At our Los Angeles based fertility center, the Center for Fertility and Gynecology, we treat patients with a variety of fertility issues including male factor, tubal factor, diminished ovarian reserve, situational infertility, unexplained infertility and others. While, each individual patient requires a unique treatment plan, all of our patients have the same goal; a healthy pregnancy. With that in mind, we will continue our discussion of what happens once a patient becomes pregnant at our center. The first part to this series can be found here.
Whether one of our patients becomes pregnant through IVF, tubal reanastamosis, IUI or any other manner, we follow standard steps to monitor the early pregnancy. Once we have established that the beta HCG (pregnancy hormone) level is rising appropriately, we schedule the first ultrasound for between 6 weeks and 6 weeks 2 days. It is important to remember that at the time of the pregnancy test, a patient is 4 weeks pregnant.
At the first ultrasound, we are looking to see 4 things:
1. Gestational sac.
The gestational sack is the structure in which the pregnancy grows. It also represents the “bag of water” that breaks when a pregnant woman’s “water breaks” near delivery
2. Yolk Sack.
Secondly, we are looking to see a structure called the yolk sac. The yolk sack is the earliest structure to form inside the gestational sac and confirms an intrauterine pregnancy. The yolk sack stops growing around 10 weeks gestation at which time it is usually no longer visable
3. Fetal heart motion.
At 6 weeks we can often see the heartbeat. It appears as a faint flicker on the ultrasound screen. The rate increases up to 170 to 190 between 9 ans 11 weeks gestation. At the initial ultrasound, the rate is usually above 100 beats per minute. Sometimes if the heartbeat is not seen at 6 weeks we see is within the next couple to 5 days. If it is not seen at that time, it may signify that the pregnancy is not progressing.
4. Fetal pole.
This is the term that describes the “baby” part of the pregnancy. At 6 weeks it looks like a cute little blob on the ultrasound screen. There is a good correlation between fetal length and gestational age. This relationship helps us to determine if the pregnancy is progressing appropriately.
If you have questions about early pregnancy or fertility, please feel free to contact us, we would be happy to speak with you.