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Early Pregnancy, especially after ART

You may not be sure yet, you might be in the middle of the two week wait or you may have just gotten your first faint pink line. Maybe it's your first beta and you're not sure what to make of it, not sure what the next step is...

If you're in the middle of the 2 week wait, you might want to read one (or both) of these:

If you've just gotten your first faint pink line, you might be confused if:

  • You previously got hormonal injections containing hCG (human chorionic gonadotropin) and are not sure the hCG from the injection is already out of your system
  • You are feeling symptoms that you are getting your period
  • You're not quite sure if a faint pink line means positive or not

 

If you were given one or more injections containing hCG (e.g., Profasi, Novarel, or Pregnyl) you can get a false positive on a pregnancy test if you wait less than 14 days. It is possible to test in order to determine when the hCG is out of your system. A positive result obtained after two consecutive negative results, using early morning urine, will usually indicate that new hCG is being produced.

Symptoms of the impending arrival of the famous 'Aunt Flow' (AF, as it is called in infertility circles, or - in everyday terms - your period) don't necessarily mean that that's in fact what's going on. Bloating and light cramping are very common in early pregnancy. If you've just gotten a faint pink line, stop panicking :-) whether you feel cramping, nausea or nothing at all, it's likely that everything is just fine.

Does a faint pink line mean positive? Actually - unless you have hCG in your body from another source - yes. It doesn't say anything about the chances of a live birth, whether you're having multiples, how far along you are, etc., but it does mean that hCG is being produced.

hCG, unfortunately, will also be produced in a chemical pregnancy. A chemical pregnancy is when there is no longer a live embryo - there was one to begin with, but it stopped developing before it would have been visible on ultrasound. Usually such pregnancies are picked up early either by non-doubling beta tests (beta = beta hCG, the 'pregnancy hormone') or by an early ultrasound that does not show a gestational sac. This ultrasound can be performed as early as 2 weeks after your missed period. Frequently, even before the first ultrasound, a woman with a chemical pregnancy will experience bleeding.

Additional Topics of interest:

Pregnancy
Early Pregnancy
Getting Pregnant
Fertility Problems
Infertility Resources

If you've just had your first beta and are wondering what to make of the results, it depends on how many days you are past ovulation or past embryo transfer.

A result of 30 at 11dpo (days past ovulation) can be fine, whereas the same result at 16dp3dt (days past 3 day transfer) is probably too low and therefore not encouraging.

In either case, the more important factor is whether the beta doubles after 2-3 days. This gets complicated when more than one embryo was transferred, in which case, even a non-doubling beta can still yield a perfectly normal pregnancy, since one beta can be on the rise, while another (of an embryo that originally implanted and stopped developing) is falling.

If you did not go through any fertility treatements and took a quantitative beta test to confirm your pregnancy, a result within normal range will not necessarily be followed up by a subsequent test.

It's an exciting and confusing time. It's common to worry that the pregnancy won't work out, to be afraid to 'jinx it' somehow, to be troubled by previous miscarriages and even to be confused as to whether the pregnancy is something you really want -- even if you've been trying for a long time.

What do I do next?

Call to make an appointment with your ObGyn. An early pregnancy needs to be confirmed by your doctor and it's important for you to get good care as soon as possible.

Should I start telling people I'm pregnant?

A good choice is probably to tell your partner first and then discuss what you want to do. Some couples start telling people the day of the positive test, others choose not to share the news until after the first ultrasound. Some wait until the end of the first trimester, until they're showing, or until after they get the results of their amniocentesis.

Are there any reasons not to tell?

By telling people, you're not 'jinxing' the pregnancy or making it any more likely for something to go wrong. On the other hand, you may feel that you are building up expectations and that if something does go wrong that you are letting people down. For this reason, some choose to keep it low key at first, telling only people who they feel particularly close to.

What else should I know?

Pregnancy involves incredible changes to your body, your relationship with your spouse and your lifestyle. It brings on a whole new set of things to worry about - am I gaining enough weight? can everyone see I'm showing? did that drink I had before I found out harm the baby? am I going to get really moody? can we afford a baby? can I take that cold medicine? am I going to lose my job? how can I get my father to stop smoking when I'm in the room? will I start vomiting on the subway during my commute? will I be able to finish the things I need to do? - just to name a few...

During most of the first half of the pregnancy, it's common to be concerned with whether the fetus is still alive. Each ultrasound brings with it the fear of what might appear (or not appear) on the screen. It's only once you start feeling the baby kick (often only after 18, 19 or even 22 weeks) that you have a little reassurance that everything's OK.

Disclaimer: The information on this page is provided for informational purposes only and is not intened to be medical advice. If you have any questions, make sure to consult with your physician.

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Common questions & simple answers:

Q - I just found out I'm pregnant and I don't have any symptoms. Does that mean something's wrong?
A - No. It's really common not to notice any change in the first few weeks. Definitely follow up your positive test with a doctor's visit, but don't worry about not feeling morning sickness.

Q - How early can I tell if it's a girl or a boy?
A - It depends how you're planning to find out. PGD (preimplantation genetic diagnosis) can test embryos (resulting from IVF) before they're ever in your uterus. CVS (chorionic villi sampling) is performed in the early weeks of pregnancy. Ultrasound can show the gender with some level of certainty at around 14-16 weeks. Amniocentesis is usually performed between the 17th and 20th week of pregnancy. (Of all of these methods, ultrasound carries the fewest risks.)

Q - I'm nauseous all day long. Does that mean something's wrong?
A - No. Actually it happens to a lot of women. Morning sickness can easily be 'all day sickness'.

Q - I can't put a thing in my mouth. Is this going to harm the baby?
A - It is very important to make sure you drink and eat enough to keep yourself healthy. If you're having trouble eating, consult your doctor.

Q - I have terrible heartburn. Is it safe to take an antacid?
A - Many doctors allow their pregnant patients to take antacids such as Tums. Check with your doctor to make sure it's OK and how often s/he recommends taking them.

Q - I just found out I'm pregnant. Do I have to give up coffee?
A - Significant research has been done on the safety of coffee in pregnancy. The results I have read show that moderat consumption (1 or 2 cups of coffee a day) are safe. (see this abstract, for example.)

Q - I just found out I'm pregnant. Is it OK for me to have a few drinks to celebrate?
A - Alcohol is linked to poor birth outcomes and long-term developmental problems. In addition, there's no known safe amount. To be on the safe side, many doctors recommend you steer clear of alcohol completely.

Q - What about a smoke now and then?
A - Being pregnant means being responsible for a whole new human being who has his or her who's whole life is ahead of him or her. Do your baby a favor by giving him or her the best chance to be healthy. If you do smoke, find out about the effects of smoking on unborn babies. Find support to stop smoking. Your child will thank you someday.

Q - I'm pregnant - is it safe to get the H1N1 vaccine against swine flu?

A - the NHS (UK National Health Service) website (see exact text here) states that both types of vaccines (Pandemrix and Celvapan) are licensed for use in pregnant women. "Licensed vaccines, including influenza vaccines, are held to a very high standard of safety and would not be licensed if they were unsafe."

They go on to say that "the seasonal flu vaccine has been given to millions of pregnant women at all stages of pregnancy and has an excellent safety record, with no reported safety concerns. This is why in the UK, and many other countries, vaccination against seasonal flu is recommended for pregnant women, whatever the stage of the pregnancy."

Research conducted by Jamieson et.al (2009) and funded by the US CDC (Center for Disease Control) has shown that "pregnant women might be at increased risk for complications from pandemic H1N1 virus infection". Additionally, pregnant women seem to be at increased risk of contracting the virus.


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