Pregnant after IVF: the early weeks and moving to NHS care

A positive test after IVF can bring huge relief and a whole new set of questions. Here’s what usually happens in the weeks that follow, and how you move from your fertility clinic to NHS maternity care.

The pregnancy test

Your clinic will give you a date to test, usually around 2 weeks after your embryo transfer, though timings vary between clinics. Most give you a urine test to do at home. Test on your date, not before. The trigger injection used before egg collection can stay in your blood for 8 to 10 days and can make a test positive when you’re not pregnant.

Still test on your date if you’ve had some bleeding, and tell your clinic the result either way.

Your early scan

If the test is positive, clinics usually offer a scan at around 7 weeks of pregnancy, about 3 weeks after the test. It checks for a heartbeat and confirms the pregnancy. A scan can’t show a pregnancy before about 6 weeks.

Until then, contact your clinic straight away if you have bleeding or one-sided tummy pain. Ectopic pregnancy, where the pregnancy grows outside the womb, may be more likely after IVF. The HFEA says never to feel you’re wasting the clinic’s time.

Keep taking your medicines

Many clinics ask you to carry on with progesterone, and sometimes other hormone medicines, for a while after a positive test. How long varies: some clinics stop it at the positive test, some continue to 7 or 8 weeks, and after a frozen embryo transfer or donor eggs some continue to 12 weeks.

Follow your own clinic’s plan. Don’t stop or change any medicine without speaking to them first, even if you have some bleeding. Keep taking folic acid and vitamin D too, as in any pregnancy (see folic acid and pregnancy vitamins).

Moving to NHS maternity care

Once your early scan confirms an ongoing pregnancy, your clinic will usually hand over your care, and some write to your GP.

You don’t need to wait for that to start your maternity care. In England you can refer yourself to NHS maternity services as soon as you know you’re pregnant, without seeing a GP, and the aim is for your first midwife appointment to be by 10 weeks. Here’s how to refer yourself to a midwife.

What to tell your midwife

At your booking appointment, tell your midwife you conceived through IVF. It helps to have to hand:

your transfer date and the age of the embryo (for example, a 5-day blastocyst)
how many embryos were transferred, and whether it was a fresh or frozen transfer
whether you used donor eggs or sperm
any medicines you’re still taking, and when your clinic said to stop

You’ll be asked about the other biological parent’s medical history too. If you used a donor, share what your clinic told you. It’s fine if you don’t know everything.

Working out your due date

After IVF, your due date can be worked out from your transfer date and the age of the embryo, rather than your last period. Your clinic will usually give you a date, or you can use our due date calculator, which has an IVF option. Tell your midwife your transfer date, and your date will be confirmed at your dating scan.

Twins

If one embryo was transferred, your chance of twins is low. If more than one was transferred, the chance of twins or triplets is higher. Carrying more than one baby has more risks for you and your babies, so you’d be offered extra scans and care. Read more about twin pregnancy.

Mixed feelings and anxiety

IVF can be emotionally draining, and that doesn’t always stop with a positive test. You might feel relief, disbelief and fear all at once, or find it hard to enjoy the pregnancy between scans. If you’ve had a loss before, the early weeks can bring that back. These feelings are understandable.

Your fertility clinic should offer you the chance to talk to a counsellor before, during and after treatment. Ask what’s available, as some clinics charge.
BICA has a directory of accredited infertility counsellors.
Tell your midwife or GP how you’re feeling. In England you can also refer yourself to NHS talking therapies.
Tommy’s midwives are on 0800 0147 800, 9am to 5pm, Monday to Friday.

When to get help

Before your early scan, call your fertility clinic first if it’s open. If you can’t reach them, or at any other time, if you have any bleeding, or tummy pain that’s severe, on one side, or not easing after resting for 30 to 60 minutes, or pain in the tip of your shoulder, contact your maternity unit or an early pregnancy unit straight away, or NHS 111 if you can’t reach them. If you haven’t seen a midwife yet, call NHS 111 or your GP surgery.

Call 999 if bleeding is heavy (soaking a pad soon after putting it on), or comes with severe tummy or shoulder pain, or with feeling sick, faint or dizzy. Also call 999 for sudden, severe tummy pain with feeling faint or dizzy, even without bleeding.

Questions people ask

When does an IVF pregnancy move to NHS care?

Usually after your early scan at around 7 weeks confirms the pregnancy. You can refer yourself to a midwife before then.

How many weeks pregnant am I after embryo transfer?

Pregnancy weeks are counted from about 2 weeks before conception. On the day of a 5-day blastocyst transfer you’re counted as 2 weeks and 5 days pregnant (2 weeks and 3 days for a 3-day embryo), so add that to the time since your transfer. Your clinic or our due date calculator can give you exact dates.

Will I have extra scans because it’s an IVF pregnancy?

Routine NHS care includes scans at around 12 weeks and 18 to 21 weeks, with extra scans if there’s a medical reason, such as twins. Ask your midwife what’s planned for you.