Congratulations! You’ve graduated. You’re likely beaming with joy while at the same time trying to keep negative, worrisome thoughts in check. Am I right?

I hope I’m wrong, but if you’re like so many of the fertility patients I see, then you may be hyper-aware of your body, emotions and sensitive to the what-ifs of pregnancy post your IVF treatment.

Now you’re pregnant, and yes, you may have dreamed of this moment for quite some time. But it’s okay not to love every second of being pregnant

You are not alone! And you do not have to manage these feelings by yourself or with the help of Google. In fact, please make a pact with me right now that you’ll do your best to avoid Google. Instead, save yourself the heartache and talk to me, your OBGYN or read articles from trusted sources like this blog if you can’t have a conversation with a doctor. I also recommend that patients seek out help from a mental health professional if needed. Get all of the help and support you need during and after pregnancy, and especially during this first trimester!

Not Feeling Overjoyed: It’s OK!

Get all of the help and support you need during and after pregnancy, and especially during this first trimester!

I want to get real for a moment. Despite the joy that comes with pregnancy, it’s okay not to love every second of it, especially if you’ve experienced infertility or miscarriages in the past. Now you’re pregnant, and yes, you may have dreamed of this moment for quite some time. You may have even invested years and a lot of financial and emotional resources, but it’s okay not to love every second of being pregnant.

You may feel tired, your body may ache, and you may feel awful. Or you may feel amazing too! I don’t want to paint a stark picture of pregnancy, but I also want to give you a reality check and a figurative hall pass to not love it, even if you’re in love with the result.

Now let’s get down to the clinical aspects of what you can expect in early pregnancy after IVF.

Fewer Visits to the Doctors, but You’re Not Alone

As a fertility patient, you’re used to being seen multiple times, even 5–6 times in a two week period! Once you’re pregnant, things change and you’re not going to have the closely monitored support you once did. It can feel a bit like you’ve left a supportive nest and are on your own in the wild.
Know that you’re not on your own. The type of care you’re going to receive will change, but it won’t be going away. You can always reach out to me or your OB-GYN, but to calm your nerves right now, here are some early symptoms you may experience that are entirely normal.

Typical Early Pregnancy Symptoms

The physical symptoms you experience may remind you of your period coming. They include:

Low back pain
Pelvic pain
Spotting or pink tinged blood

The Tests Will Continue. Here’s What to Expect

1. A test to confirm that your HCG level post transfer are above 15

It’s rare for your doctor to say you’re officially pregnant if your HCG levels are under 15. You and your fertility doctor (and OBGYN) will watch these levels closely, in the beginning, to know that you’re moving in the right direction.
I like to see a doubling of the HCG level every two days. However, if it doesn’t double, it doesn’t necessarily spell trouble. Fifteen percent of healthy pregnancies don’t have a doubling rate every 48 hours.

Even if your levels haven’t doubled, don’t panic. Repeat the test 2–3 days later, and then repeat it another few days later to monitor.

2. An ultrasound will confirm your embryo has implanted in your uterus.

For my patients, 2.5 weeks after their positive pregnancy test I bring them in for an ultrasound to confirm implantation. Within the first 14 weeks, I’ll also do an ultrasound to confirm a heartbeat. This is a moment for celebration.

Transfering to Your OBGYN

You’ll transfer from your fertility doctor to your OB-GYN after ten weeks of pregnancy or sooner. It’s typically the week when you stop taking your hormones shots. Talk to your fertility doctor about when they’d like for you to graduate from their care.

Still More Tests

Even if you’ve done genetic testing to confirm that the pregnancy is genetically healthy, you can expect a few more tests in the first trimester that will establish the health of your fetus and placenta.

1.Noninvasive Prenatal Test (NIPT) 
This test measures cell-free DNA in your blood that provides a screening tool for the most common chromosomal disorders: Down syndrome, Edwards syndrome, and Patau syndrome.

2. A single gene disorder test
This test that tells you if the pregnancy is affected by very rare disorders like RETT syndrome.

3. A Quad Screen

This test helps to identify one particular hormone, called PAPP-A, that I like to see in my patients as a sign of placental health.

2nd Trimester: Your Baby’s Health

Once you get to the second trimester, you’ll do more tests to reassure you about baby’s health.

1. An Anatomy Scan

This test looks at your baby’s fingers and toes and the ventricles of the heart and brain.

2. A alpha-fetoprotein (AFP) blood test

This test is to confirm that the baby does not have a neural tube defect like Spina Bifida.

While this is not a conclusive list of the tests you’ll be doing in pregnancy, it should give you an idea.

It’s important to think of you and your OBGYN as a team and to work together to ensure you and your baby are healthy

It’s important to think of you and your OBGYN as a team and to work together to ensure you and your baby are healthy. Understand that your tests could look different from someone else’s?—?another instance of why personalized fertility care is essential to expect from your doctor.

Expect for specific routine measures of your health at every doctor’s appointment. He or she will check your weight, blood pressure, urine protein and urine glucose checks throughout your pregnancy.

The 3rd and 4th Trimester

Remember that there are two other trimesters. The third trimester is when everyone starts asking you if you have your crib ready yet? If you have the stroller yet? Is the baby’s room ready yet? I always like to remind people, to prevent overwhelm syndrome, to keep it simple. All you really need in the beginning is a boob, a diaper and a onesie! And, of course, a lot of love!

When it comes to the 4th trimester, that’s postpartum. It’s a time that we really want to make sure that your mental health is well taken care of. Feeling depressed is not uncommon, especially after a fertility journey. Make sure that you’re talking to your OB-GYN and you’re talking to a therapist, so that you can get the help that you need as you transition from the 3rd to 4th trimester.

I know all too well the ups and down of pregnancy because I go through it with my patients every day, so I hope you know that you’re not alone if you’re feeling anxious after a fertility journey.

Anytime you have a question make sure you’re getting them answered by your doctor?—?not Google.

If you find yourself pregnant and worried then talking with your doctor is always the best option to discuss your fears or concerns. If you can’t get in touch with them or want additional support then, please reach out. I mean it!

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