Pregnancy

 

Day 14

Fourteen days after the follicular puncture is when the first test is conducted to see if pregnancy has occurred.

If menstruation has not occurred, a blood ßhCG test will be conducted on this day. If this test is not possible, a pregnancy test may be conducted two days later. If menstruation occurs before day 14, our clinic should be informed.

If not resident in Barcelona and unable to attend our clinic, we will explain by phone the steps to be followed in order to check if a pregnancy has been achieved.

It is important to remember that some treatments may prevent menstruation.

Remember that you should be in constant contact with the IVF team if you do or if you don't get pregnancy in order to establish future plans.

A few months should be allowed to lapse before repeating an IVF cycle, during which time it is advisable to continue monitoring menstruation dates.

Pregnancy

The results obtained on “day 14” indicate whether or not implantation of one of the transferred embryos has occurred. As this is an extremely early pregnancy, it is still too early to confirm the existence of an evolutive pregnancy.

In some cases, the pregnancy is monitored during the first two weeks by conducing successive blood tests to monitor ßhCG hormone levels.

If the progression is favourable, an ultrasound is conducted to confirm the pregnancy and this also shows if it is a single or multiple pregnancy. It is not always possible to observe the foetal heart beat in the first ultrasound so it is often necessary to repeat this after a few days.

Multiple pregnancies are more common with IVF (20%) than with natural conception (1-2%). This is because in some cases more than one embryo is transferred, but the actual probability of having triplets is very low. In some cases, the first ultrasound may show the presence of more than one yolk sac which subsequently does not develop. Its viability is determined by successive ultrasounds which your doctor will indicate when these are to be conducted.

No special treatment is necessary for pregnancies resulting from IVF treatment. Instructions given by the doctor managing the pregnancy should be followed.

As in the case of natural conception, miscarriages, ectopic pregnancies and malformations may occur with IVF and these should be duly diagnosed and treated.

  • The rate of IVF miscarriage is around 15%, with incipient miscarriages being more frequent than those at advanced stage.
  • The risk of ectopic pregnancy (extrauterine) with IVF is 1%. An ectopic pregnancy can only be confirmed via ultrasound and when detected, the gynaecologist should be contacted immediately.
  • The possibility of malformation with an IVF pregnancy is the same as that with natural conception. Normally, if an embryo is a carrier of some chromosome abnormality, this is rapidly detected even before implantation. Some embryos may be implanted but may not survive past the third month, and less than 1% would reach full-term, resulting in the birth of a child with some abnormality. This is the same as with spontaneous reproduction.

If you wish to have a prenatal diagnosis (chorion biopsy, amniocentesis) to rule out any concerns you may have in this respect or you are in a risk group (family history or advanced age), inform your doctor. These tests are conducted between week 9 and 16 of pregnancy.

Birth

To calculate the due date, a normal pregnancy is considered as 40 weeks from date of last menstrual period.

In IVF patients, the theoretic date of the last period is taken as 14 days before the follicular puncture.

The type of birth (vaginal or caesarean) shall be decided by the doctor depending on the nature of each case.

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