The first ultrasound after IVF

IVF can be an exciting and nerve-wracking process, particularly while you’re waiting for the first ultrasound. The excitement of waiting to see a growing pregnancy after the protracted treatment process is both hopeful and inquisitive. This is a turning point in many people’s lives, bringing comfort and a first look at a fresh start.

Usually, the first ultrasound following IVF is planned for the sixth or seventh week of pregnancy. Confirming the procedure’s success and making sure everything is going according to plan require this early scan. Additionally, parents might learn at this time how many embryos have implanted, particularly in situations where several embryos were transferred.

Though much anticipated, this appointment may also raise a lot of concerns and feelings. It can reduce some of the anxiety and increase the enjoyment of the scan if you know what to expect during it.

Why do an ultrasound after transfer?

Strangely, a completely paradoxical situation arises with the first ultrasound following the IVF protocol: the much anticipated and fought-for pregnancy proves to be so significant for a woman that, should it be successfully developing in her body, she fears having the ultrasound to avoid harming the unborn child. A woman who has been battling infertility for a number of years may occasionally be forced to visit the ultrasound diagnostics office without any arguments.

There is no reason to be afraid of ultrasound scanning because it is a completely certain that the ultrasonic waves, which form the basis of the ultrasonic machine’s operation, do not have any adverse effects on the fetus. It is crucial to have the first ultrasound following the IVF procedure. In the event that multiple embryos were transferred, it is also done to determine the number of implanted embryos in addition to confirming that pregnancy has indeed occurred.

It is crucial to identify a twin pregnancy as soon as possible because it calls for a slightly different obstetric strategy.

In general, a woman who became pregnant through in vitro fertilization has to get used to the fact that she will need to visit the ultrasound more frequently than a woman who became pregnant naturally. Due to the increased risk of miscarriage, frozen pregnancy, premature birth, and pathology of placenta formation, pregnancies following IVF require closer monitoring.

A blood test for hCG is used to determine pregnancy following IVF; this is trustworthy proof of the pregnancy’s occurrence. It can be carried out 12–14 days following the transfer of the embryo. The dynamics of the rise in hCG concentration and its growth, while indicative of the development of pregnancy, are not comprehensive enough to capture all its aspects. This can only be carried out in light of the ultrasound’s findings.

It is advised that the first ultrasound following in vitro fertilization (IVF) be performed on day 21 of the delayed period, or one week after the start of the delay. For diagnostic purposes, the age of three gestational weeks is crucial. It confirms the existence of a pregnancy following successful IVF, determines the number of fetuses within the uterus and their individual viability, and aids in evaluating the state of the ovaries following the hormonal stimulation required by the protocol, thereby ruling out the chance of an early miscarriage.

Furthermore, it is possible to determine whether a woman has an ectopic pregnancy complication by performing an ultrasound scan on her 21st day of pregnancy.

An ultrasound of the pelvic organs should be done around the same time as an unsuccessful IVF cycle in order to help identify the reason for the failure and design a new IVF protocol.

What it shows?

It is theoretically possible to perform an ultrasound earlier than 21 days following embryo transfer, but the reality is that it will be nearly impossible to see a microscopic embryo, even with the most advanced technology. The doctor can only measure the size of the yolk sac, which serves as the developing baby’s primary food storage, the thickness of the uterine endometrium, and the location and size of the fertilized egg attachment by the end of the third week of pregnancy.

The heartbeat can be recorded if the initial ultrasound is performed a little later, specifically between the 21st and 28th day following transfer (at 5–6 obstetric weeks). It is crucial to diagnose multiple pregnancies as soon as possible.

As the 28th day post-transfer approaches, the embryo’s coccygeal-parietal size, or CTE, is measured. This is the distance that varies when the embryo reaches its maximum extension from the coccyx to the crown. This stage usually has 3-6 mm. The parameter’s compliance with the norm suggests that the embryo is receiving enough oxygen and nutrients, and that its growth rate is suitable.

The size of the embryos after IVF can vary greatly because implantation takes place at various times. In one woman, the transferred embryo is placed in the uterus’s functional layer on day three; in another, it isn’t placed there until day seven. Consequently, it is necessary to compare the dynamics of the growth of hCG—a hormone secreted by the chorionic villi following implantation—with the ultrasound data. The growth of hCG should be greater if there are two fetuses.

It goes without saying that the earlier-implanted embryo will be somewhat bigger than the later-implanted embryo. Five-five embryos are implanted with a higher success rate than three-day embryos, according to statistics.

The baby’s heart beats at a frequency of 80–85 beats per minute at the start of the sixth obstetric week, which occurs 22–24 days after the transfer. Normally, the baby’s heart rate ranges from 103 to 123 beats per minute on the 28th and 29th day following the transfer.

The likelihood of a threatened miscarriage is assessed by the doctor during the first ultrasound by looking for signs of an elevated tone in the uterine muscles and a closed cervical canal.

How it goes?

There are two methods for performing the first ultrasound scan following the embryo transfer: using a transvaginal sensor or placing the sensor on the anterior abdominal wall. The choice of method is made by the doctor. The best method is transvaginal scanning, which gives you the most accurate assessment of the fetal egg’s attachment site, the cervix’s health, the ovaries’ size and structure, the uterus’s dimensions, and whether there are any potential signs of a spontaneous pregnancy termination threat.

When a woman has a lot of belly fat and is overweight, transvaginal examination often yields more accurate results because it makes the transabdominal method of examination more difficult to visualize. Occasionally, a combined examination is required, in which case two sensors will be used alternately to conduct the examination.

It’s much simpler than you might think to get ready for an ultrasound. Online advice suggesting visiting the doctor empty-handed is utterly ridiculous. Neither eating nor having sex the day before an ultrasound examination reduces its informativeness.

However, you should still avoid soda and legumes when eating cabbage to prevent the production of more gas in the intestines. Gases can cause intestinal loops to swell and press against the uterus, which can make diagnosis more challenging. Consequently, it is advised to take "Smecta" or "Simethicone" a few hours prior to seeing a doctor.

Can I have a drink before my ultrasound? This is a typical query. Before a transabdominal ultrasound, you should only drink about half a liter of water to ensure that your bladder is full and can better transmit ultrasound waves. It is actually advisable to empty your bladder and bowels before a transvaginal ultrasound rather than drinking anything before the procedure.

It is not advisable to press your physician for a Doppler ultrasound or to have your first ultrasound performed in 3D or 4D. These tests can be done later because they are not thought to be informative in the early stages and because neither you nor your doctor will notice a significant difference between a standard two-dimensional ultrasound and the most recent 4D technology.

It takes roughly thirty minutes to complete the procedure. A woman receives her results right away following the examination. Following the ultrasound, the attending obstetrician-gynecologist can make recommendations based on anamnesis and other examinations.

For parents, the first ultrasound following in vitro fertilization (IVF) is an emotional and significant milestone because it verifies whether the embryo has implanted successfully and whether the pregnancy is developing as planned. This scan, which is typically carried out between 6 and 8 weeks, offers the first look at the unborn child and can identify vital information like the presence of a heartbeat. In addition to providing doctors with useful information to help guide the next steps in the pregnancy, it helps reassure parents.

Features

The additional ultrasound diagnostics of the mammary glands are one of the unique characteristics of the first ultrasonography following the transfer. This is done to determine whether the woman has any issues or neoplasms in her breasts, as well as to evaluate how well she tolerated hormonal stimulation of the ovaries. The majority of breast tumors are hormone-dependent and can grow when stimulated by hormones.

There is no need for a mammary gland ultrasound if a woman is able to conceive naturally, without the use of hormone stimulation, and transfers a fertilized egg during the implantation window.

Other than that, an ultrasound scan following IVF is essentially the same as a comparable confirmatory diagnostic procedure following a naturally occurring pregnancy.

When is the next examination?

In order to determine the gestational age and development rate of the fetus (or fetuses), it is frequently necessary to repeat the ultrasound examination following the initial one, which is performed on the 21st to 28th day following the transfer of embryos. Women are invited to a follow-up procedure in two to three weeks in this instance.

In the event that the first-second ultrasound reveals no pathology, it is advised that a woman undergo the following tests within a generally accepted time frame:

• at 12-13 weeks (as part of the first prenatal screening);
• at 19-21 weeks (as part of the second prenatal screening);
• at 30-32 weeks (as part of the final screening, which summarizes the results of the first two);
• before childbirth (to choose the tactics of delivery and determine the accuracy of the expected day of birth).

Ultrasonography can be recommended for multiple pregnancies not just during the specified times but also in between. When and how often to perform the examination during a given pregnancy is decided by the doctor.

A significant turning point for any couple is their first ultrasound following IVF. This is the point at which perseverance, hard work, and hope begin to feel more tangible. Even though there are still steps left in the journey, relief and excitement are brought on by hearing the heartbeat or seeing the first images.

Important details regarding the pregnancy, such as the number of embryos and their development, as well as the mother’s general health, are provided by this scan. It also gives doctors peace of mind that the IVF procedure was successful by enabling them to ensure that everything is going according to plan.

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