When to take a pregnancy test after ivf transfer

Pregnancy Test

The detection of a pregnancy hormone called, Beta-hCG is only possible after successful embryo transfer. This hormone is very significant in pregnancy tests and can tell us about the pregnancy result. It is why doctors recommend doing a blood pregnancy test to confirm the pregnancy.

You should not go for a urine pregnancy test before two weeks of embryo transfer because the hCG level varies at the time of pregnancy. It remains constant in the initial stage, but it decreases in case of miscarriage.

What Do We Measure in Pregnancy Tests

During a pregnancy test, doctors measure beta-human chorionic gonadotropin hormone. This hormone comes from the trophectoderm cells of the embryo. After the implantation, its production increases and becomes noticeable.

Implantation occurs after three to eight days of the embryo transfer procedure. It indicates the presence of the production of hCG in your bloodstream in a detectable account. The amount of HCG increases with the progress of the pregnancy. After ten days of ovulation, 25 mIU hCG is present in an average woman, but it becomes 50 mIU after 12 days and doubles again after two weeks. This measurement varies from one woman to another woman.

Blood Pregnancy Test and Home pregnancy test

One can do a blood test for hCG to confirm the pregnancy. When you visit a doctor for this test, they can monitor and measure the presence of hCG in the blood. It is more appropriate, reliable and sensitive than a home pregnancy test.

Also, people can measure hCG level with a home pregnancy test or urine test, as well. The sensitivity varies from one to another pregnancy test. The home pregnancy test is sensitive to 100 mIU, and it cannot detect if one’s level is 75 mIU. You may not get the accurate result until you test it after some days of embryo implantation. Repeat the test if your test result comes negative.

So, if you do a home pregnancy test in the initial stages, it can show you an inappropriate result. Your excitement for testing is understandable, but you have to wait for it.

HCG Test vs Ultrasound

The people who face several IVF failures, it is hard for them to believe that they are finally pregnant even after seeing the positive result. In some cases, a low level of hCG can occur in normal pregnancies, and they also deliver normal and healthy babies. You can opt for doing an ultrasound rather than testing the hCG level to test the pregnancy. To confirm the yolk presence and gestational sac, they will perform an ultrasound scan after two weeks.

So, in cases where an HCG test doesn’t confirm a pregnancy, an ultrasound scan can.

The Right Time For a Pregnancy Test

Many people wonder why they cannot test hCG after one week of embryo transfer. It is because it doesn’t make any sense. A doctor can detect a healthy pregnancy at the right time when it starts producing the hCG hormone. Results of any test made before two weeks of embryo transfer will be similar to the one given by your doctor before 36 hours of egg collection. Doctors perform repeated blood tests for HCG after 48 to 72 hours.

The increasing level of hCG indicates a healthy pregnancy, but if it is not happening like that, this can be a non-workable pregnancy. If the person is bleeding, she also needs to do the test because bleeding can occur in a pregnant woman, too. If you experience spotting or bleeding, you need not worry.

After your embryo transfer, we give you a pregnancy test kit and explain how to use it. You need to take the test 16 days after your egg collection. We tell you the date at your embryo transfer.

It is important to take a pregnancy test 16 days after your egg collection, even if you bleed before this time. Some people who bleed after a cycle could have an ectopic pregnancy. This is when a fertilised egg attaches (implants) itself outside of the womb. It cannot develop into a baby and your health may be at risk if the pregnancy continues. This is an uncommon but serious complication of IVF.

You need to email or phone the assisted conception unit (ACU) to give us the result of your pregnancy test.

Please do not take the pregnancy test earlier than the date that we give you. We know that this wait can be difficult. However, the trigger injection that you had before egg collection can stay in your blood stream for 8 to 10 days. It can make the test positive, even if you are not pregnant.

A positive pregnancy test

A positive result means that 1 or more embryos have attached to the lining of your womb (implanted). We cannot see this on a scan until you are about 6 weeks' pregnant (4 weeks after embryo transfer).

Scan when you are 7 weeks' pregnant

We usually arrange for you to have a scan when you are about 7 weeks' pregnant. This allows us to check the baby’s heartbeat.

Sadly, we sometimes diagnose miscarriages. This happens to about 10% (1 in 10) to 20% (1 in 5) of people. The risk depends on your age and other factors.

We also diagnose ectopic pregnancies at this stage when the embryo attaches itself outside the womb. This happens to about 1% (1 in 100) to 3% (3 in 100) of people. Unfortunately, it is not possible to save ectopic pregnancies.

Our fertility counsellors can give you emotional support.

Antenatal care

If we confirm that you have an ongoing pregnancy, we write to your GP. They arrange antenatal care at your local hospital.

Read about antenatal care at Guy's and St Thomas'.

You must keep taking the hormone progesterone until you are 8 weeks' pregnant.

Unfortunately, a small number of pregnancies can still result in a miscarriage, even if early scans are encouraging.

Please tell us if you have any of these symptoms after a positive pregnancy test and before your first scan:

• heavy bleeding
• brown spotting (discharge)
• sharp tummy (abdominal) pain, particularly if on one side
• shoulder pain
• feeling faint

We can then arrange for our medical team to review you.

A negative pregnancy test

A negative result sadly means that the treatment has not been successful.

It's impossible to see exactly what happens to the embryos when we have transferred them to your womb. In most cases, it's likely that the embryos stop dividing. They then do not reach the right stage of development to be able to attach to the womb. Embryos are less likely to attach if they are not of the best quality. 

You might already have started bleeding but, if not, your period will come in the next few days. This might be heavier than normal because of the medicines that you have taken. They make the lining of the womb thicker than usual.

We know that this can be a disappointing time. It is important that you phone or email us with your result and speak to one of the nurses.

We offer you an appointment to see a senior doctor within 4 to 6 weeks. You can then talk about the cycle and possible treatment options for the future.

You might also find it helpful to see one of our fertility counsellors. 

Please stop taking progesterone if you have a negative pregnancy test.

Trying IVF again

We recommend that you wait at least 2 months before you try IVF again. This is so you can have a break from treatment and give yourself time to recover. Your body also needs a chance to recover from the medicine.

If you have frozen embryos, we usually recommend using these before trying another fresh embryo transfer.

Read about frozen embryo transfer.

Number of attempts

We do not have a set limit for the number of attempts that you can have. After each unsuccessful cycle, we offer you an appointment with a senior member of the team. We talk about the reasons why your cycle may have failed and how we may be able to improve your chances of success.

We assess you individually and give you advice about the likely success of more cycles. If we feel your chances of success are very low, we will be honest with you and may recommend that you stop treatment.

Some clinical commissioning groups (CCGs) only pay for 1 cycle of treatment. You might have to pay for any more attempts yourself. Most people need more than 1 embryo transfer to achieve a live birth.

Extra treatment for your next cycle

You might need extra treatment for your next cycle. For example, some people have non-cancerous growths called fibroids in the womb. Some people's fallopian tubes, which connect the ovaries to the womb, are swollen and contain fluid. We might recommend surgery to remove the fibroids or fallopian tubes before your next IVF or ICSI cycle.

If you had problems with the thickening of the womb lining, we might add extra medicines to try and improve this in any future attempt.

You might read about treatments in the press or online that claim they can improve your chances of successful IVF. Many of these treatments have not been proven to work and may be harmful.

Our policy is only to use treatments that are shown to be effective. Please talk to our doctors if you have any questions about other treatments that you heard about somewhere else.

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