You might think that natural pregnancy and pregnancy through IVF would be the same, but there are a few differences to be aware of. If you have been naturally pregnant before, you might think that you know exactly what to expect. But there are some extra precautions, considerations, and doctor visits that you will need to prepare for if you are conceiving through IVF.
For the most part the symptoms of pregnancy are the same, regardless of how it began. However, women that go through IVF might be more in tune or notice their symptoms more than that of a natural pregnancy.
This could be due to the medication they are taking, or the sheer fact that they know they are pregnant a lot sooner than most natural pregnancies. Because they are aware of their pregnancy from the very beginning it can feel as if they have been pregnant even longer, as most natural pregnancies do not know until they are one or two months along.
A common worry that women who do a fresh embryo transfer may have is that of ovarian hyper-stimulation syndrome (OHSS) occurring. This is an uncommon condition that can occur from an excess amount of egg production. If you believe this is happening to you, make sure to speak with your doctor as soon as possible.
Natural Pregnancy and Doctor Visits
When you become pregnant naturally your first prenatal visit is usually between ten to 12 weeks pregnant. You will usually find out that you are pregnant by an at home pregnancy test or if you go to your OB and request a blood test.
- Once a month from 10 to 28 weeks
- Once every two weeks from 28 to 36 weeks
- Every week from 36 to 41 weeks
IVF Pregnancy and Doctor Visits
When conceiving through IVF you will be monitored closely by your fertility doctor throughout your whole first trimester. You will be taking daily medications such as estrogen and progesterone injections to help maintain your pregnancy throughout this trimester. Most women are able to stop these medications after your 12th week of pregnancy.
For example you will likely have the following appointments during your first trimester
- Transfer Date – This is where your embryo will be transferred for implantation.
- Beta Testing –These are blood tests done within ten to 14 days of your transfer to check your estrogen and hCG levels to confirm pregnancy.
- Two weeks later, an ultrasound will be done to confirm the number of embryos, health, and the viability of the pregnancy
- Around eight or nine weeks pregnant, there will be another ultrasound to check on the pregnancy and then “graduate” from your fertility clinic
- At 11 weeks along, you will have your first appointment with your OB/GYN or midwife. Your doctor may recommend a genetic screening test for Down’s Syndrome or other related conditions, even if you have had your embryos previously tested.
- At 18 to 20 weeks, you will have an ultrasound to review the baby’s anatomy (the same one they do during a natural pregnancy). This ultrasound may also include checking the baby’s heart as some IVF pregnancies are at a slight increase of risk for abnormalities physically
- If your pregnancy is a healthy pregnancy than you will continue to see your doctor for the same amount of appointments as a natural pregnancy
If doctors find a fetal abnormality, your doctor will likely have you see a maternal fetal medicine or pediatric specialist.
If you are having twins or multiples you will also have extra appointments for ultrasounds during your second and third trimester to watch for normal growth and well being of the babies.
What is a Maternal Fetal Medicine Doctor?
If complications or irregularities are found during your pregnancy, you will likely be referred to a maternal fetal medicine doctor. They specialize in high-risk pregnancies that threaten the health or life of the mother or her fetus. It is common for some women that are pregnant via IVF to be referred to a MFM as a high-risk pregnancy to monitor the growth of the baby even if the pregnancy is completely healthy.
Are there Different Risks?
Regardless of a natural or IVF pregnancy, there are always potential risks for complications. IVF pregnancies may be at an increased risk for some of these conditions.
Some of the complications that might occur are:
- Fetal Growth Restriction: IVF pregnancies from a fresh embryo transfer are at a higher risk for growth restriction. This will usually mean that you will have extra ultrasounds to monitor the baby’s size and well being. This is also the case for moms that are above the age of 35.
- Gestational Diabetes: For IVF pregnancies, if infertility is due to PCOS or obesity should receive an early screening for diabetes. Regardless of your early screening result, all women will be tested by their 28th week of pregnancy. For many women working on their diet and exercise can help to maintain their blood sugar levels throughout pregnancy.
- Preeclampsia: Women who do a fresh embryo transfer may be at a higher risk for developing this condition. If you have an advanced maternal age, obesity, or polycystic ovary syndrome your risk is higher. Your doctor may wish to have you take baby aspirin throughout your first trimester to help lower this risk.
The Risk of Multiples with IVF
If you are pregnant with multiples you will require special care. This is more common to occur with IVF pregnancies, however happens naturally as well. The odds increase with IVF because many women have more than one embryo implanted to help increase the chance of getting pregnant. A study showed that about 11.5 percent of IVF pregnancies resulted in multiples for women under the age of 35.
Carrying twins or triplets is usually considered a high risk pregnancy as it does increase the chance of premature labor and low birth weight.
Babies that are born through IVF have a slightly higher chance of birth defects. The rate is about one to two percent higher. These birth defects are usually due to the nature of the mother’s infertility and age, rather than the IVF process itself.
A few other possible complications or concerns would be:
- Delivery Concerns: If you have had surgery to your uterus or have uterine factor infertility you will need to discuss your delivery options with your doctor. Women who have had surgeries such as a large fibroid removal, may need to schedule a c-section to avoid going into labor.
- Placenta Previa: This is a condition where the placenta sits over the cervix. Most cases will go away on their own. Women who have had surgery or scarring within their uterus can have problems when it comes time to deliver the placenta. Their placenta should be examined carefully throughout the pregnancy to help detect any issues. IVF pregnancies are more at risk for this condition. If the placenta does not move on its own you will likely be required to have a c-section.
Many of the risks that you have to worry about for an IVF pregnancy are the same for a natural pregnancy. The major differences are the slight risk increase that can come with IVF pregnancies, as well as the increase of doctor visits.