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You're Pregnant: Transitioning Care from Fertility Doctor to OB-GYN
For women who are pregnant from infertility treatment, it is difficult to imagine that in just a few short weeks, you will be released from your fertility doctor’s care, back into the stirrups at your regular OB-GYN’s office. To some, this milestone brings a sigh of relief, but to others, it can evoke feelings of anxiety.
What to Expect After Your BFP (Positive Pregnancy Test)
After infertility treatment, you will be scheduled for a blood pregnancy test, known as a beta hCG, at approximately 12-14 days past ovulation. In the case of in vitro fertilization (IVF), the blood test is administered 12-14 days after egg retrieval. Your fertility clinic will repeat your blood test one or two more times to ensure your hCG is rising appropriately and that your progesterone and other hormone levels are appropriate for sustaining a pregnancy.
Between 5-7 weeks’ gestation, you will return to your fertility clinic for an ultrasound. This scan will verify the pregnancy is viable, look for heartbeat, and check for multiple fetuses.
Between 7-10 weeks’ gestation, your fertility doctor will release you from his or her care to your OB-GYN. During this time frame, the placenta begins to take over production of progesterone, and your risk of miscarriage drops. After a heartbeat is seen on ultrasound, the chance of miscarriage decreases as follows:
- At 6 weeks to 16%
- Between 7-9 weeks to 5%
- After 11 weeks to 1%.
How to Prepare for Transition of Care
Once your final ultrasound is completed, your fertility doctor will inform you that it is time to contact your OB-GYN to transition your care. Questions to help you prepare for the transition include:
- When should I schedule my first OB-GYN appointment?
- In the event of bleeding or other complications, should I contact my fertility doctor or my OB-GYN?
- Will my records be sent to my OB-GYN?
Should I See a High Risk or Maternal Fetal Medicine Doctor?
If you are pregnant with a multiple gestation of twins or more, you may consider seeing a high risk OB-GYN or Maternal Fetal Medicine (MFM) doctor. Similarly, if you are of advanced maternal age (above the age of 35) or experiencing pregnancy complications, you should see a high risk or MFM doctor.