IVF Worked — You're Pregnant. What Happens Next?
After the appointments, medications, injections, scans, procedures and waiting, you've finally heard the words you've been hoping for:
You're pregnant.
For women and couples who have been through IVF, that positive pregnancy test can bring enormous excitement and relief. But it can also bring a completely new set of questions.
When do I leave my fertility specialist?
When should I book an obstetrician?
Will I need more scans?
Is an IVF pregnancy automatically high risk?
And perhaps the biggest question of all — what happens now?
If you've become pregnant through IVF and are starting to think about pregnancy care in Melbourne, here's what you need to know.
Is an IVF pregnancy automatically high risk?
Not necessarily.
IVF tells us how your pregnancy began. It doesn't, on its own, tell us exactly how your pregnancy will progress.
Many women who conceive through IVF go on to have straightforward pregnancies and healthy babies.
However, pregnancies conceived using assisted reproductive technology can have an increased risk of certain complications. Your individual risk also depends on other factors including your age, medical history, whether you're carrying one baby or multiples, previous pregnancy history and the reason IVF was required.
This is why I prefer to assess the woman and her pregnancy individually rather than simply attaching a label.
When do I move from my IVF specialist to an obstetrician?
This is one of the most common questions after successful IVF treatment.
Your fertility clinic will usually continue looking after you during the very early stages of pregnancy. This may include blood tests and an early ultrasound to confirm that the pregnancy is developing appropriately.
Once an ongoing pregnancy has been established, your care will generally transition from your fertility specialist to your maternity care provider.
If you are planning private obstetric care in Melbourne, it's worth contacting your chosen obstetrician early rather than waiting until you've officially finished with your IVF clinic.
You don't need to choose between the two. There will usually be a period where the transition is coordinated between your fertility specialist and obstetrician.
What happens at your first obstetric appointment after IVF?
Your first appointment gives us an opportunity to look at the whole picture — not simply the fact that IVF was used.
We'll review your medical and pregnancy history, including your fertility treatment and any relevant information about the embryo transfer.
We'll also discuss your general health, medications, previous pregnancies if applicable, genetic and prenatal screening options, upcoming ultrasounds and what you can expect over the following months.
Most importantly, it's an opportunity to ask questions.
IVF patients have often spent months or years in a very medical environment where dates, numbers, hormone levels and scan results matter enormously. Moving into routine pregnancy care can actually feel surprisingly unfamiliar.
That's completely understandable.
Will I need more scans because I had IVF?
An IVF pregnancy does warrant some particular considerations when planning antenatal care, but that doesn't mean you'll necessarily spend your entire pregnancy having additional scans.
Early ultrasound is commonly already part of your fertility treatment.
Later in pregnancy, detailed assessment of your baby's anatomy, placenta and umbilical cord is important. Depending on your individual circumstances, additional assessment of fetal growth may also be recommended later in pregnancy.
Exactly how much monitoring you need should be based on your pregnancy, rather than simply applying the same schedule to every woman who has conceived through IVF.
What about genetic screening if the embryo was already tested?
This is another excellent question.
Some IVF patients have undergone preimplantation genetic testing (PGT) before embryo transfer and understandably wonder whether prenatal screening is still necessary.
PGT and prenatal genetic screening aren't necessarily interchangeable.
Even if an embryo has undergone genetic testing, prenatal screening and diagnostic testing options should still be discussed once pregnancy is established.
Your obstetrician can explain the available options, including non-invasive prenatal testing (NIPT), ultrasound screening and, when appropriate, diagnostic tests such as chorionic villus sampling (CVS) or amniocentesis.
The important thing is understanding what each test can — and cannot — tell you so that you can make an informed decision.
Does IVF increase the chance of twins?
Fertility treatment has historically been associated with a higher rate of twin and multiple pregnancies, particularly when more than one embryo was transferred.
Modern IVF practice increasingly uses single embryo transfer, which has reduced this considerably.
If you are pregnant with twins following IVF, however, the fact that it is a multiple pregnancy becomes particularly important.
Twin pregnancies require different monitoring from singleton pregnancies, and the type of twins — particularly whether they share a placenta — helps determine how frequently they should be assessed.
As both an obstetrician and Maternal-Fetal Medicine specialist, twin and multiple pregnancy care is an area I have a particular interest in.
Will IVF affect how I give birth?
IVF itself does not automatically mean you need a caesarean section.
Your birth plan should take into account the same broader considerations we use in any pregnancy: your health, your baby's wellbeing and position, placental location, previous births or caesareans, pregnancy complications and, importantly, your own preferences.
For some women, vaginal birth will be entirely appropriate.
For others, a planned caesarean may ultimately be the safest or preferred option.
Those decisions don't need to be made when you've only just discovered you're pregnant. Birth planning is an ongoing conversation throughout pregnancy.
Why can pregnancy after IVF feel so different?
There's another part of IVF pregnancy that isn't always discussed enough.
It can be difficult to stop worrying.
When becoming pregnant has required enormous effort, time and sometimes considerable disappointment along the way, seeing a positive pregnancy test doesn't necessarily make all that anxiety disappear overnight.
Some women find themselves analysing every symptom. Others become worried before every scan or find it difficult to believe everything is progressing normally.
Having continuity of care can be particularly valuable in this situation.
One of the benefits of private obstetric care is having the same obstetrician following your pregnancy, knowing your history and being available to talk through concerns as they arise.
Pregnancy shouldn't become nine months of waiting for something to go wrong.
Do I need a Maternal-Fetal Medicine specialist after IVF?
Not every IVF pregnancy requires Maternal-Fetal Medicine care.
An MFM specialist may become particularly valuable when IVF is accompanied by other factors such as:
- Twin or multiple pregnancy
- Maternal medical conditions
- Previous significant pregnancy complications
- Concerns identified on ultrasound
- Fetal growth concerns
- Placental complications
- Other factors that make the pregnancy more complex
My training in both Obstetrics and Maternal-Fetal Medicine, together with obstetric ultrasound, means that if a pregnancy does become more complicated, specialist assessment can be incorporated into your ongoing pregnancy care.
For many women, however, their IVF pregnancy will progress normally.
And that's exactly what we hope to see.
IVF was the beginning. Now you're having a baby.
For months — and sometimes years — the focus may have been on getting pregnant.
Once IVF succeeds, something quite significant changes.
The goal is no longer a positive pregnancy test.
It's supporting you through a healthy pregnancy and safely bringing your baby into the world.
If you've recently become pregnant through IVF and are considering private obstetric care in Melbourne, you don't need to wait until you've finished with your fertility clinic to start thinking about what comes next.
You're very welcome to contact our East Melbourne rooms and speak with Team Cole about your pregnancy and when your first appointment with Dr Stephen Cole should be.
Dr Stephen Cole is a Melbourne obstetrician and Maternal-Fetal Medicine specialist providing private pregnancy care for straightforward and complex pregnancies, including IVF pregnancies, twin and multiple pregnancies and high-risk obstetric care.