Congratulations!

Your blood test results indicate that you are Pregnant.

You should be taking Folic Acid as part of your Pre Natal Work Up and should continue to take this up to 12 weeks of pregnancy. For the dosage to be taken, please ring your doctor’s rooms. Iron supplements may be required. Please ring your doctor for his direct instructions on this issue.

Progesterone pessaries or crinone gel are sometimes used to restore/maintain progesterone levels during early pregnancy. Progesterone is most important to keep the endometrium (the lining on the uterus) lush to sustain the foetus.

Progesterone levels can be most unstable during the first 12 weeks of any pregnancy, until the placenta is fully formed and functioning. Therefore some patients may need to take pessaries until this time. Blood tests will be taken at regular intervals to monitor these levels and alter doses of progesterone pessaries or crinone gel as necessary.

The use of progesterone pessaries or crinone gel in pregnancy has not been associated with any increased risk of foetal malformations.

Your first Antenatal Ultrasound to verify a foetal sac in the uterus with a heartbeat is usually done at 6–7 weeks, from the last Day 1 of your period. (For those ladies on IVF the weeks of pregnancy are counted from the day of your pick up plus two weeks). Please contact your doctor’s rooms at approximately 4–5 weeks to book this ultrasound. The Canberra Fertility Centre does service pregnancy ultrasounds on Fridays.

A further scan and blood for Neuchal Fold translucency is arranged for approximately 12 weeks gestation. Your GP is able to arrange this. Antenatal visits with your delivering doctor usually begin at 12 to 14 weeks of pregnancy. Please book this appointment with your doctor when pregnancy has been confirmed.

If you would like an obstetrician for delivery, please book in as soon as possible.

PREGNANCY—“TIME OF GREAT TRANSITION”
Problems in early Pregnancy

If you experience any of the symptoms listed below, please advise your doctor’s rooms:

Abdominal Pain or Severe Cramping;

Fever or Chills, Persistent Vomiting; and

Painful Urination Vaginal Bleeding*
(*bleeding does not always indicate problems)

Early changes in Pregnancy
Listed below are common changes that you may experience in early pregnancy. Occasionally light bleeding or spotting will occur at the time of the expected menstrual period, but it is not a typical menstrual flow. This should be reported to your doctor.

Frequent Symptoms

• Breast enlargement and tenderness;

• Nausea (at any time of the day or night) and vomiting;

• Frequent urination;

• Fatigue;

• Increased vaginal discharge;

• Headaches; and

• Mild cramping.

These symptoms will usually resolve after the first 12-14 weeks (first trimester).

Effects of Fertility Treatment on Pregnancy
Babies conceived with the aid of fertility drugs do not have an increased risk of birth defects. There is no greater chance of developmental delays that have been observed in children conceived with fertility drugs.

The normal rate of birth defect is 2–3% in any pregnancy.

Miscarriage
Approximately 15% of all pregnancies end in miscarriage. This incidence increases with maternal age. A pregnancy conceived with medical help is monitored closely and miscarriage can be recognised/avoided earlier than in naturally conceived pregnancies. Most miscarriages occur due to a random problem with the embryo.

Recurrent Miscarriage Factors

• Abnormalities in shape of uterus;

• Chromosomal abnormalities;

• Untreated hormonal disorders;

• Maternal age greater than 35 years;

• Immunological factors;

• Smoking; and

• Inadequate diet, especially green vegetables.

Multiple Pregnancy
Multiple pregnancies occur more commonly in pregnancies conceived with the use of fertility medications and procedures. A multiple birth (pregnancy) is often seen as a blessing to many couples although medically they are at a higher risk of premature birth. Early diagnosis of multiple births is essential to anticipate potential problems and reduce the risk. Doctors may monitor these pregnancies more closely and restrict activities during this time.

Ovarian Hyperstimulation Syndrome
For those women experiencing OHSS after a stimulated oocyte pick up cycle, embryo transfer and subsequent early pregnancy diagnosis, the syndrome will have no effect on the developing foetus. The side effects experienced are bloating, nausea and vomiting, and malaise. It is usually treated with rest, analgesics, and fluids and generally subsides in early pregnancy.

Do’s and Don’ts in Pregnancy

• Eat a well balanced diet. A healthy diet is essential;

• Pregnant women should not try to lose weight during the pregnancy;

• Alcohol, smoking, medications, and recreational drugs have potential risks to the developing foetus;

• Alcohol—disabilities and physical malformations in the foetus;

• Smoking—Foetal death, premature delivery, learning disorders in child, growth retardation;

• Ask your doctor before commencing any medication as to its possible effects on your baby;

• Activity should be continued during your pregnancy as long as these activities are appropriate for pregnant women, walking and swimming are excellent forms of daily excercise;

• Don’t attempt to increase your level of fitness during pregnancy;

• Consult your doctor about commencing any exercise program;

• Do travel during your pregnancy, but avoid travelling too long in a sitting position. This cramps the blood flow to the uterus and may form clots in the legs. It is best to walk around every 2 hours;

• Don’t travel within 2 weeks of your due date—see your doctor if travelling is essential;

• Check with your doctor, but it is usually safe to have sexual intercourse during pregnancy. There is no evidence that intercourse or orgasm is harmful to the foetus; and

• Don’t have sexual intercourse if it is painful or uncomfortable. Speak to your doctor over these concerns.

Physiological Adjustment
Pregnancy is a great event, especially after experiencing infertility problems. Infertile couples often feel the need to be extra careful to assure the safety of the pregnancy. These are concerns that may be related to couples experiencing “the transition from a ‘defective’ function into a ‘normal’ function (pregnancy)”. These feelings may persist throughout pregnancy. It is normal to react to the news of a positive pregnancy test with a little fear as well as excitement.

It is normal for all pregnant women to have mixed feelings about their pregnancy. It is also okay to complain about nausea, fatigue, etc. The reality of pregnancy may be very different from what was expected. Please voice these concerns to your doctor or the Nurse Cordinator at the unit. When to share the news of pregnancy is a very personal decision and each couple will know the right time for them to share their special news with family, friends and co-workers.

SUMMARY
The transition from infertility treatment to pregnancy can be exciting but difficult. Women should get plenty of rest, exercise, eat healthily and follow their doctor’s advice.

We at the Canberra Fertility Centre wish you all the very best in your pregnancy, and hope to hear from you of your progress.