First Pregnancy Scan after IVF Treatment

Tests are conducted to confirm pregnancy after IVF and also for Egg Donation. The first ultrasound in which one can see the pregnancy is something all parents look forward to very emotionally. This is more so for those, who have gone through treatments for assisted reproduction. For such patients, after having a positive pregnancy test done, their anxiety does not go away but also gets stronger until the pregnancy is observed as developing normally. It is essential to know what happens during such exploration and also what to expect.

When is it done?

It usually needs to be done between weeks 5 and 7 of pregnancy, and therefore between 3 and 5 weeks after the embryo transfer. To calculate one’s pregnancy after IVF treatment, a set of last menstrual period date 14 days before egg retrieval is taken into consideration.

The scanning is done exactly one month after the embryo transfer to observe whether the pregnancy is progressing or not.

How is it done?

The ultrasound must also be done vaginally. This does show the images more clearly, and it is also more precise in showing that everything is evolving rather correctly. The ultrasound does not negatively affect pregnancy.

Why is it important to do an ultrasound in the 6th or 7th week?

• One can confirm that the pregnancy is in the uterus, and one can rule out an ectopic pregnancy that is found outside one’s uterus.
• One can see if it is a single or even multiple pregnancy.
• It does allow one to evaluate whether or not the pregnancy evolution is as it should have been. If it is not evolving that entirely then one can find out the reason for it.

What will we see in the scan?

In the first scan after IVF carried out in week 6 or 7 of pregnancy one can observe the following structures:

Gestational Sac. This is observed foremost. It is a dark image, which is surrounded by a halo and is found within the uterus, in the endometrium. One can observe this growth during ovarian stimulation. The average size of it at week 6 is around 14mm, but this also varies greatly as the sacs are much smaller and also much bigger and are not considered abnormal.

Yolk Sac. This is indeed a vestigial structure that is seen at the start of embryonic development. It’s round and white in shape and resembles the follicles during the stimulation. It also measures around 3-4mm, and if it is larger than 6mm it is also considered a poor prognosis.

Heartbeat. It tends to appear around week 6. The heart rate at this time is also between 90 and 110 beats per minute, and will also increase in the coming weeks.

Embryo. The cell mass consists of the embryo’s organs. It is rather a structure attached to the yolk sac. In week 6 sometimes it is not yet seen, as its size is between 2-8mm and thus varies greatly, and will also grow very quickly around 1mm daily.

Is the pregnancy is lost if structures not seen?

We must be cautious in interpreting the ultrasound findings at this time since there are several factors that can lead to an incorrect diagnosis:

1. The variations in normal embryo development. Even though it is very early on in the pregnancy, there are many variations in the appearance of ultrasound findings. Therefore any diagnosis must be confirmed a few days later.

2. Differences in the quality of the image depend on the patient. Every patient is different, and their tissues pass the ultrasounds waves in different ways. Images can be unclear if the transmission is not good.

3. The variations in normal embryo development. Even though it is very early on in the pregnancy, there are many variations in the appearance of ultrasound findings. Therefore any diagnosis must be confirmed a few days later.

4. Differences in the quality of the image depend on the patient. Every patient is different, and their tissues pass the ultrasounds waves in different ways. Images can be unclear if the transmission is not good.

5. Placement of uterus and location of the gestational sac. Depending on the distance between the ultrasound probe and the gestational sac, the image can be more or less clear. This can mean that the diagnosis is inconclusive.