You've been waiting for this for so long and at last your pregnancy test after IVF is positive. Now what happens? Well, in spite of the fact that you might want to shout the good news from a rooftop, it is probably best to be cautiously optimistic for now. A positive pregnancy test is just one step in the IVF process. You've cleared another hurdle, but there are still a few more to go.
A pregnancy test measures the amount of hCG (human chorionic gonadotropin) in your blood. This is a hormone that is secreted when you are pregnant. Many patients ask what is a “good” number to have on a first pregnancy test after IVF, and they want to know what their hCG level means. Any level greater than 5 is considered positive, but there's no magic number. What is most important is that the level continues to increase. That is why we check it again in 2-3 days. As a general rule, we are expecting the amount of hCG to nearly double about every 48 hours. If that does not occur, your doctor will likely repeat the blood test in 2 days to check it again.
Sometimes, if the hCG level may not rise appropriately. This may or may not be a problem. Some pregnancies may start as a twin, but only one of the embryos may continue to progress. In this case, after what seems to be an abnormal rise in the hCG levels, subsequent levels go up steadily.
If serial hCG levels do not rise appropriately, this could be an indication of an early miscarriage (“chemical pregnancy”). This means that the embryo implanted and started to grow, but then stopped developing very early, so the only sign of pregnancy is the hCG level – the chemical.
If the level of hCG does rise appropriately, we will have you return in one week. At this time, we will check both the hCG level and perform your first OB ultrasound. You will be approximately 5 weeks pregnant, and your hCG level is usually about 1,000. We are generally able to visualize one or more gestational sacs in the uterus which further confirms that your pregnancy is progressing well.
If your hCG level is rising, but there is no gestational sac visible in the uterus then your doctor would be concerned about a possible ectopic pregnancy. This occurs when the embryo implants in a place other than the uterus (usually a fallopian tube), and it would not be a viable pregnancy. The chance of this happening, however, is only about 2%.
If there is a gestational sac seen in the uterus, then you will return the following week for another ultrasound. At this time, we are usually able to detect the heartbeat of the fetus. What a glorious sound! The ultrasound tech will also measure the size of the fetus so that it can be compared to measurements in subsequent ultrasounds. All of this helps assure you that your pregnancy is progressing normally.
So once you have a positive pregnancy test, remember the road to parenthood is not a sprint, but rather a 9 month marathon until you cross the finish line and hold your precious baby for the very first time!
Janet Chiaramonte joined the staff of Invia Fertility as a registered nurse in 2005. Years ago (too many to count), she received her Bachelor's Degree in Psychology, and then worked for a decade at Children's Memorial Hospital in an administrative position. She always wanted to be part of the patient care side of medicine though, so she went back to school and received an Associate's Degree in Nursing.