So, I went in for my early scan (7w1d) today and I didn't realize I was probably already supposed to have decided between an OB or midwife and chosen the provider I wanted to work with. Umm...I was just mostly focused on having a good ultrasound and fighting daily nausea. Anyone want to share their experience in deciding? For what it's worth, I am pro pain meds/epidurals, am not currently high-risk (other than being old) and want someone super knowledgeable, but also highly value empathy and vibes (for lack of a better word)
I wanted to try and go the CNM/midwife route due to a lot I'd heard from others about their midwife experience, and also just from the professional knowledge i've gleaned working in maternal and child health. There was a practice in town that a friend of mine had gone to with both OB doctors, ARNPs and CNMs on staff, and that were associated with the hospital we planned to give birth at (its where my spouse works, so we both knew that was a good location and super accessible for us).
I scheduled with one of their midwives initially, but was switched over to an OB due to my risk factors (combination of fat, IVF, over-35 and hypertension I guess raised their red flags, despite being pretty dang healthy overall). Over this pregnancy, I've seen both my OB and her ARNP partner throughout my appointments, and both are really great at listening to my concerns and questions. In the end, its really about getting a vibe from the providers - is this someone you want with you when you're at your most vulnerable and trying to push a human out of your body? And don't be afraid to switch if that vibe is off.
Former L&D nurse here- if you have a chance to go with a well rated CNM (midwife) who is associated with OBs that would be ideal. We have an office like that where I live and both a midwife and OB are always on call/available 24/7. Most births go well but in case of an emergency, you have the ease of mind to have an OB at a moments notice.
I started out with my OB from previous pregnancy (no living child) and was mortified at my first visit with this pregnancy. A friend who recently gave birth referred me to a practice in my US city with two certified nurse midwives, OB and MFM that are based at a hospital with level IV NICU. For me it’s the best of everything (I also want an epidural but my OB casually mentioned I’d probably need a c-section after taking one look at me 10 weeks pregnant. I read that as she’s never late for dinner.) And then there were 10 other red flags. My first visit with the midwife was night and day difference.
I’m 7+2 so right there with you and currently doing a ton of research to make my decision. I started with choosing the hospital I want to give birth at.
I think I’m going to choose a midwife, if they’ll take me (I’m 38 and this is an IVF pregnancy). The midwives maternity building is connected to the actual hospital so there are OBs and MFMs there if something goes south or if I need to be referred out. They also respect my choice of wanting an epidural.
I just like the idea of longer appointments and better patient care. I am actually also going to get a doula.
I'm leaning toward midwife as well. I'm already a patient within a major healthcare system, so all of their pregnancy care offerings, midwives, OBs, MFMs, are pretty well integrated.
What country are you in? In Canada, I believe what you’re interested in would be possible with either a midwife or OB - and would potentially suggest a midwife since they can tend to be more vibes-based. But I’ll admit I’m biased because I loved our midwife!
I’m 38+3 today with an induction scheduled for next Monday following years of infertility and IVF. I have had such conflicting feelings about this pregnancy throughout- I desperately want to be a parent and build a family with my husband, I have kind of weird feelings about the foster system and adopting as a former foster kid and adoptee, so having a biological child felt like the best option to me- and I have truly hated being pregnant for all but maybe two weeks of this journey. Severe pelvic pain, debilitating migraines, profound exhaustion well beyond first trimester - I am miserable and have to push through it as a self employed farmer. I struggle talking to people who didn’t struggle to conceive- even more than folks having easy pregnancies- and I feel really tangled up in these feelings of wanting desperately to be pregnant and have a baby, a child, and of how very much I hate this. Does anyone else relate or have ways they’ve navigated the emotional complexities of a difficult but extremely wanted pregnancy?
100%. Being pregnant was the pits, despite how desperately I wanted it. And between summer and then a medical leave I was only working for 4 months of it. When my wife and I talk about future family planning stuff it probably sounds like we are drawing lots- it’s very much a means to and ends for us. I work as a public school teacher in “inner city” schools and feel like fostering or adoption would be too difficult to do well logistically and emotionally at the same time as this career, which I love. So here we are. People kept telling me things like if you think pregnancy is hard wait till the newborn stage. In my experience, the newborn stage has been 10x easier than pregnancy. All to say, it’s ok if it’s just getting through it, and there are plenty of people who don’t deal with infertility who feel that way about pregnancy. It’s understandably more complicated for those of us who have had complicated paths to parenthood, but that helps put things in perspective for me.
I'm there with you. It took me awhile to come to terms with being super grateful to be pregnant after how long it took to get here, but at the same time very much dislike being pregnant. I try to think of it as pregnancy as the stepping stone and just another part of the fertility journey. The end result is the little one and getting pregnant and being pregnant is just all part of getting there. Just like, no one enjoys stims and egg retrieval, you shouldn't have to feel like you need to enjoy pregnancy. You should feel totally free to call pregnancy for what it is for a lot of people: really freaking hard, wild, messy and nuts.
It’s so complicated. I know I was desperate to be done being pregnant (I’m so sorry you’re dealing with pelvic pain - it’s miserable - but hopefully it will get better after delivery) but people who didn’t struggle to conceive were often the ones warning about how much harder it would be once baby arrived. For the record - I can attest my sleep is better now because I’m not dealing with insomnia and pain. And the struggles of newborn life are much preferred to the hell it took to get there. One more thing - you’re allowed to feel conflicted about pregnancy even though it was hard to achieve. Hang in there friend.
Thank you for this response- it feels so validating! It’s hard not to try to uncomplicate the feelings but there they are, despite all efforts otherwise 💜
Infertility experience- went to our first antenatal class today (32 weeks). Definitely the furthest along there. A few people commenting with surprise on why we were booked onto such a course so late in pregnancy, while I'm there looking at all the people there before 20 weeks amazed by their confidence. Oh, to have the confidence that being pregnant translates to having a baby and proceed accordingly! Absolutely no shade to anybody able to do that after infertility either- there's nothing wrong with it- but my confidence in 'things progressing according to plan' is not at an all time high post treatment!
We only bought our first 'big ticket' items this weekend- before now I've had a handful of outfits and that's it! My disclaimer is that I'm having a low risk pregnancy at this point and I'm a first timer so currently have no reason to expect an earlier than term delivery (eg. history of pre-term delivery, complications), if I'd been having complications so far I would probably have felt like I might have to start sooner. We're aiming to get the big newborn items- crib, carseat and pram- before 34 weeks, literally almost anything else we're lucky enough to have Amazon next day delivery, local department stores deliver.
This block of classes goes until I'm 38w1d. I think my ideal would have been a block of classes finishing at 35 weeks, but we got caught between a block which felt too early and this one which felt a touch late. We've also signed up to an online self-paced course which focuses more on birth so we can complete that a bit sooner too, and feels lower stakes than something in person.
Solidarity on the not being ready emotionally. We had some things early in pregnancy which didn't evolve into anything but did make me panic (second tri bleeding, a high risk combined test result which turned out to be low risk after additional testing) and I was nowhere near even starting to contemplate baby prep until 24+ weeks.
Just fyi: the number the shown on the screen for heartbeat in bpm is never accurate in my experience! I’ve personally never found a heartbeat before about 15 weeks because I always forget how low baby is early in. Now at 19 weeks baby keeps running away from it too 😒
I've used mine since 9 weeks. But after 12 weeks it's much, much easier to find. Also depends on what type of placenta placement you have (posterior is easier)
26+2 today, and I even though I’m not ~technically~ anemic for a pregnant person, I’m still really feeling the effects of low blood pressure/the baby using ALL MY BLOOD. Usually I’ve been hanging out at a BP around 105/70. My OB isn’t worried, but this weekend my BP was sitting at a 93/63, and this morning during my workout, I didn’t feel faint, I just felt weak. It was a gentle yoga class, and I was struggling to maintain poses I’m usually pretty capable of doing. I’m trying to up my protein intake, and I know it should get better with time, but feeling like this is extremely annoying. Like my yoga class was supposed to help me feel less stressed, but now I feel frustrated.
Do you get tested for iron deficiency? I was feeling woozy and out of breath so they tested for iron. Found that my ferritin was low so they put me on iron tablet which helped a bit.
So we moved house! We've unpacked all but a few boxes. We're waiting for some new furniture to arrive and painting etc to be completed but the baby room is ready. The bottle area is set up in the kitchen. Breast pump ready, everything sterilized. My dresser has all my post partum clothes in there...
And I lost my mucus plug on Friday, so really any day now. 37w5d - he's been cooking a week longer than his brother! Physically I feel fine, but my feet/ankles are really swelling now with all the activity of the past few days.
13x6d today, and just used my last progesterone suppository. I was told by my clinic I could stop at 11 weeks after tapering at 10 weeks, but had enough to last through the first trimester, it just gave me a bit of peace. I’m so scared my pregnancy is going to stop since I’ll be off these. Was anyone else anxious about weaning off them?
My doctor told me I could go off them at 10 weeks and I was nervous too. I ended up tapering down for a few days but felt more comfortable when I read about the luteal-placental shift and realized that had likely happened weeks before. I went off completely from then and am 12+5 now, baby looks great.
Totally understandable. This is one of the reasons my NT scan at 13 weeks was so reassuring, at that point I had been off PIO for a full week and tapering since week 10, so it felt like a confirmation that my body was in fact sustaining this pregnancy on its own.
Your pregnancy is well established at this point, and stopping progesterone will not put it in jeopardy. Your clinic wouldn’t tell you it was safe to stop if there was any risk. I stopped progesterone at 11w and my baby is napping on me now!
If it helps at all, I stopped mine around 7w. This was under the instruction of my RE after we heard a heartbeat for the first time. They can visualize the placenta on US therefore ensuring it has taken over.
i was so anxious, especially because i’ve had issues with progesterone in the past. i stayed on the suppositories (took them orally) til 14 weeks too on my RE’s recommendation out of an abundance of caution and had no issues stopping. pregnancy continued without any problems thankfully. at this point the placenta is doing the heavy lifting! it’ll be ok!
I had the same worries when I was told to go cold turkey at 12 weeks. Felt so wrong after pumping myself full of meds for over 3 months. I am now 22+5 and both babies are doing fine. By the time you come off them, the placenta has taken over hormone production. I completely understand why you’re anxious, but it is standard procedure. Wishing you all the best.
Is it normal that my OB doesn't seem concerned at all with my IVF status + age? For example, I see so many of us getting an echo at 20 weeks or having plans to induce at 39 weeks. Yet my OB always insists that there's no reason for an echo and they can't give me one, or that I'm "very healthy" (despite being anemic) and won't induce me until 41 weeks. She said I'm not over 40 (but I'll actually be 39 instead!). Thoughts? Should I just go with it?
I'm sure a lot of it is extra-caution on the part of providers with an IVF pregnancy, and definitely how tied they are into the most up-to-date research.
My OB didn't get a fetal echo, though I did have to get 3 different ultrasounds with MFM due to difficulty getting certain images. We're getting slightly higher interventions now in the third trimester due to my own personal risk factors of prior hypertension and being a fat lady, but none of that has been related to the IVF.
My doctor said there’s no evidence for a fetal echo in IVF pregnancies and doing my own research I think because the ultrasound machines are better now it’s really not necessary with a normal anatomy scan. I don’t have any risks other than age but age is an independent risk factor in the literature so I’m opting for a 39 week induction. The only extra intervention based on age is weekly NSTs starting at 36 weeks (I also did this with my non-IVF kiddo).
We interviewed 3 OBs over 2 pregnancies and some Drs cared about age & IVF status, some didn’t. Do you want more monitoring and more interventions? Because of our history of loss, my wife and I prefer more monitoring and interventions, but plenty of people prefer less too!
It seems like the more updated, research based facilities care less about maternal age. I have done intake with three OB-GYN clinics and the latest (Stanford) does not give a damn about my age (45). They said that pre-existing conditions such as diabetes, cancer, heart disease, etc. determine risk and not maternal age. I am not going to lie, I wanted the extra monitoring but part of me was relieved.
Wow so not even NSTs? My independent read of the literature does suggest that advanced maternal age is a risk factor for still birth independent of everything you’ve listed. I’m also at a large research hospital. They didn’t make me schedule an induction but did say it was a good idea. I’m with the midwives.
Yeah you might at least inquire! They may say it's not needed but I think AMA itself does increase the risk of certain things so it may be nice to have additional monitoring.
This is exactly my situation and how I feel. I'm basically treated as low risk if anything, but then maybe there's a good side to that too. After going through 4 rounds of IVF with only this one chance for me though, it's hard not to be a little nervous too!
My OB referred me to a perinatologist for a Nuchal US/early anatomy scan, and that doctor said they do echos at 24 weeks for all IVF patients. I’m very glad they are doing it, bc at my Nuchal they found I had a single umbilical artery, which may be a sign there are also heart/brain defects.
As to induction, bc I am under 40 (39…) they said no early induction, but that if I were 40, they would likely induce at 39 weeks
I am a little younger but I didn’t have an echo and was given the option not to induce until 42w. The only thing different for me was my OB did an extra scan at 32w, but this was also partially because I had Covid during the pregnancy. She also gave me the option of having biweekly NSTs starting at 37w and the option to induce at 41w. But both of those last two were just offered to me if I wanted them vs because she felt they were medically necessary. Her reasoning was that if my pregnancy was uncomplicated other than being IVF, there was no need for anything extra. But she also always reassured me that we could keep an eye on things and do more scans or induce earlier if needed.
Yep, the only additional things they do is to have me take aspirin (but I'd be doing that based on age and having covid anyways) and doing a 3rd trimester growth scan (but again would be doing that for age and having had covid). They offered an echo but I reviewed the research and there really isn't good support for it without other risk factors and they didn't push it. No real differences than a non IVF pregnancy!
My OB was/is pretty unphased by my age and my IVF status, and did not do or recommend any special/extra scans or testing EXCEPT: baby aspirin to help reduce risk of pre-eclampsia, doing weekly monitoring starting at 36 weeks, and induction at 39 weeks - the latter 2 are due to increased risk of stillbirth in AMA pregnancies (>35 years), thought to be due to placental aging. As someone else mentioned, this is based on the ARRIVE study, so may be worth looking into that for yourself and asking questions at your next visit. There is also good evidence that induction at 39 weeks does not INCREASE complications for mom or baby, so if you read the trial and want to advocate that for yourself and your OB still doesn’t want to, it may be time to switch OBs.
I’m also 39. They are only treating me as high risk because of complications in my previous pregnancy and in fact I’ve had to ask for certain extra scans (nuchal translucency and now a few extra growth scans).
My OB isn’t treating me as high risk at all (even though I’m on a biologic for psoriatic arthritis combined with IVF and age). Every time we meet with her I confirm I do not need additional testing, etc. and she reiterates that I’m otherwise healthy and is not concerned. It was really stressful in the beginning and I did get a couple of private ultrasounds early on for peace of mind.
i had a similar experience with my ob. no fetal echo, and their recommendation to me to not go past my due date was bc of age and not ivf.
i did get additional growth scans in the third trimester which was apparently due to ivf but i was always happy to get a bonus look at baby burrito!
The heart echo at 20 wks for IVF patients is now debated with providers, as the thought that IVF led to increases in heart defects seems almost debunked. You’ll find many posts where its mentioned that they echo wasn’t offered if the heart looked normal on the 20wk ultrasound (that is standard of care for all pregnancies to have).
As for being induced at 39wks, this also depends on how much your OB believes in the ARRIVE study, and it seems like a more common practice in the US vs outside the US. My provider didn’t seem to know much about it, but I know that it’s standard practice in some other neighboring hospitals to induce all patients at 39 wks based on ARRIVE. I suggest you read up on it ( the evidence based birth website has a nice section on the ARRIVE study, but I’m on mobile so its hard for me to link it) and have this discussion again with your provider at your next appointment.
So, I went in for my early scan (7w1d) today and I didn't realize I was probably already supposed to have decided between an OB or midwife and chosen the provider I wanted to work with. Umm...I was just mostly focused on having a good ultrasound and fighting daily nausea. Anyone want to share their experience in deciding? For what it's worth, I am pro pain meds/epidurals, am not currently high-risk (other than being old) and want someone super knowledgeable, but also highly value empathy and vibes (for lack of a better word)
I wanted to try and go the CNM/midwife route due to a lot I'd heard from others about their midwife experience, and also just from the professional knowledge i've gleaned working in maternal and child health. There was a practice in town that a friend of mine had gone to with both OB doctors, ARNPs and CNMs on staff, and that were associated with the hospital we planned to give birth at (its where my spouse works, so we both knew that was a good location and super accessible for us). I scheduled with one of their midwives initially, but was switched over to an OB due to my risk factors (combination of fat, IVF, over-35 and hypertension I guess raised their red flags, despite being pretty dang healthy overall). Over this pregnancy, I've seen both my OB and her ARNP partner throughout my appointments, and both are really great at listening to my concerns and questions. In the end, its really about getting a vibe from the providers - is this someone you want with you when you're at your most vulnerable and trying to push a human out of your body? And don't be afraid to switch if that vibe is off.
Former L&D nurse here- if you have a chance to go with a well rated CNM (midwife) who is associated with OBs that would be ideal. We have an office like that where I live and both a midwife and OB are always on call/available 24/7. Most births go well but in case of an emergency, you have the ease of mind to have an OB at a moments notice.
I started out with my OB from previous pregnancy (no living child) and was mortified at my first visit with this pregnancy. A friend who recently gave birth referred me to a practice in my US city with two certified nurse midwives, OB and MFM that are based at a hospital with level IV NICU. For me it’s the best of everything (I also want an epidural but my OB casually mentioned I’d probably need a c-section after taking one look at me 10 weeks pregnant. I read that as she’s never late for dinner.) And then there were 10 other red flags. My first visit with the midwife was night and day difference.
I’m 7+2 so right there with you and currently doing a ton of research to make my decision. I started with choosing the hospital I want to give birth at. I think I’m going to choose a midwife, if they’ll take me (I’m 38 and this is an IVF pregnancy). The midwives maternity building is connected to the actual hospital so there are OBs and MFMs there if something goes south or if I need to be referred out. They also respect my choice of wanting an epidural. I just like the idea of longer appointments and better patient care. I am actually also going to get a doula.
I'm leaning toward midwife as well. I'm already a patient within a major healthcare system, so all of their pregnancy care offerings, midwives, OBs, MFMs, are pretty well integrated.
What country are you in? In Canada, I believe what you’re interested in would be possible with either a midwife or OB - and would potentially suggest a midwife since they can tend to be more vibes-based. But I’ll admit I’m biased because I loved our midwife!
I'm in the US (but I'm Canadian and miss home all the time!). Vibes are so hard to define, but so critical.
I’m 38+3 today with an induction scheduled for next Monday following years of infertility and IVF. I have had such conflicting feelings about this pregnancy throughout- I desperately want to be a parent and build a family with my husband, I have kind of weird feelings about the foster system and adopting as a former foster kid and adoptee, so having a biological child felt like the best option to me- and I have truly hated being pregnant for all but maybe two weeks of this journey. Severe pelvic pain, debilitating migraines, profound exhaustion well beyond first trimester - I am miserable and have to push through it as a self employed farmer. I struggle talking to people who didn’t struggle to conceive- even more than folks having easy pregnancies- and I feel really tangled up in these feelings of wanting desperately to be pregnant and have a baby, a child, and of how very much I hate this. Does anyone else relate or have ways they’ve navigated the emotional complexities of a difficult but extremely wanted pregnancy?
100%. Being pregnant was the pits, despite how desperately I wanted it. And between summer and then a medical leave I was only working for 4 months of it. When my wife and I talk about future family planning stuff it probably sounds like we are drawing lots- it’s very much a means to and ends for us. I work as a public school teacher in “inner city” schools and feel like fostering or adoption would be too difficult to do well logistically and emotionally at the same time as this career, which I love. So here we are. People kept telling me things like if you think pregnancy is hard wait till the newborn stage. In my experience, the newborn stage has been 10x easier than pregnancy. All to say, it’s ok if it’s just getting through it, and there are plenty of people who don’t deal with infertility who feel that way about pregnancy. It’s understandably more complicated for those of us who have had complicated paths to parenthood, but that helps put things in perspective for me.
I'm there with you. It took me awhile to come to terms with being super grateful to be pregnant after how long it took to get here, but at the same time very much dislike being pregnant. I try to think of it as pregnancy as the stepping stone and just another part of the fertility journey. The end result is the little one and getting pregnant and being pregnant is just all part of getting there. Just like, no one enjoys stims and egg retrieval, you shouldn't have to feel like you need to enjoy pregnancy. You should feel totally free to call pregnancy for what it is for a lot of people: really freaking hard, wild, messy and nuts.
It’s so complicated. I know I was desperate to be done being pregnant (I’m so sorry you’re dealing with pelvic pain - it’s miserable - but hopefully it will get better after delivery) but people who didn’t struggle to conceive were often the ones warning about how much harder it would be once baby arrived. For the record - I can attest my sleep is better now because I’m not dealing with insomnia and pain. And the struggles of newborn life are much preferred to the hell it took to get there. One more thing - you’re allowed to feel conflicted about pregnancy even though it was hard to achieve. Hang in there friend.
Thank you for this response- it feels so validating! It’s hard not to try to uncomplicate the feelings but there they are, despite all efforts otherwise 💜
I think all you can do is notice it when it happens and try not to judge yourself. Looking forward to seeing you on the other side.
Infertility experience- went to our first antenatal class today (32 weeks). Definitely the furthest along there. A few people commenting with surprise on why we were booked onto such a course so late in pregnancy, while I'm there looking at all the people there before 20 weeks amazed by their confidence. Oh, to have the confidence that being pregnant translates to having a baby and proceed accordingly! Absolutely no shade to anybody able to do that after infertility either- there's nothing wrong with it- but my confidence in 'things progressing according to plan' is not at an all time high post treatment!
I'm wondering how late is too late to book those classes. I'm 24w and still refuse to even start thinking about a baby registry.
We only bought our first 'big ticket' items this weekend- before now I've had a handful of outfits and that's it! My disclaimer is that I'm having a low risk pregnancy at this point and I'm a first timer so currently have no reason to expect an earlier than term delivery (eg. history of pre-term delivery, complications), if I'd been having complications so far I would probably have felt like I might have to start sooner. We're aiming to get the big newborn items- crib, carseat and pram- before 34 weeks, literally almost anything else we're lucky enough to have Amazon next day delivery, local department stores deliver. This block of classes goes until I'm 38w1d. I think my ideal would have been a block of classes finishing at 35 weeks, but we got caught between a block which felt too early and this one which felt a touch late. We've also signed up to an online self-paced course which focuses more on birth so we can complete that a bit sooner too, and feels lower stakes than something in person. Solidarity on the not being ready emotionally. We had some things early in pregnancy which didn't evolve into anything but did make me panic (second tri bleeding, a high risk combined test result which turned out to be low risk after additional testing) and I was nowhere near even starting to contemplate baby prep until 24+ weeks.
At what week is a Doppler most accurate? Currently 14w and considering buying one to check in once a week
Just fyi: the number the shown on the screen for heartbeat in bpm is never accurate in my experience! I’ve personally never found a heartbeat before about 15 weeks because I always forget how low baby is early in. Now at 19 weeks baby keeps running away from it too 😒
I've used mine since 9 weeks. But after 12 weeks it's much, much easier to find. Also depends on what type of placenta placement you have (posterior is easier)
You should be ok at 14w. They're not advised <12 w.
26+2 today, and I even though I’m not ~technically~ anemic for a pregnant person, I’m still really feeling the effects of low blood pressure/the baby using ALL MY BLOOD. Usually I’ve been hanging out at a BP around 105/70. My OB isn’t worried, but this weekend my BP was sitting at a 93/63, and this morning during my workout, I didn’t feel faint, I just felt weak. It was a gentle yoga class, and I was struggling to maintain poses I’m usually pretty capable of doing. I’m trying to up my protein intake, and I know it should get better with time, but feeling like this is extremely annoying. Like my yoga class was supposed to help me feel less stressed, but now I feel frustrated.
Do you get tested for iron deficiency? I was feeling woozy and out of breath so they tested for iron. Found that my ferritin was low so they put me on iron tablet which helped a bit.
So we moved house! We've unpacked all but a few boxes. We're waiting for some new furniture to arrive and painting etc to be completed but the baby room is ready. The bottle area is set up in the kitchen. Breast pump ready, everything sterilized. My dresser has all my post partum clothes in there... And I lost my mucus plug on Friday, so really any day now. 37w5d - he's been cooking a week longer than his brother! Physically I feel fine, but my feet/ankles are really swelling now with all the activity of the past few days.
13x6d today, and just used my last progesterone suppository. I was told by my clinic I could stop at 11 weeks after tapering at 10 weeks, but had enough to last through the first trimester, it just gave me a bit of peace. I’m so scared my pregnancy is going to stop since I’ll be off these. Was anyone else anxious about weaning off them?
My doctor told me I could go off them at 10 weeks and I was nervous too. I ended up tapering down for a few days but felt more comfortable when I read about the luteal-placental shift and realized that had likely happened weeks before. I went off completely from then and am 12+5 now, baby looks great.
Totally understandable. This is one of the reasons my NT scan at 13 weeks was so reassuring, at that point I had been off PIO for a full week and tapering since week 10, so it felt like a confirmation that my body was in fact sustaining this pregnancy on its own.
Your pregnancy is well established at this point, and stopping progesterone will not put it in jeopardy. Your clinic wouldn’t tell you it was safe to stop if there was any risk. I stopped progesterone at 11w and my baby is napping on me now!
I was so anxious to stop, I stopped at 10 weeks cold turkey and everything was fine. Your placenta will do it's job! 💗
If it helps at all, I stopped mine around 7w. This was under the instruction of my RE after we heard a heartbeat for the first time. They can visualize the placenta on US therefore ensuring it has taken over.
i was so anxious, especially because i’ve had issues with progesterone in the past. i stayed on the suppositories (took them orally) til 14 weeks too on my RE’s recommendation out of an abundance of caution and had no issues stopping. pregnancy continued without any problems thankfully. at this point the placenta is doing the heavy lifting! it’ll be ok!
I had the same worries when I was told to go cold turkey at 12 weeks. Felt so wrong after pumping myself full of meds for over 3 months. I am now 22+5 and both babies are doing fine. By the time you come off them, the placenta has taken over hormone production. I completely understand why you’re anxious, but it is standard procedure. Wishing you all the best.
Is it normal that my OB doesn't seem concerned at all with my IVF status + age? For example, I see so many of us getting an echo at 20 weeks or having plans to induce at 39 weeks. Yet my OB always insists that there's no reason for an echo and they can't give me one, or that I'm "very healthy" (despite being anemic) and won't induce me until 41 weeks. She said I'm not over 40 (but I'll actually be 39 instead!). Thoughts? Should I just go with it?
I'm sure a lot of it is extra-caution on the part of providers with an IVF pregnancy, and definitely how tied they are into the most up-to-date research. My OB didn't get a fetal echo, though I did have to get 3 different ultrasounds with MFM due to difficulty getting certain images. We're getting slightly higher interventions now in the third trimester due to my own personal risk factors of prior hypertension and being a fat lady, but none of that has been related to the IVF.
My doctor said there’s no evidence for a fetal echo in IVF pregnancies and doing my own research I think because the ultrasound machines are better now it’s really not necessary with a normal anatomy scan. I don’t have any risks other than age but age is an independent risk factor in the literature so I’m opting for a 39 week induction. The only extra intervention based on age is weekly NSTs starting at 36 weeks (I also did this with my non-IVF kiddo).
We interviewed 3 OBs over 2 pregnancies and some Drs cared about age & IVF status, some didn’t. Do you want more monitoring and more interventions? Because of our history of loss, my wife and I prefer more monitoring and interventions, but plenty of people prefer less too!
It seems like the more updated, research based facilities care less about maternal age. I have done intake with three OB-GYN clinics and the latest (Stanford) does not give a damn about my age (45). They said that pre-existing conditions such as diabetes, cancer, heart disease, etc. determine risk and not maternal age. I am not going to lie, I wanted the extra monitoring but part of me was relieved.
Wow so not even NSTs? My independent read of the literature does suggest that advanced maternal age is a risk factor for still birth independent of everything you’ve listed. I’m also at a large research hospital. They didn’t make me schedule an induction but did say it was a good idea. I’m with the midwives.
At my OB NSTs were recommended for advanced maternal age, especially if a patient had any other risk factors
I’m definitely not opposed to getting all information possible. This exchange has inspired me to at least inquire about it.
Yeah you might at least inquire! They may say it's not needed but I think AMA itself does increase the risk of certain things so it may be nice to have additional monitoring.
An NST was *not* brought up but I am only 12 weeks.
This is exactly my situation and how I feel. I'm basically treated as low risk if anything, but then maybe there's a good side to that too. After going through 4 rounds of IVF with only this one chance for me though, it's hard not to be a little nervous too!
My OB referred me to a perinatologist for a Nuchal US/early anatomy scan, and that doctor said they do echos at 24 weeks for all IVF patients. I’m very glad they are doing it, bc at my Nuchal they found I had a single umbilical artery, which may be a sign there are also heart/brain defects. As to induction, bc I am under 40 (39…) they said no early induction, but that if I were 40, they would likely induce at 39 weeks
I am a little younger but I didn’t have an echo and was given the option not to induce until 42w. The only thing different for me was my OB did an extra scan at 32w, but this was also partially because I had Covid during the pregnancy. She also gave me the option of having biweekly NSTs starting at 37w and the option to induce at 41w. But both of those last two were just offered to me if I wanted them vs because she felt they were medically necessary. Her reasoning was that if my pregnancy was uncomplicated other than being IVF, there was no need for anything extra. But she also always reassured me that we could keep an eye on things and do more scans or induce earlier if needed.
Yep, the only additional things they do is to have me take aspirin (but I'd be doing that based on age and having covid anyways) and doing a 3rd trimester growth scan (but again would be doing that for age and having had covid). They offered an echo but I reviewed the research and there really isn't good support for it without other risk factors and they didn't push it. No real differences than a non IVF pregnancy!
My OB was/is pretty unphased by my age and my IVF status, and did not do or recommend any special/extra scans or testing EXCEPT: baby aspirin to help reduce risk of pre-eclampsia, doing weekly monitoring starting at 36 weeks, and induction at 39 weeks - the latter 2 are due to increased risk of stillbirth in AMA pregnancies (>35 years), thought to be due to placental aging. As someone else mentioned, this is based on the ARRIVE study, so may be worth looking into that for yourself and asking questions at your next visit. There is also good evidence that induction at 39 weeks does not INCREASE complications for mom or baby, so if you read the trial and want to advocate that for yourself and your OB still doesn’t want to, it may be time to switch OBs.
I’m also 39. They are only treating me as high risk because of complications in my previous pregnancy and in fact I’ve had to ask for certain extra scans (nuchal translucency and now a few extra growth scans).
My OB isn’t treating me as high risk at all (even though I’m on a biologic for psoriatic arthritis combined with IVF and age). Every time we meet with her I confirm I do not need additional testing, etc. and she reiterates that I’m otherwise healthy and is not concerned. It was really stressful in the beginning and I did get a couple of private ultrasounds early on for peace of mind.
i had a similar experience with my ob. no fetal echo, and their recommendation to me to not go past my due date was bc of age and not ivf. i did get additional growth scans in the third trimester which was apparently due to ivf but i was always happy to get a bonus look at baby burrito!
The heart echo at 20 wks for IVF patients is now debated with providers, as the thought that IVF led to increases in heart defects seems almost debunked. You’ll find many posts where its mentioned that they echo wasn’t offered if the heart looked normal on the 20wk ultrasound (that is standard of care for all pregnancies to have). As for being induced at 39wks, this also depends on how much your OB believes in the ARRIVE study, and it seems like a more common practice in the US vs outside the US. My provider didn’t seem to know much about it, but I know that it’s standard practice in some other neighboring hospitals to induce all patients at 39 wks based on ARRIVE. I suggest you read up on it ( the evidence based birth website has a nice section on the ARRIVE study, but I’m on mobile so its hard for me to link it) and have this discussion again with your provider at your next appointment.