Pregnancy After IVF: Progesterone, Extra Scans and Feelings

Early weeks with the fertility clinic

• Your due date is set precisely from the transfer or retrieval date, so dating scans rarely change it.
• Expect blood hCG tests and early ultrasounds to confirm the pregnancy is in the uterus and to count heartbeats.
• Many clinics continue progesterone and sometimes estrogen support until about 8-12 weeks. Follow your clinic's stop date; don't stop early on your own.
• You'll usually "graduate" to an OB, midwife or family doctor at about 8-10 weeks. It can feel like losing a safety net; ask for an early first visit if that helps.

Health differences to know about

• Most IVF pregnancies go smoothly. Some risks are modestly higher, partly from the reasons people need treatment and partly from treatment itself.
• Twins and more: much more common if more than one embryo was transferred, or with ovulation pills or injections. Twin pregnancies carry higher risks; see the twins and multiples guide.
• Preeclampsia, placenta previa, and placenta growing too deeply are more common, especially after a frozen transfer using a medicated cycle and after donor eggs.
• Slightly higher chance of preterm birth, small or large babies, and gestational diabetes.
• Ectopic pregnancy is still possible, and rarely one in the uterus plus one outside it.
• A "vanishing twin" (one sac stops growing early) is common and usually doesn't affect the other.

Extra care that's often offered

• Low-dose aspirin if you have preeclampsia risk factors; IVF itself counts as a moderate one.
• A detailed anatomy scan, and often a fetal heart scan (echocardiogram) around 22-24 weeks, since heart differences are slightly more common.
• Genetic screening is still offered even if embryos were tested before transfer (PGT). Embryo testing can miss things, so it doesn't replace prenatal screening.
• Possible growth scans in the third trimester.

Every route to parenthood

• Donor eggs, sperm or embryos: tell your prenatal team, since it affects some screening and risk estimates. Thinking ahead about how to share your child's origin story helps; see the LGBTQ+ parents guide and the adoption and foster families guide for ideas.
• Gestational surrogacy: clarify early who attends visits, who gets results, and birth plans, in line with your legal agreement.
• Single parents by choice and LGBTQ+ couples: ask your clinic about parentage steps before birth.

The emotional side

• After infertility, it's common to feel unable to relax, to expect bad news at every scan, or to feel guilty for complaining about symptoms. All normal.
• Feelings can be complicated by friends still trying, or by embryos still in storage.
• Pregnancy-after-infertility groups and therapists who know fertility care can help. See the pregnancy after loss guide if you've had losses.

When to check in

• Ask your new prenatal team about aspirin, a fetal heart scan and genetic screening at your first visit.
• Contact your clinic or provider the same day for bleeding, sharp one-sided pain, or sudden belly swelling, weight gain and shortness of breath after egg retrieval (possible ovarian hyperstimulation).
• If you faint or have severe belly or shoulder-tip pain, call 911.