Assisted reproductive technology (ART) pregnancies carry their own set of medical concerns.
More Intense First-Trimester Medical Care
While the average mom- to-be doesn't undergo her first ultrasound until 12 weeks, followed by a second (and often final) scan at 20 weeks, an ART patient often sees her baby's heart beating at six weeks (four weeks after conception).
Weekly ultrasounds usually continue until week 10, when a patient is released to her OB-GYN—a graduation often met with reluctance. "They feel uneasy about the comparatively laid-back nature of an obstetrical practice," says John C. Jarrett II, M.D., co-author of The Fertility Guide: A Couples Handbook for When You Want to Have a Baby (More Than Anything Else) (Health Press). "But by the time their fertility doctor has released them, we're very confident they'll have a successful pregnancy," he says.
Thirty percent of all women experience bleeding during the first half of pregnancy, but Jarrett says at least 60 percent of his patients spot in their first trimesters. "The hormones used to stimulate egg production thicken the uterine lining, making spotting more likely," he explains.
Nearly half of ART pregnancies are twins or higher order multiples, and these are associated with several complications including gestational diabetes and preterm labor. More IVF patients are opting to only transfer one embryo in an effort to reduce the likelihood of twins, and a 2011 study found no significant difference in pregnancy rates.
Lower Birth Weight
While miscarriage rates are similar for natural and ART pregnancies (15 percent to 20 percent, usually during the first seven weeks of pregnancy), the risk of obstetrical complications jumps for ART pregnancies. According to the Centers for Disease Control and Prevention, 14 percent of ART singletons and 65 percent of ART twins are born preterm; 9 percent and 57 percent, respectively, have low birth weights. However, Jarrett attributes such elevated risks to genetic predisposition rather than to the treatments themselves.