Pregnancy management after IVF

IVF was a success – the long-awaited pregnancy came. Congratulations!

But it’s too early to relax, and this long stage should take place under medical supervision. We will talk with a gynecologist in more detail about the management of pregnancy after in vitro fertilization.

Stages of pregnancy after IVF

After artificial insemination, the development of pregnancy proceeds in the same way as with natural conception (1). Pregnancy includes three stages – trimesters. The last trimester ends with childbirth.

In the first trimester, the process of formation of the main organs of the baby takes place, the heartbeat begins to be heard on the ultrasound. The mother may experience discharge mixed with blood, which is usually the norm, but may also indicate a pathological process. Therefore, it is important to start monitoring with a doctor as soon as possible.

In the second trimester, the fetus takes on a characteristic shape. During this period, the doctor prescribes many studies and tests to establish the condition of the fetus and exclude serious pathologies.

Towards the end of pregnancy, a new risk arises: early placental abruption, through which oxygen and nutrients are exchanged between mother and child. This can cause oxygen starvation, hypoxia in the baby. Doctors carefully monitor the state of the placenta to prevent harmful effects on the baby’s brain. Uterine contractions may also begin, which will be an indication for hospitalization for observation and treatment in a maternity hospital.

Examinations and analyzes

Before the IVF procedure, couples (both women and men) undergo a thorough examination, pass many different tests. But even after a positive pregnancy test, research does not stop. Most of the laboratory research will be duplicated. This is necessary to prevent complications and control the course of pregnancy.

An impressive list of mandatory tests and examinations awaits any expectant mother. Throughout the 40 weeks, a woman periodically retakes all tests: a general blood and urine test, smears on the vaginal flora and others, and also visits highly specialized specialists to monitor her health (2).

The reasons for resorting to the IVF procedure may require additional examinations. Much attention is paid to the coagulogram – the study of the blood coagulation system. This analysis is important, because in preparation for IVF, women take a large number of hormonal drugs. They increase the risk of blood clotting.

After the IVF procedure, a blood test is performed for hCG, a hormone whose concentration increases with successful embryo transfer. The analysis is prescribed a couple of weeks after the procedure to confirm the fact of pregnancy.

After another 3-4 weeks, an ultrasound scan will find out the number of embryos that have taken root in the uterus and exclude an ectopic pregnancy. Then the study is carried out to understand that the pregnancy is developing correctly.

Closer to 12 weeks of pregnancy, the first screening is carried out to assess the development of the child, to determine the risk of genetic diseases. It includes a blood test for PAPP-A and hCG proteins and fetal ultrasound.

At a period of 20 weeks, a second screening is planned, an ultrasound examination (ultrasound), which excludes malformations of the baby.

At the 30th week and a little later, a study of the vessels of the fetus and blood circulation in the placenta is prescribed – dopplerometry. The heart of the embryo is also observed using the method of cardiotocography and ultrasound.

By the end of the term, after the 37th week, the woman is hospitalized for a planned natural birth or preparation for a planned caesarean section.

Features of pregnancy management after IVF

The child develops in the same way, regardless of whether the pregnancy occurred naturally or as a result of IVF.

But the risk during pregnancy as a result of artificial insemination, unfortunately, is higher. One of the main reasons is the female body, initially weakened by unsuccessful attempts at pregnancy and various diseases. Indeed, the IVF procedure is most often resorted to with serious pathologies in the future mother. If the underlying problem was the man’s health, the risk may be lower.

Also, after IVF, multiple pregnancy is possible, since several embryos are implanted into the uterus to increase the likelihood of success of a complex procedure. If the ultrasound showed that there are too many embryos, an excessive load on the woman’s body is possible. With multiple pregnancies, one of the babies may receive less nutrients and oxygen.

Why is it important to be under medical supervision?

It is difficult for a pregnant woman to independently assess how a child develops. Especially until she feels the fetal movement. Therefore, to understand whether the pregnancy is developing correctly, whether there is a tone – a state when the muscles of the uterus are tense, can only be assessed by a doctor upon examination. Careful monitoring of a pregnant woman after an IVF procedure minimizes the risk of preterm labor.

Medical supervision is carried out to reduce the risk of miscarriage, early diagnosis of developmental abnormalities, prevention of infection after the procedure, etc.

If necessary, hormonal support is prescribed for a successful pregnancy. With multiple pregnancies, doctors develop tactics for carrying several babies at the same time.

Possible risks of pregnancy after IVF

The main risk after IVF is miscarriage, premature birth. Failures after IVF procedure occur for a number of reasons. The age of the patient, health pathologies, hormonal effects before the procedure, decreased immunity and psychological stress that women experience before IVF can cause early termination of pregnancy.

Multiple pregnancies are not uncommon during IVF, while the load on the woman’s body increases, and all embryos may lack nutrients.

Popular questions and answers

There are many prejudices and myths associated with IVF. Answers popular questions from patients obstetrician-gynecologist Lekareva Tatiana.

Sources of

1. Podzolkova N. M., Skvortsova M. Yu., Prilutskaya S. G. / Pregnancy after IVF: risk factors for obstetric complications. reproduction problems. // 2020
2. Features of pregnancy management after IVF / N. A. Makhalova, A. V. Novoseltseva // 2006