For many couples struggling with infertility and pregnancy loss, getting a positive pregnancy test is the moment they have been waiting for – sometimes for months or even years. The goal has been achieved, but now there’s a new set of questions: When should I be seen by my doctor? How do I know the baby is healthy? What happens next?
Testing Hormone Levels
Fertility specialists tend to closely monitor patients in the early first trimester. Patients are encouraged to call the clinic as soon as they are aware of a positive home pregnancy test, so that an in-office blood test measuring the exact level of pregnancy hormone, hCG, can be performed. In cases such as in vitro fertilization (IVF), the date for this in-office test will have already been set. Other hormone levels that are essential in pregnancy, such as estradiol and progesterone, may be tested in some situations. After getting this initial baseline hCG, follow up levels are then drawn, usually at 48-hour intervals. Doctors look for patterns in the rate of rise of hCG to help determine if any early problems are likely to exist.
Following these initial blood tests, an ultrasound evaluation is generally performed at five to seven weeks of gestation. During this evaluation, doctors can assess different factors, including the number of babies present; the presence of certain markers, such as a fetal heart beat; and the exact location of the pregnancy within the uterus. Ultrasounds are oftentimes performed each week for two to three weeks to ensure that proper fetal growth and development are occurring.
At nine to ten weeks gestation, physicians may perform a blood test for maternal cell-free DNA. Through this blood test, placental DNA (identical to fetal DNA in the vast majority of cases) is analyzed. This new technology allows physicians to identify many cases of genetic abnormalities such as trisomies in a non-invasive way. Also, the chromosomes that determine the gender of the baby are examined for abnormalities, so the sex of your baby will be reported unless you choose to suppress this information.
Transitioning from Your Fertility Specialist to Your OB/GYN
After the completion of this series of ultrasounds and blood tests through nine weeks or so of gestation, there is a high degree of confidence that a pregnancy is healthy and viable. At this time, fertility specialists will often refer patients to their general OB/GYN for the remainder of their prenatal care and delivery.
While this is a happy time, it’s normal to feel anxiety as you “graduate” to the care of your OB/GYN. Because of the intense nature of fertility treatments, you often develop close relationships with the fertility team. In addition, you become used to and comforted by the frequent feedback on how your treatment is progressing. Your OB/GYN will continue to monitor you from this point forward, and you’ll be seen about every four weeks depending on your situation.
We always love to see our miracle babies at Fertility Associates of Memphis! Please keep us posted on your baby news – our Facebook page is a great place to share your pictures. For us, there is no higher calling than to help create families together. Thank you for trusting us with your care.