IVF PRIMER

Two weeks after retrieval a sensitive blood pregnancy test (quantitative hCG) is performed to determine if implantation has taken place. It is important to have the test done even if you are spotting or bleeding. If the test is negative, luteal supplementation with progesterone is stopped and a period follows within a few days. If the test is positive, it is repeated in a couple of days to determine whether there is normal growth. In cases where hCG is used during the luteal phase, a low hCG level is detected from the residual of the injection and the test has to be done twice before implantation can be confirmed. In the presence of pregnancy, progesterone is often continued unless a blood test determines that your ovaries are producing sufficient quantity of this hormone.

In some instances the first HCG test is higher than the second even in the absence of hCG injections during the luteal phase. These cases are classified as "biochemical" pregnancies, which do not progress to the clinical state. Biochemical pregnancies are not included in the calculation of the success rate in our program. If your pregnancy progresses normally, you will be scheduled for an ultrasound examination about 4 weeks after the retrieval in order to visualize the pregnancy. About 4-5% have been ectopic, i.e., in the tube. This complication usually requires either a laparoscopy to remove the ectopic pregnancy or medical treatment with methotrexate.

With intrauterine pregnancies there is still the risk of miscarriage which increases with advanced age. We usually perform a second ultrasound examination at 9-10 weeks to confirm normal development of the fetus. In the unlikely event that a high-order multi-fetal pregnancy, i.e. more than twins, is found, we discuss with you the relative benefits and risks of the multi-fetal pregnancy reduction procedure (The Dilemma of Twins).

The Keeley Family