Once the pregnancy test is positive, the post embryo transfer medications are usually continued for another 2 weeks.
A pregnancy scan is then done by radiologist at 6 to 7 weeks i.e after 2 to 3 weeks of positive pregnancy test to confirm the location and no. of pregnancies. In most cases cardiac activity can be seen by this time. In next few weeks of pregnancy till the completion of three months medical support is continued.
The continuation of IVF pregnancy is a spontaneous natural event, neither the pregnant lady nor the doctor can do much apart from waiting and watching to see how the pregnancy is progressing. Sometimes spotting or bleeding can occur. This may be part of the healthy developing pregnancy or it can also indicate miscarriage or very rarely pregnancy in the tubes.
As three months of pregnancy are over, we are more reassured that things will proceed smoothly. Medical support of pregnancy is carried on. Routine antenatal visits including ultrasounds are recommended like any other pregnancy.
The decision for the route of delivery depends on the status of the mouth of the womb (cervix), usg findings at term pregnancy and other factors like: previous caesarean section if any. Normal vaginal delivery can be recommended to women carrying IVF pregnancies. However, the threshold of alarm is high as it is a precious pregnancy and obstetricians do not hesitate to perform a caesarean section if necessary.
There are occasions when after the positive pregnancy test, multiple pregnancy is detected in the ultrasound done two weeks later. This happens in about 20% of the cases, where 15 to 18 % are twins and 2% are triplets or quadruplets. It is usually recommended to reduce triplets to twins (by fetal medicine specialist) as chances of preterm delivery in them is as high as 30%. Twins are allowed to continue. Cervical cerclage (stitch around the cervix) is recommended in these cases to avoid premature delivery.