To Test or Not to Test: The Early Pregnancy Debate After IVF

Ever wondered if testing early after an IVF embryo transfer is worth the stress—or the potential answers it might bring? In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols tackles the big question many IVF patients face: to test or not to test before the official day 10 pregnancy test. We explore why clinics often discourage early testing, from the risks of false negatives and positives to the emotional toll of seeing uncertain results.

But that’s not all—we also discuss why some patients choose to test early, whether it’s to manage their expectations, share a private moment with their partner, or gain insight into their cycle’s progress. With real-life examples, expert advice, and a touch of humor, this episode will help you navigate the pros and cons of early testing and decide what’s best for you. Whether you’re in the two-week wait or just curious about the process, this episode is packed with insights to guide your journey. Don’t miss it!

Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform.

Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com.

Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com.

Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Transcript

0:01

Today we talk about testing early after IVF. Does it bring clarity or confusion? I'm Dr. Mark Amols and this is Taco about Fertility Tuesday. If you've been through ivf, then there's a very good chance that your clinic told you not to test early whenever you did an embryo transfer. But have you ever been tempted to peek at your IVF results early? Well, today we're going to talk about why some clinics say don't and why some patients just can't wait. Now, for many people I have gone through, they probably went through the same scenario as myself. When my wife and I went through IVF the first time, we were so afraid to break any rules that we absolutely did not check early. We were afraid to, we were told not to. And when you can't get pregnant and someone tells you not to do something, you listen to it because you want to be pregnant really bad. But the second time we didn't follow the rules. Now, technically I was my own doctor, so I actually didn't follow my own advice, nor did my wife, but she never listens to me anyway. So it kind of makes sense why she cheated. But the point was, is that when I was going through the second time, my fears were a little bit different. I was already blessed and had my daughters and so I wasn't too afraid if the test came back low or high or negative. Now don't get me wrong, that 10 day wait is unbearable. I mean, everything that you've been working towards, everything that you've ever wanted, you now have to wait 10 days for. I struggled waiting 24 hours to hear the results of American Idol. I wish I could have cheated that night if found the result. So waiting 10 days, yeah, that was tough. But the question comes up then, why do clinics tell you not to test early? From a standpoint of if it's going to hurt your chances, the aner is absolutely not. There is absolutely no danger in testing early. You cannot hurt anything by testing early. But there are some risk of the test not being perfect. The accuracy of an early urine pregnancy test is very good, but not when its done extremely early. There are the chances of false positives and the chances of false negatives. For example, if you check the blood work on day four, you will see that there's just a slight bit of hcg. Most of the time it will even be negative on blood work. So if you do the urine pregnancy test on day four, it's definitely going to be negative. Well, the same thing can be true on day five or day Six, because if you don't have a test that has high sensitivity, the urine pregnancy test can be negative. And you could think you weren't pregnant. And then that could cause harm, not just from the emotional aspect, but then if you decide that, let's say, stop your progesterone, you could then end the pregnancy because you stopped it too soon, not realizing that you just didn't see the results yet because your test can't see it that early. So if there is one thing that you will hear through the theme of this is always go for your pregnancy Test on day 10 when the clinic wants you to have it, regardless what you think. Because sometimes test can be wrong. This reminds me of two separate situations. The first one was a friend of mine and she at, home tested and it was negative. And I believe she tested on like day six or seven. And so when she came in on day 10, she's like, well, I know it didn't work. And I said, well, listen, let's just check. Those tests aren't perfect. And she was already convinced there's no way it worked. And lo, behold, she was pregnant. The number was actually pretty decent. It was close to 50. And she ended up going on and things went fine. So here's a situation where she just happened to have a test that wasn't that good, told her was negative, and it actually wasn't. And I can tell you that the HCG should have been there by then. So there was just something wrong with her test, or somehow something went wrong. On the other token, I had the patient who actually had a blood test, and this was done through labcor, and it came back negative. And so I called the patient, let her know, I'm so sorry this came back negative. She said, that's so strange because my urine pregnancy test are positive. But as you can imagine, I was extremely confused. And lo and behold, we had LabCorp run it again, and it was their test that was wrong. So this is why it's so important to make sure that, you end up having that final test. So that way, in case something's wrong with the urine test, the blood bone will show it. But as you see, there was also a benefit by her doing the urine test because we would have told her to stop everything and she would have. But before we get into some of the positives, let's still talk about some of the negatives. One of the main reasons why Clins don't want to detest early is because it's not really an absolute value. It's a quantitative result that tells you there is HCG there, but it doesn't tell you that the number is appropriate and that the pregnancy is doing well. And so, as you can imagine, you find out it's positive, you're completely excited, and then you come in on day 10, you find out the number is as good as you thought it was. That rollercoaster of emotion is exhausting. Even just seeing early pregnancy tests and watching the strip get a little bit darker, maybe a little bit lighter, now you start worrying about the pregnancy. It creates an emotional roller coaster that is extremely difficult. And so I do agree that on, that first IVF transfer, it may not be a great test to do because IVF is already stressful enough. Now you have to take the stress of wondering, did it work, did it not work? Or you're doing something wrong. The other situation, why they tell you not to test too early is because it depends on whether you did a frozen embryo transfer or whether you did a fresh embryo transfer or even a modified natural frozen embryo transfer. If you did a modified natural frozen embryo transfer or a fresh embryo transfer where you had an 8 CG trigger, it is possible that you could be picking up the HCG from the triger shot. And so now you think you're pregnant when in reality you're not. So in summary, if you are doing a frozen embryo transfer, then any ECG found is likely from a pregnancy. If you have a modified natural frozen embryo transfer or a natural embryo transfer after a fresh cycle, then you have to be careful that you're going to get a false positive and you shouldn't test earlier than day nine or ten. So then why do people test early? Well, for a lot of reasons, you know, you may feel compelled because you have curiosity or hope, or maybe even you just want to set expectations because you don't want to have to wait for the phone call telling if're pregnant or not that you want to know ahead of time. Maybe now you can do it with your partner being there versus being alone. There's no question that the online forums and support groups are probably going to be encouraging this because they might have done it. There's always that idea of, but what was their circumstances? Was it their first transfer or now they felt like, hey, this is only extra because now I already have a kid, or is it the first time where there's a lot writing on it? All those things may affect whether you want to test early or not. In the end, it needs to be your personal choice and something that you're okay with. If you're the type of person who feels like if you test too early and that bad news, you're going to be sadder then waiting till the end, then I tell you, don't do it. The same thing is if you're the type of person who feels like if you had the positive on the home pregnancy test and then later found out it wasn't good, that would be crushing, I wouldn't do it as well. But if you're someone who says, hey, I'm okay with this, I want to know early, I want to see it get darker, and I'm okay with knowing that this isn't the final outcome, that it could be different, then there's nothing really wrong doing it as long as it's not a fresh transfer or a modified natural cycle. Because then the HCG would be giving you false positives. And in addition, it's not all negative. Matter of fact, there are some potential benefits of early testing. As I mentioned, early you might be able to do it with your partner, whereas the other test may not come in when your partner is there. And so you want to do it together. Maybe something else is coming up and you don't want it to coincide with that. Maybe you have some other bad news and you don't want it to stack up and cause, further stress. But there's even another benefit, and that is it actually does give you some insight into the levels and patterns of the levels on how things are going. And what I mean by that is if you are seeing positive pregnancy tests early on and then your day 10 comes back zero and they tell you you're not pregnant, then you know that it did implant, that things started and then something happened. Now it's not as good as a quantitative measurement where you can draw your bloods on day five, seven, nine, ten, stuff like that. There you can actually see the absolute numbers and can even get more details. But maybe your clinic doesn't do that. And so if they don't do the early ACG testing, then you can do the home printanc test at home. And that can give you some insight. If it ends up being very low level where you see just a faint line the whole time and it never goes up and goes back down, that may be an implantation issue and that struggled the whole time. If it's a very faint line and goes to day 10 and that number is low and keeps going up, but it's still very low, that could be something like a NEXTC topic. If the levels looking really good and it's getting darker and darker and all of a sudden the next day it's lighter and something major could have happened that caused a caastrophic issue that caused the ACG level to drop severely, telling you that something may be developmental or some issue occurred and that's why the pregnancy was lost. The point is, it's not all bad news. There are some good things you can get from it. It's just important to remember that HCG levels might not be detectable on day five. So it's important that even if you don't see it positive, don't give up. Keep going. In the same token, don't ever stop your medications until you are directed to by your doctor. And the most important part of all this is always do the follow up HCG from your clinic. I don't care if you think you'not pregnant, always get that test because no test is perfect and there's no question that yourine pregnancy test can be off and make it a false result. In the end. There is no wrong thing to do. You can test early, you can wait and not test whatever is best for you. The only thing that is wrong is you don't want to test early if you use an ACG trigger and you also don't want to stop any medications if it's negative. You always want to make sure you get the HCG level that your clinic ordered. It's just important to do what you feel comfortable with and what you feel you can emotionally handle. I can honestly say we didnt even think for a second about testing early on our first IVF transfer, but on our second, yeah we were definitely checking early. I hope you enjoyed that podcast. I bet maybe you have thought about this once before and were scared to check early and at least now you know its not unreasonable to do just understand the emotional aspects of it and what some of the pitfalls can be. Also hope you learned some of the benefits of doing the testing early where you may be able to give you some insight in case it didn't work. As always, I greatly appreciate everyone who listens to this podcast and I always say if you can tell everyone about our podcast give us a five star review on your favorite medium. But most of all keep coming back. I look forward to talking to you again next week in 2025 on our season seven of Talk About Fertility Tuesday.