January 26, 2012

Pregnant or Not Pregnant?

Endometrial Scratching

Fertility treatments allow patients to be empowered and to regain hope.  Once the patient has engaged in treatment, the two-week wait prior to pregnancy confirmation can be unbearable. Pregnant or not pregnant?

Not surprisingly, patients search for both emotional and physical signs to affirm or deny the potential of pregnancy; all while watching the calendar turn at a turtle’s pace.  One becomes hyperaware of weight, the body’s reaction to elevating progesterone and the psychologic stress involved.  The amount of rent-free brain space afforded to becoming pregnancy often is greater than prior to presenting to the fertility center to initiate treatment.

This two-week time between anticipated fertilization and pregnancy test is related to biology.  Once the embryo is created from fertilization of the egg by the sperm, the embryo must develop.  As it develops, the implanting blastocyst (stage of embryo development) becomes more specialized forming both the fetus and the placenta.  This placental tissue much reach a critical mass as it is releasing pregnancy hormone into the maternal circulation.  Pregnancy hormone is hCG (human chorionic gonadotropin).  Patients return to the center on one of the first days that this level can be detected accurately.

We recommend that patients refrain from performing home pregnancy tests as they are not as sensitive as blood levels and can render both false-positive as well as false-negative results; thus, they can provide more angst than affirmation.

Pregnancy hormone, along with progesterone (natural and supplemented) causes very rapid transitions in the women’s body in preparation for providing the most accommodating environment for the pregnancy.   Some women perceive these changes and some do not.

They symptoms can include a perception in ability in changes in respiratory rate – pregnant women tend to breathe more rapidly with more shallow breathes; Bloating and constipation can be an issue – intestinal motility slows so maximal nutrition can be pulled from the gut.   Breast soreness and tenderness is a direct effect from progesterone exposure and it is exceedingly difficult to make it not noticeable.  Having more symptoms does not mean that pregnancy did not occur.  Ironically, many women are more hopeful the more uncomfortable they become.

One of the best ways to get through this time is to keep one occupied.  A calendar with daily projects and activities will help to pass the time.  Women should continue their healthful diets and ways as well continue to take their prenatal vitamins as discussed previously with their health care teams.  Remember, healthy mothers make healthy babies.

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Danielle Vitiello, Ph.D., M.D.

Danielle Vitiello, Ph.D., M.D. Board-Certified in Obstetrics and Gynecology, Reproductive Endocrinology and Infertility