IVF pregnancy: your first ultrasounds after embryo transfer

The first test after transfer

Your clinic gives you a date for a pregnancy test. Cleveland Clinic says a blood test is done “approximately nine to 14 days after embryo transfer,” and Mayo Clinic says at least 12 days after egg retrieval (Cleveland Clinic, Mayo Clinic). In England, for fresh transfers, Cambridge IVF and Guy’s and St Thomas’ set it for 16 days after egg collection, and Cambridge asks for a urine test (Cambridge IVF, Guy’s and St Thomas’). NYU Langone Fertility Center in New York measures beta-hCG, the pregnancy hormone (NYU Langone Fertility Center).

Try not to test early at home. The HFEA, the UK’s fertility regulator, warns that “you may get a false result” (HFEA). Mayo Clinic adds that a test taken soon after fertility medicine that contains hCG may give a false positive (Mayo Clinic).

Some clinics repeat the blood test to see the level rise: NYU Langone books the first scan “once your levels rise appropriately.” A positive result can’t show where the pregnancy is: ultrasound shows “whether the pregnancy is inside or outside the uterus,” says the American Society for Reproductive Medicine (ASRM) (ASRM). Home pregnancy test or ultrasound? compares the two.

If a test is positive and then turns negative before a pregnancy sac can be seen, ASRM calls it a biochemical pregnancy (ASRM). It’s a real loss, and the support lines further down are for you too.

When is the first ultrasound after embryo transfer?

Clinics set their own dates; these examples fall at about 6 to 7 weeks of pregnancy. In England, the NHS says you’ll come back to the clinic “for a scan when you’re around 7 weeks pregnant,” to check the heartbeat and confirm the pregnancy (NHS). Newcastle’s NHS clinic offers one “about 3 weeks after a positive pregnancy test” (Newcastle Hospitals). NYU Langone scans “usually between weeks six and seven.”

How IVF weeks are counted

After IVF, your weeks are set from the transfer date, not a period. ACOG, the American College of Obstetricians and Gynecologists, puts the due date 261 days after a day-5 transfer, or 263 days after a day-3 one (ACOG Committee Opinion 700). How far along am I? has the sums. For a day-5 transfer:

1. Transfer day: 2 weeks and 5 days of pregnancy.
2. Test day, 9 to 14 days later: 4 weeks to 4 weeks and 5 days.
3. 23 days after transfer: 6 weeks.
4. 30 days after transfer: 7 weeks.

With a day-3 embryo, each week comes 2 days later: 6 weeks is 25 days after transfer.

What the clinic checks at each scan

These are medical scans. A U.S. guideline from imaging and obstetric societies, including ACOG, lists what a first-trimester scan should record (ACR–ACOG–AIUM–SMFM–SRU). The typical weeks below, for internal scans, come from a 2024 lexicon by a panel the Society of Radiologists in Ultrasound (SRU) convened (SRU, 2024).

• Where the pregnancy is. The scan looks for a pregnancy sac and records its location. Guy’s and St Thomas’, which usually scans at about 7 weeks, diagnoses ectopic pregnancies “at this stage.”
• How many. “Fetal number should be documented,” the guideline says.
• A yolk sac. A small ring inside the sac, seen at about 5½ weeks. The lexicon calls a yolk sac in a fluid-filled sac inside the uterus “incontrovertible evidence of a pregnancy.”
• The embryo and its heartbeat. “An embryo with cardiac activity is typically visualized at 6 weeks.” When can you see the heartbeat on an ultrasound? covers the flicker.
• Its size. The crown-rump length, from head to bottom. After IVF, your due date still comes from the transfer.

Some clinics add a second scan; at Pacific Fertility Center, it “assesses the growth and progression of the embryo” (Pacific Fertility Center). Even a scan that shows all of this isn’t a promise: ASRM notes that miscarriage “may occur after ART, even after ultrasound identifies a pregnancy in the uterus.”

Twins and more

The chance of twins or more rises “when more than one embryo is transferred,” ASRM says. In 2024, about 79% of embryo transfer cycles reported to the Society for Assisted Reproductive Technology (SART) used elective single embryo transfer, and twins were about 2.6% of U.S. IVF births (ASRM, 2026). In the UK in 2023, 88% of IVF cycles were single embryo transfers, and the multiple birth rate from IVF was 3.4% (HFEA, 2025). Can you see twins at 6 weeks? explains when two sacs and two heartbeats can show.

Ectopic and heterotopic pregnancy after IVF

An ectopic pregnancy is “any pregnancy that grows outside of the uterus,” in ASRM’s words. Mayo Clinic says “some research suggests” that women who have IVF or similar treatments are more likely to have one (Mayo Clinic). Two national studies give a sense of scale:

• U.S. CDC researchers studied 553,577 pregnancies reported to the National ART Surveillance System from 2001 to 2011. The ectopic rate, which included heterotopic pregnancies, fell from 2.0% in 2001 to 1.6% in 2011. In fresh cycles using the patient’s own eggs, it was 1.6% with one embryo transferred and 2.5% with four or more (Perkins and colleagues, Obstetrics & Gynecology, 2015).
• UK. Researchers based in Brussels studied the HFEA’s national database: 161,967 treatment cycles that led to a pregnancy from 2000 to 2012, 153,115 of them after IVF or ICSI. About 1.4% of those IVF and ICSI pregnancies were ectopic, and the rate fell over time (Santos-Ribeiro and colleagues, Human Reproduction, 2016).

A heterotopic pregnancy is one in the uterus and another outside it, at the same time. The SRU lexicon calls it “extremely rare,” but says it “occurs with increased frequency in patients undergoing infertility treatment.” In the U.S. study, 485 of the 553,577 pregnancies were heterotopic, fewer than 1 in 1,000. So after IVF, a pregnancy seen in the uterus doesn’t rule out one elsewhere: the StatPearls medical reference notes that an ectopic pregnancy may occur alongside a normally developing one in the uterus (StatPearls). Symptoms count, whatever a scan has shown.

Until you graduate, the call about milder symptoms may be to your fertility clinic: Cambridge IVF asks anyone with “a positive pregnancy test and lower abdominal pain or bleeding” to “contact us immediately.”

In the UK, call 999 or go to A&E for any of the symptoms in the box. If you’re pregnant and bleeding, the NHS in England says to call 999 for heavy bleeding, severe tummy pain, shoulder pain, or feeling sick, faint or dizzy. For light bleeding or spotting with no or only mild pain, it points you to your maternity unit, an early pregnancy unit or NHS 111 (NHS).

Measuring behind, or no heartbeat yet

IVF dates come from the transfer, not the calendar, so a small measurement can’t be put down to late ovulation, one reason a naturally conceived pregnancy can measure behind.

If a scan shows no heartbeat yet, it can simply mean it’s early: a scan right at 6 weeks can come before the heartbeat shows. It can also be a sign of a problem, and so can a small embryo. Only your doctor or midwife can tell what it means. Tell your doctor or midwife, even if you feel well, and ask your clinic what happens next.

When a pregnancy hasn’t grown as expected, Newcastle’s clinic says, “we need time sometimes to confirm a diagnosis,” which may require more scans and blood tests. No heartbeat on an early ultrasound explains how doctors tell “too early” from a loss, and Measuring behind on your first ultrasound covers size, with a section on IVF.

When do you graduate from the fertility clinic?

There’s no set week; your clinic will tell you. Mayo Clinic says that if you’re pregnant after IVF, “you’ll likely be referred to an obstetrician or other pregnancy specialist for prenatal care.” Three clinics show the range:

• New York: NYU Langone Fertility Center says most of its patients “graduate” from fertility care around 8 to 10 weeks.
• San Francisco Bay Area: Pacific Fertility Center monitors early pregnancy “up until 10 weeks.”
• London: Guy’s and St Thomas’ scans at about 7 weeks and writes to your GP if it confirms an ongoing pregnancy. The GP arranges antenatal care.

University of Bristol researchers interviewed 20 people who had conceived with treatment at three fertility clinics in the south of England: 12 women and 8 male partners, at 28 weeks of pregnancy. They described a “gap” in their care, “in terms of time and intensity,” after leaving the fertility clinic. That gap, with their history of treatment, “heightened their fear of pregnancy loss” (French and colleagues, British Journal of General Practice, 2015).

Before you leave the clinic

1. Get your dates and reports: your transfer date, the embryo’s age, your due date and your scan reports. NYU Langone shares “your full treatment and pregnancy summary” with your next provider.
2. Check your medicines. Ask how long to keep taking progesterone or other hormones. Guy’s and St Thomas’ says progesterone until 8 weeks; Cleveland Clinic says most people continue it through the first trimester. Cambridge IVF asks its patients not to stop medicine it prescribed without “discussing it with us.”
3. Book your first prenatal visit, and tell the practice it’s an IVF pregnancy, with your transfer date. Why your first prenatal appointment isn’t until 8 to 12 weeks explains the wait.
4. Know who to call in between, day and night, about bleeding or pain.

The worry after infertility or loss

After a long road, a positive test may not feel like relief. University of Melbourne researchers reviewed 28 studies, reported in 46 papers, on pregnancy and early parenting after assisted conception. Anxiety about the baby’s survival appeared higher than in comparison groups, while emotional well-being and attachment to the baby were similar. They called the evidence “emergent” (Hammarberg and colleagues, Human Reproduction Update, 2008).

Newcastle’s NHS clinic says the first scan “can be a very anxiety provoking appointment,” and that you can bring someone with you. If you’ve had a loss before, Pregnant after a loss: seeing your baby early covers the care you may be offered and how to ask for what you need at a scan.

ASRM says “Many ART programs have a mental health professional on staff,” so ask yours. If worry takes over, tell your doctor or midwife. In the U.S., the National Maternal Mental Health Hotline, 1-833-TLC-MAMA (1-833-852-6262), is free, confidential and open 24/7 in English and Spanish (HRSA). Postpartum Support International’s HelpLine is 1-800-944-4773, and PSI’s free online groups include “Pregnancy After Loss” (PSI, PSI groups). In the U.S., RESOLVE: The National Infertility Association lists peer-led support groups (RESOLVE).

A keepsake look between the clinic and your first visit

Our Pregnancy Check, in Glendale, Los Angeles County, is a short, private 2D ultrasound in the first 10 weeks. On a big screen, we point out what you’re looking at and tell you what we could and couldn’t see. You take home 8 black-and-white prints, for $100, with no referral or insurance.

It never replaces your clinic’s scans or your prenatal care. Where the pregnancy is, how many babies there are and how it’s growing are medical findings, for your clinic. We can’t diagnose, date a pregnancy, check on your health or tell you everything is OK.

Call (818) 243-7010 first, and we’ll tell you whether it’s a good day to come. If it’s too early to see, you come back for a second look, almost always at no charge. Little or nothing on screen can also be a sign of a problem, and only your doctor or midwife can tell which. Tell your doctor or midwife, even if you feel well. Same-day appointments are often available. Past 10 weeks? Heartbeat-only visits start at 11 weeks.

The FDA and the AIUM discourage scans done only for keepsakes (FDA, AIUM). ACOG says ultrasound should be used only to answer a medical question or bring a medical benefit (ACOG Committee Opinion 723). Safety, in plain words quotes them, and Is an early ultrasound safe for the baby? reviews the research. See how the Pregnancy Check works.

Enter your clinic’s due date: the planner marks what you can book today and what opens after, and keeps your entry only on your device.

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