Pink/red/brown spotting, which can be blood mixed with vaginal discharge, is common after an egg retrieval/embryo transfer/IUI and is typically not concerning. Heavy bright red bleeding should be reported to your team nurse.

Following a treatment cycle, we will draw one HCG level 10 days after embryo transfer (or 14 days after IUI). If it is positive, we will get one more 48 hours later. If there is an appropriate interval rise, the next step is an early OB ultrasound at 6-7 weeks gestation (which is actually just a couple weeks after your blood tests).

If a reassuring level is seen on the second HCG test, the further HCG levels are not needed and the prenatal ultrasound can be scheduled. If the HCG level is not rising appropriately, your team will follow serial levels to help determine if this is a viable pregnancy.

With any pregnancy there is a risk of an abnormal pregnancy/early pregnancy loss or an ectopic pregnancy (a pregnancy outside of the uterus). These scenarios can present with abnormally rising HCG levels and are followed closely by your team.

There can be several reasons for bleeding in early pregnancy and this would warrant a call to your team nurse, especially if bright red and heavy like a period. As above, light spotting in early pregnancy is very common and often not concerning.

An IVF-derived embryo can split after transfer and result in an identical twin pregnancy, or a concurrent natural conception can occur if unprotected sex was had around the time of the transfer.