From Fear to Confidence: When Pregnancy Becomes Safer

The moment you see a positive pregnancy test, excitement kicks in—but so does fear. Every cramp, every symptom (or lack of symptoms) can send you spiraling into anxiety. And for those who’ve battled infertility, that fear is even more intense. But when does the risk of miscarriage truly drop? When can you finally breathe easier and enjoy your pregnancy?

In this episode of Taco Bout Fertility Tuesday, we break down the numbers, the milestones, and the science behind when pregnancy becomes safer. Whether you're newly pregnant, supporting a loved one, or just want to understand the stats, this episode will give you the facts—and maybe even some peace of mind.

🎧 Tune in now and find out when you can go from fear to confidence in pregnancy!

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

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Today we talk about when can you finally stop holding your breath and start enjoying your pregnancy? I'm, Dr. Mark Amols and this is Taco about Fertility Tuesday. The moment you see a positive pregnancy test, the excitement kicks in, but so does the worry. Every cramp, every symptom or lack of symptoms can send you down a rabbit hole of anxiety. But for those who struggle with infertility, that fear is amplified. Unlike someone who conceives naturally or might be comfortable waiting until 12 weeks to Seeno us. fertility patients have been through too much to wait. We track every milestone, we analyze every detail. We wonder if this pregnancy will finally be the one. But the truth is, miscarage risks change week by week, and at certain milestones, those risk drop significantly. So when can you finally let your guard down? Well, lets break it down today, step by step. They early weeks. The early weeks of pregnancy, which is between weeks three and four, are the highest risk. The odds of miscarriage at this time is about one in four pregnancies will end in the miscarriage. That's 25%. Now, most of these are due to chromosomal abnormalies and often go unnoticed, such as a late period or maybe a little bit of a heavier period. These are usually marked by a heavy period with cramping, and that may indicate a loss. The takeaway is it is too early to let your guard down at this point. But early losses are usually not preventable either, because they are usually due to chromosomal problems. The first signs of hope, when you see that gestational sac between weeks five and six, your miscargeage rate now drops down to 20% or less. It's only one in five pregnancies. And in the miscarriage, if you listen to last week's episode, we talked about blighted ovums. So at this point, you want to make sure you see a gestational sac with a yolk sack within it. Seeing a gestational sac on ultrasound is a good sign. And if you're one of the lucky ones to see, an early heartbeat, where there's a flicker, the CH there's even better that the miscuagege rate will go down. As with the early portion of pregnancy, light spotting is very common, but heavy bleeding could be a concern. If that occurs, please make sure you reach out to your doctor. Overall, at this stage, there's some reassurance, but it's still a delicate phase. The heartbeat milestone. At this point, you're about six to seven weeks and the odds of a miscarriage are about one in 20. That means 5% or less are going to have a miscarriage once the heartbeat is detected. This is truly one of the first major turning points. The majority of pregnancies will continue successfully from this point. Now, while the fear is normal, the data does show that making it here is a great sign and the chances are things will go well. Now, it doesn't mean everyone will up having success, but Overall, statistically only 1 out of 20 people will end up having a miscarriage once hitting a heartbeat at six to seven weeks. One interesting fact is that if you see a heartbeat by eight weeks, at that point most of the organogenesis has occurred and now your miscarriage risk is equal to those who went through PGTA, which is essentially less than 5%. When you have PGTA, your chances are always less than 5% of having a miscarriage. So for those who did not have PGT testing, once you hit that eight week mark and see a heartbeat, you are at the same risk of a miscarriage as everyone else who did pgta. The end of the first trimester, this phase is somewhere between 8 weeks and 13 weeks. The actual end of the first trimester is at 12 weeks. The chances of miscarriage now are less than 1 in 25, which means less than 4% chance of a miscarriage. At this point. The placenta has started taking over, which further reduced the risk of a miscarriage. Even subcort heorrhages now, which are usually small, are tiny compared to the size of the placenta which reduce the risk of, miscarriage at this point. This is a common point where a lot of people will announce that they are pregnant because again, less than 4% are going to have a miscarriage. Now if youre a fertility patient, you probably are still scared and for good reason. Youve worked so hard to get to this point and so its not unusual for fertility patients to hold back from sharing the news at this point and usually like the wait until the NAMI scan at 20 weeks. However, if you made this far, the odds are very much in your favor and it s not unreasonable to let people know the happiness that ah, you have just obtained through your successful fertility treatment. The second trimester. The second trimester is between weeks 14 and 20 and this is essentially the safe zone. The odds of a miscarriage are less than 1 in 100, meaning less than 1% if you made it to this point. Take a deep breath and relax. Now, in no way am I saying that something can't happen. I'JUST saying the chances are so Low at this point. This is why we usually call this the safe zone. But as a fertility patient, until that baby is in your arm, it may never feel safe. But from a medical speaking standpoint, you can truly let your guard down. Now, this phase is also sometimes called the honeymoon phase in pregnancy because this is when all your energy starts to return and nausea usually reduces. The other best part is you usually undergo your anatomy scan where you're able to be told everything's looking really good. 24 weeks and beyond. For people who have got pregnant naturally, 20 weeks is in their mind, the safe zone. And that is because most of them end up going on to have success. Like we talked about, less than 1%. But for fertility patients, 24 weeks is really the one that we look at. The reason we like to look at that is that is almost the first time that the baby can survive outside of the womb. Yes, you will read about fetal viability sometimes at ah, 23 weeks. But most of that data is usually based off of the fact that the baby may have incorrect dates and really was closer to 24 weeks. And so if you're looking at a measurement, say, well, where will the baby have, viability in general? Think 24 weeks. Now, I dont want to confuse this in any way. It doesnt mean that 24 weeks that the baby will survive, it just means it has hit the point of viability where there is a chance. And you are looking at around a 50 to 60% chance of survival with intensive medical care if the baby can make it to 24 weeks. So where a discussion is going to go now is after 24 weeks it's not about miscarriages anymore, but, more about the risk during pregnancy, such as preterm labor or preecclampsia that can lead to the baby being born early. And what are the risks of that. So as I mentioned, at 24 weeks the neonatal mortality rate is going to be higher. And this is because every baby is slightly different when it comes to their lung maturity and how well they're going to do. To give you the an idea of the difference between advanced age and early preterm age, at 22 weeks, about 76.5% of fetuses will pass away, whereas at 36 weeks, 0.2% will. I remember with my wife many times I would say, I just hope we can make it to 24 weeks, because in my mind there was the first point that my child could survive outside the womb. But the real number I would say was 28. And I knew that because at that point, almost 95% of babies born by 28 weeks are going to be fine. Now, when I say fine, I'm saying may not have mortality. They may still have some morbidity that leads to complications, just like mortality. As the fetus gets further along, there is less chance of morbidity, such as things like cerebral palsy, respir distress syndrome and infections. But the reason why my wife and I wanted to get to at least 28 weeks is if you have twins and they're identical, that is the point where if there is twin, twin transfusion, the babies can usually survive even if it develops, if it develops that late. Whereas, if it's earlier, it can cause some great concern. By 30 weeks, the mortality rate is less than 1%. And by 31 weeks it's 0.3%. As you get further along, everything goes down. By 36 weeks, 0.2%. And by 37 weeks there's only about 1.1 mortalities per thousand live births. At this point, it's no longer about the baby not surviving, but usually a complication that can occur. I wish I could tell you this is the rule and that there is never the exception to these roles, but that is not true. Matter of fact, I'had patients who have made it all the way the term and unfortunately had a cord accident where the baby cut off its own blood supply from twisting around too much. I've had babies who had been born, but then following afterwards, something happened. There are many people who make it to 20 weeks and then can lose, their baby at 22 weeks. This podcast is not being done to tell you it's safe. It's just trying to give you a statistical idea of if you can breathe a little bit better. There is never a point you're going to feel comfortable when you have to go through fertility. My daughters are now 18 years old and I get scared every time they want to go to a party by themselves. I'm not going to pretend when they were born that I was'a helicopter parent watching to make sure everything is okay because I work so hard to get them that my fear of losing them is probably unhealthy. It's unfortunate that miscarriages happen. Its unfortunate that some babies are born premature. It'unfortunate m that sometimes there are fetal deaths. I hope this never happens to you. But I also hope that you now can at least take a deep breath and sigh to know that you may be past a point of great concern and that statistically speaking, chances are everything. Should go. Fine. Maybe some of you already knew these statistics. Maybe you weren't worried, but maybe you have a friend who doesn't know these statistics. Maybe they think that their miscarriage risk is 25% at eight weeks. And what's interesting is that even if you have had recurrent miscares, technically the rates not as high as many people think. And so if you have a friend who thinks this or has a friend who might be newly pregnant and is worried about these things, let her know about this episode. It might be able to relieve some of her fears. More important than my podcast is to talk to your doctor. Sometimes your situation might be slightly different and so its'always good to talk to your doctor who can really give you your specific wr. As always, I greatly appreciate everyone who listen to this podcast and I really appreciate everyone tell everyone about it. If you like us, give us a five star review on your favorite medium and tell all your friends about us. I look forward to talking you again next week on Talk About Fertility Tuesday.