Pay Attention to the First 3 Months

Women who become pregnant through IVF need especially careful monitoring during the first 3 months of pregnancy. Pregnancies achieved through IVF often involve older maternal age and other health issues, which can increase the risk of complications for both the mother and the baby.

One out of every five pregnancies is considered high-risk. However, in referral centers such as IVF clinics, this rate can rise to one out of every two pregnancies.

Why Can a Pregnancy Be High-Risk?

A pregnancy may be considered high-risk if the mother has a chronic illness, has experienced complications in a previous pregnancy, or has a history of pregnancy loss.

In addition:

  • Women over the age of 35 have a higher risk of having a baby with chromosomal abnormalities.
  • Mothers under the age of 17 have a greater risk of fetal growth restriction.
  • Twin or triplet pregnancies carry a higher risk of premature birth and other complications.
  • Conditions such as diabetes, thyroid disease, high blood pressure, heart disease, anemia, or clotting disorders also increase risk.

Pregnancies achieved through IVF are generally considered high-risk, especially during the first trimester. Some of these risks are related to IVF itself, while others are related to maternal age and accompanying health conditions. Women undergoing IVF more often have thyroid disease, insulin resistance, and clotting disorders. Chromosomal abnormalities are also seen more frequently. While chromosomal abnormalities occur in about 2–3% of the general population, this rate rises to 5–6% among couples seeking IVF treatment. Therefore, genetic counseling before pregnancy and careful monitoring during pregnancy are particularly important.

Why Are the First 3 Months Different?

A pregnancy test is performed 12 days after embryo transfer. During this waiting period, medications are used to support embryo implantation, and these treatments continue until the placenta develops. Despite these supportive treatments, the risk of early pregnancy loss is slightly higher than in natural pregnancies.

Two Consecutive Miscarriages

A single miscarriage does not automatically make a future pregnancy high-risk. However, if a woman has had two or three consecutive miscarriages, further medical evaluation is necessary.

If signs of miscarriage appear very early in pregnancy, there is up to a 65% chance that the fetus may have a severe abnormality. In such cases, miscarriage may represent a natural process in which an unhealthy pregnancy ends. However, treating underlying health problems may prevent the loss of a healthy pregnancy.

Multiple pregnancies are among the most important high-risk pregnancy categories. As the number of babies increases, the duration of pregnancy becomes shorter and premature birth becomes more likely.

Are There Signs of a High-Risk Pregnancy?

There are some warning signs that pregnant women themselves can notice:

Especially during the first 3 months, pay attention to bleeding, pain, and fever. These symptoms can be dangerous for the baby. The risk of miscarriage is greatest in the first 8 weeks. Vaginal bleeding is an urgent problem at any stage of pregnancy.

In later stages of pregnancy, warning signs include:

  • Swelling in the hands, feet, and face
  • Excessive weight gain after the 20th week
  • Blood pressure of 140/90 mmHg or higher
  • Blurred vision or seeing spots
  • Decreased fetal movements
  • Increased vaginal discharge
  • Pelvic pain
  • Leakage of fluid
  • Severe headaches
  • Severe nausea
  • Painful or frequent urination

If any of these symptoms occur, the pregnant woman should contact her doctor immediately.

Ultrasound examination in the early weeks answers important questions, such as whether the pregnancy is inside the uterus and whether it is a multiple pregnancy. In high-risk pregnancies, ultrasound is repeated every 3–4 weeks to monitor the baby’s growth and detect possible abnormalities.

Between weeks 11 and 14, a first-trimester screening test and nuchal translucency measurement are used to assess the risk of Down syndrome. Between weeks 16 and 18, AFP measurement or triple/quadruple screening tests may identify chromosomal abnormalities and neural tube defects.

If there is a high risk of chromosomal abnormalities, a definite diagnosis can be made by taking a sample from the placenta (chorionic villus sampling) or the amniotic fluid (amniocentesis).

Good medical management can help make a high-risk pregnancy healthier. However, if severe abnormalities incompatible with life are detected, there may unfortunately be no treatment available.