro Fertilization (IVF) Cycles.” https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/progesterone-supplementation-during-in-vitro-fertilization-ivf-cycles/.
- Coomarasamy, Arri, Adam J. Devall, Jan J. Brosens, Siobhan Quenby, Mary D. Stephenson, Sony Sierra, Ole B. Christiansen et al. “Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence.” August 2020 https://pubmed.ncbi.nlm.nih.gov/32008730/.
- King, N., L. A. Bernardi, J. Tolentino, J. Zhang, A. Lawson, and R. B. Barnes. “Serum HCG values are as predictive of live birth after single embryo transfer as early pregnancy ultrasound.” November 2017. https://www.fertstert.org/article/S0015-0282(17)31536-4/pdf.