hCG level testing

About 10 days after your transfer, your doctor will have you come in for a blood test to check your human chorionic gonadotropin (or hCG) levels. hCG levels rise when an embryo implants in the uterus and a blood test can typically detect the hormone before at-home urine pregnancy tests. hCG levels below 5 mIU/mL are considered negative for pregnancy. Anything between 6-24 mIU/mL is a gray area, which could indicate a biochemical pregnancy, a type of early pregnancy loss. 

Research suggests that pregnancies with hCG levels that reach at least 100 mIU/mL within 10 days of a five-day transfer or 12 days following a three-day transfer are the ones most likely to result in a successful pregnancy. Although high hCG levels are typically a more promising sign, rising hCG levels are more important than the initial number. Your fertility clinic will want to check your hCG levels every few days, and then weekly, to make sure the levels continue to double every 48 hours.

The ultrasound

You will have your first ultrasound when you are five weeks pregnant to confirm that there is a gestational sac — a fluid-filled body containing the embryo. Then, when you’re six weeks pregnant, you’ll return for another ultrasound, this time where you’ll be able to hear the baby’s heartbeat. Later, toward the end of your second trimester, you’ll have a full anatomy scan, taking a detailed look at baby from head to toe. 

Graduating from the fertility clinic

Fertility clinics typically monitor IVF pregnancies up until weeks eight to ten of pregnancy. During this time, you will be prescribed progesterone suppositories or injections. Studies show that progesterone increases the pregnancy rate following IVF and helps decrease the risk of miscarriage. Once you graduate from your fertility clinic, you will see your obstetrician At a traditional schedule with several weeks between appointments. Though this can be nerve-racking, especially considering how closely your fertility clinic monitors you, it’s the normal schedule of appointments. If you have a high-risk pregnancy due to a health condition or a history of pregnancy loss, you may have more frequent appointments. 

It can be hard to feel calm after getting pregnant using IVF, even after you reach your second and third trimesters. Your road to parenthood might not look like what you expected, and that’s OK. You worked hard for this pregnancy, so you deserve to enjoy it. If the fear of pregnancy loss feels all-encompassing, try opening up about these complicated feelings to a friend, trusted loved one, or mental health professional. It’s important to take time to celebrate each milestone, no matter how small. The IVF process takes away some of the big firsts, like the randomness of a positive at-home pregnancy test, or, for some, being surprised by the sex of the baby, but that doesn’t mean you can’t make your own unique memories. 

Reviewed by the Ovia Health Clinical Team

Sources

• American Society for Reproductive Medicine. “Progesterone Supplementation During In Vitro Fertilization (IVF) Cycles.” https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/progesterone-supplementation-during-in-vitro-fertilization-ivf-cycles/.
• Coomarasamy, Arri, Adam J. Devall, Jan J. Brosens, Siobhan Quenby, Mary D. Stephenson, Sony Sierra, Ole B. Christiansen et al. “Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence.” August 2020 https://pubmed.ncbi.nlm.nih.gov/32008730/.
• King, N., L. A. Bernardi, J. Tolentino, J. Zhang, A. Lawson, and R. B. Barnes. “Serum HCG values are as predictive of live birth after single embryo transfer as early pregnancy ultrasound.” November 2017. https://www.fertstert.org/article/S0015-0282(17)31536-4/pdf.

Here’s the latest from the Ovia Health Clinical Team, including answers to your questions and some practical guidance. 

If I’m pregnant and I get COVID-19, will the infection be worse?

It’s possible. Research indicates that pregnant people and recently pregnant people (within 42 days of giving birth) are at higher risk for significant complications from COVID-19 than their non-pregnant peers. This means that while the overall risk for severe illness is low, there is an increased risk of hospitalization, intubation and mechanical ventilation, blood clots, and requiring intensive care. There is also an increased risk of adverse pregnancy outcomes, including preterm birth and possibly an increased risk of pregnancy loss when compared to pregnant women who did not get COVID-19. 

These risks are compounded for Black pregnant people, who have long experienced nearly twice the risk of preterm birth when compared to white people. Many studies have demonstrated that race is likely an independent risk factor when it comes to healthcare outcomes like preterm birth, separate from other risk factors like income or education. That race-related risk may stem from chronic stresses of societal racism as well as the race-related inequalities that have been identified within the healthcare system. 

Pregnant parents who test positive for COVID-19 should be offered a discussion about the medication Paxlovid. You can read more about that here.

What can I do to prevent infection?

Prevention is no different for pregnant people than it is for anyone else. Follow the advice that you receive from your local health department, from the CDC, and from your healthcare provider. Avoid going to public places if you think or know you have COVID-19, to prevent spreading it to others. 

If you know local rates of Covid are high, wear masks when indoors and practice social distancing. Being vaccinated has been shown to provide protection against severe COVID-19 disease. However, you can still get sick and pass the illness on to vulnerable people who aren’t vaccinated or cannot be vaccinated (like newborns).

Is hand sanitizer safe in pregnancy?

Yes, Yes, YES. The CDC reports [3] that handwashing with soap and water is more effective than hand sanitizer. However, you can’t take the sink in your car or on a walk or to the grocery, so make sure you use hand sanitizer regularly in addition to handwashing. Furthermore, it’s often much easier to wipe hand sanitizer on your children’s hands than it is to get them properly washed, so consider this a regular habit as well.

If I get COVID-19, will I pass it to my fetus?

The most recent research on the topic says that transmitting COVID-19 while pregnant is very rare – for moms in North America, the rate was about 0.1%. This does not include the risk of passing it to your newborn during routine care postpartum. However, studies suggest that people who tested positive for COVID-19 during pregnancy are more likely to have complications, such as preterm birth [6]. There is no evidence that cesarean delivery reduces the risk of infection for Baby, so this is not recommended.

What about during and after birth?

It is extremely important that you call your healthcare provider before you go to the hospital if you think you have COVID-19. Once at the hospital, your provider knows what to do to reduce the risk that your baby (and the healthcare professionals who care for you) will become infected.

Keep in mind that testing positive for COVID-19 when in labor may cause changes to your birth plan and hospital stay. You may want to consider extra precautions in the last weeks of pregnancy to avoid this.

What is the risk to my baby? And what about the risk to my other children?

Children seem to be at less risk of becoming really sick with COVID-19 than adults are, but infants make up the bulk of serious cases and hospitalizations in children under 17. Current evidence suggests that babies are not likely to get COVID-19 from their mothers as long as preventative steps are taken, such as wearing a mask around your baby, washing your hands for 20 seconds prior to holding your baby, and having them sleep 6 feet away from you. You should still do everything you can to reduce the risk of exposure. Children with certain underlying conditions are at risk for complications from COVID-19, so it is important to keep them safe and communicate with their pediatrician.

Is breastfeeding safe if I think I have COVID-19?

There are many benefits to breastfeeding for parents and babies. It appears unlikely that COVID-19 can be transmitted through breast milk, though helpful antibodies can be passed along! 

If you test positive for COVID-19, this may impact the care of your newborn. In-hospital, the CDC recommends discussing with your provider the risks and benefits of caring for your newborn while sick. Mildly ill people generally room in and care for their newborns. If you are seriously ill, this may not feel like a physically possible or safe option. Once you are home, wash your hands frequently — and always before touching your baby. Wear a mask when you are within 6 feet of your baby or another person. If you have a caregiver who lives with you, they should also wear a mask whenever caring for your baby.

We know that with other illnesses, you pass antibodies to your baby through your breast milk. Antibodies are what your body makes to help fight off illness. The research into COVID antibodies in breastmilk is really encouraging and suggests that antibodies are passed through breast milk after infection or vaccination. 

What if I’m trying to conceive and not yet pregnant?

There’s no evidence that COVID-19 or any similar viruses impact conception or cause birth defects if you are sick when you conceive.

Should pregnant people get the COVID-19 vaccine?

Multiple well-respected clinical organizations, including the ACOG (the American College of Obstetricians and Gynecologists) and the ACNM (American College of Nurse-Midwives), recommend the vaccine to people who are trying to conceive, pregnant, and breastfeeding [11].

The first clinical trials for the COVID-19 vaccines manufactured by Pfizer-BioNTech, Moderna, and Novavax did not include participants who were known to be pregnant or breastfeeding. This is typical for pharmaceutical research. Recent studies have included pregnant people and show that there is no increased risk and that vaccines given in any trimester do not negatively impact pregnancy outcomes. In addition, vaccinating in the second or third trimester may offer additional protection to your newborn.

Additionally, none of these COVID-19 vaccines contain a “live” virus. This means you cannot get COVID-19 from the vaccines. In general, vaccines that do not contain “live” viruses are safe during pregnancy and do not have increased risks for infertility, miscarriage, fetal anomalies, or stillbirth. Side effects of the COVID-19 vaccines include pain at the site of injection, fever, fatigue, and chills. These typically go away after a couple of days. These side effects are normal and expected and are indicators of your immune system doing its job to learn to protect you from the virus. There have been very rare reports of unexpected, adverse reactions from the vaccines. A severe allergic reaction called anaphylaxis can happen in very rare cases. The incidences of these adverse events are so low that getting vaccinated remains safer than potentially getting infected with COVID-19. [12].

You can also reach out to the experts at Mother to Baby for more information. Your midwife, doctor, or other healthcare professional is also a great resource for more information about the COVID-19 vaccine. Ultimately, you are the one who knows what is best for your body and your family.

Reviewed by the Ovia Health Clinical Team

Sources:

Dara D. Mendez, Vijaya K. Hogan & Jennifer F. Culhane “Institutional racism, neighborhood factors, stress, and preterm birth”. Ethnicity & Health. 19:5, 479-499. October 18, 2013.

Jasmine D. Johnson et al., “Racial Disparities in Prematurity Persist Among Women of High Socioeconomic Status,” American Journal of Obstetrics & Gynecology 2. 2(3), 100104. Nov 10, 2020

James W. Collins Jr et al., “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination,” American Journal of Public Health. 94(12), 2132–2138. December 2004.

Braveman Paula, et al. “Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes” Frontiers in Reproductive Health. Vol. 3. 684207 September 2, 2021.

Gina Nebesar, Co-Founder of Ovia Health

I was so excited to speak with my two dear friends Becca and Jean Ann recently. Just this year they started on the crazy journey that is parenthood with their beautiful baby girl, Roz. They’re total badasses at home and at work, they’re incredible people, and now they have this gorgeous family. Their TTC journey took them a little while, and IVF helped them get pregnant, and I’m really grateful they could share their story – including incredible advice about choosing and buying sperm, real talk about IVF shots, and really candid conversation about adjusting to life as new moms.

IVF success stories: Two moms talk about growing their family… and how

I want to start by saying congrats! I know you just celebrated your 5 year anniversary, a big milestone. And an even bigger milestone is the birth of your baby girl! I’d love if you could start by telling us a little about your beautiful family.

Becca: We did just celebrate our five-year wedding anniversary, and in April we had our baby girl Roz. She’s almost 5 months old. And it’s been great so far!

I just left town for the first time, and left her alone this weekend with Jean Ann, her other mom. And in that 48 hours she learned how to roll over, without me there! And now she sleeps on her stomach, so I came home to a totally different baby. But I feel like she’s changing every single day, so it’s really awesome.

I love hearing about how people make the decision to start a family. Could you tell us a little bit about your journey to becoming parents?

Jean Ann: Because we’re two women, one question that I asked a lot is how we decided who will carry. And when your partner basically says, “One thing I’ve always wanted to do in my life is be pregnant and give birth, like, totally unprompted,” you’re like, “Cool, that seemed too easy.” Becca had always wanted to do that, and I’m still sort of on the fence – it doesn’t seem like something I have to do. So Becca had decided that she was excited about that a few years ago, and eventually I got more excited about it.

The first thing we had to do was choose a sperm donor. That was probably one of the biggest decisions we’ve ever made. Because you have to decide if you want an anonymous donor or someone you know. And we actually had a good friend who offered. And we took it pretty seriously, but ultimately decided it was important for us to have our own separate family unit. So then we looked at a lot of the websites for sperm. It’s basically like a KAYAK for sperm, and you can sort for different things.

Becca: It’s almost like online dating!

Jean Ann: We wanted someone that hopefully shared a lot of my characteristics. So were able to find someone who was half-Asian, he was getting a graduate degree in chemistry. We could even listen to a 45-minute interview with him where he talked about his favorite books, and he just seemed very thoughtful, quiet, serious, and nice.

Becca: We spent a lot of time looking for sperm – really thinking about these profiles and listening and narrowing it down. I remember we had all these pieces of paper on the kitchen table – we had written down the different donor numbers and which ones we liked – and then we narrowed it down.

And we actually had kind of had a long journey. It was about two and a half years from buying sperm until having Roz. Buying the sperm was step one. I remember, they were having an end-of-year sale, so we had to get it in before the end of 2015!

Were they really? Like, they were really having a sale?

Jean Ann: Yeah, it’s expensive. It’s something that there’s a lot of in the world, but it’s not cheap!

Becca: Well, it wasn’t quite a sale, but they were like, “We’ll throw in an Amazon gift card if you buy today!”

Jean Ann: “And three years of free storage!” But, yeah, we’ve actually spent several thousands of dollars on sperm, if you can believe it.

So, obviously, you found a great deal, but how did you get started with that process?

Becca: Really, we just Googled.

Jean Ann: There’s three or four big sperm cryo websites.

Becca: The one we went with is called California Cryo, one of the largest ones. For us, they felt right— it was a good website experience, and their customer service has been great. We did look at the big ones, some other small ones, and some local ones.

Jean Ann: But I think, for us, wanting a donor who was half-Asian like me was important, and that actually narrowed it down a lot. It went from like 550 to like, eight.

Becca: So then we could spend our time kind of really thinking through those people.

Jean Ann: You can definitely get a situation where there’s a run on the sperm. So we had this total disaster about a year later, where we had used up half the vials that we’d bought, and we were getting really low, and we went online, and they had sold out! And the donor had stopped donating! So we recommend you check what’s in stock a lot.

Becca: Yes, check frequently! And if you can afford it, buy more than you think you need.

Jean Ann: Buy a lot!

Becca: Because you can store it, and you can sell it back if you don’t need it.

Jean Ann: Nothing is worse than the feeling of having decided on someone to be your sperm donor and being very excited about them, and being halfway through the journey, and then realizing that if you want to have more than just one kid that you’re going to run out of sperm.

Becca: You’re going to run out and you may have to use different sperm.

Any other advice about that process for others that are just starting out with sperm donation?

Jean Ann: Just check your sperm stock frequently. And if you’re really excited and settled on someone, I would buy more than you need or just be willing to have a weekly reminder to check that it’s not running out.

Becca: I think the other thing is I would pony up for the extra access to information. Because I think, for us, the interviews with the sperm donors, that was the most impactful. You can only tell so much from a baby picture and some  generic likes and dislikes – which is the basic info you get – but I actually think you can get a pretty good feel for a person from something like an audio interview. It’s like a typical website where it’s like, “Pay to unlock this feature!” but it’s worth it to pay for that premium membership.

So, in December 2015, once you made that decision about your donor, how did things progress from there?

Becca: So that winter when we were back home from the holidays, we started trying to get pregnant, and we were doing IUI.

Jean Ann: You basically have two options, you can do IUI or IVF with donated sperm. IUI is basically artificial insemination.

Becca: Turkey baster!

Jean Ann: The turkey baster method, but at a facility. So we started with IUI.

Becca: I actually got very lucky with the first IUI try in February 2016. I was tracking my ovulation – I was using the Ovia app – and I was peeing on sticks and all of that, and when my ovulation test said I was ovulating we went in for the IUI, we did IUI, and I got pregnant that very first time. And it was amazing! We were so excited! First try!

And then in the spring at about 12 weeks I had a miscarriage. So I got almost through my first trimester, and I had a miscarriage. That sucked, that was a setback and sad, and that was really hard.

So the summer of 2016 was kind of recovering from that, and then it takes a while to get back on track, especially when you have a miscarriage when you’re that far along there’s a lot that your body has a lot to process and then re-regulate. And then we didn’t have a chance to try again until September of that year. So we got back on the horse and started trying again. And we were gonna continue to do IUI at that same facility because it had worked that first time.

And I started tracking my ovulation and going back in monthly, but something was wonky with my cycles. I would think I was ovulating, but I would go in and I wasn’t ovulating. I think one or two times we did get an ovulation, and we tried, but I didn’t get pregnant.

Jean Ann: And that’s when we started running out of sperm. And we realized that there wasn’t more. So that’s when we panicked, realized we couldn’t get anymore, and so we decided to move to IVF. But neither of our insurances, we thought, really covered IVF.  We were both on my insurance, and it wasn’t explicit. It was basically like, “Your IVF is covered, if it’s for a medical reason.”

Becca: “Medically necessary.”

Jean Ann: Yeah, “medically necessary,” that’s the phrase that’s used – and so I went down this whole rabbit hole to figure out if that means coverage if you’re gay. It took forever. But basically, no, being gay was not a “medically neccessary” reason, so it wouldn’t be covered. So I fumed about this for a while.

And then I ended up talking to our company’s head of HR kind of randomly about something else, and I just kind of mentioned this to her and didn’t expect it to go anywhere—I just figured this would sort of take some kind of lawsuit situation to change it— but she was like, “Oh, really? I didn’t know that!” Then two days later somebody that worked for her called and they were like, “Oh, we added it for same-sex couples to our insurance, so it’s covered now!” So I guess some advice would be to know that in terms of your health insurance, you may be able to change the coverage for something like this, depending on your company.

I constantly tell women to ask for those benefits, because they might end up with that exact same story. I was in a meeting recently with a health plan and an employer where we we pointed out in the language of the plan how it was alienating to same-sex couples. And the woman didn’t even realize it and was like, “I’ve gotta change it!” She had just never read the fine print before, but then took action to change it as well. I’m so glad that you asked about it, and I wish more people would!

Becca: Yeah, it was pretty awesome. So, we started IVF in the summer of 2017, and there’s a whole series of tests and all sorts of painful things they need to do to make sure you’re ready for it. And that takes months— you have to wait a few cycles, you have to get on the right timing. So I remember this being such a frustrating time in our lives. It felt like everything was going slowly and like everyday I had to be at the doctor doing some other painful thing. It was a rough period. It is funny now looking back on it, because it all feels like such a blur in retrospect, but at the time it felt really pronounced and painful.

Jean Ann: As someone that has now done IVF three times myself – and Becca has done it once – it’s not as bad as people think it is. It sucks giving yourself the shots, but it’s fast. It’s like a two week period of shots.

Becca: At this point we’ve both done it, because as the journey continues, we ended up having a baby and decided that we wanted to at least give ourselves the option to having another baby in the future with Jean Ann’s eggs.

Can you share more about that experience and what it’s like? Again, I’m sorry to hear about this part of the journey. I just can’t imagine having the 12 week miscarriage, that’s just awful, and the fear of the sperm running out, and then going through the pain of IVF. And I know you say it’s not that bad, but I think maybe you’re just tougher than many – that sounds really hard to me!

Becca: Honestly after being pregnant for nine months, you can barely remember the IVF, it’s like a blip. But I think that the shots – for us at least – I think the shots look scarier than they end up being.

Jean Ann: I feel like the first and second time you’re really just like, am I really going to stab myself in the leg with this needle?

Becca: The thought of it is tough. The first time is the hardest, because you’re just staring at this needle and you’re like looking at your leg, and you’re just like, so I’m really just going to push this in, huh? But it’s a needle, and it’s made to go in. I actually think over the two week period of shots, it gets progressively more painful toward the end. So the last few days are the worst. I think at that point you’re feeling a little bit bloated, you’re not allowed to go to the gym, you’re giving yourself shots every single night. For some reason those last few nights hurt the worst. At that point you’ve shot yourself everywhere on your legs, everywhere on your stomach, and you’re looking for a new spot. So those last few nights, you just want it to be over.

Jean Ann: And then you have the trigger shot, and everybody makes a big deal of the trigger shot. Somebody else gives you that one, and it has to be at an exact time – like, 1:45 in the morning, 10:30 p.m. – so when you go in to have your eggs be retrieved, it’s exactly 36 hours after the trigger shot.

Becca: And then for the egg retrieval process you do go under.

Jean Ann: Under some very temporary anesthesia. You’re all the way under, but it’s very short. And then you’re done!

Becca: And then there’s some anxiety as you wait to hear your egg count. For us we were doing embryos, so right when they retrieved the eggs they fertilized them with our frozen donor sperm. So after that you’re kind of waiting on eggshells – no pun intended – to hear how many of your embryos made it to day 3 or day 5, or just what the status of them is. And we’ve been on both sides of the spectrum. For me, I was really fortunate, I had a pretty high egg count, and with just one retrieval I got enough embryos that we felt comfortable and were able to freeze them. For Jean Ann, on her first and second try she didn’t get that many, and so she’s had to go through the egg retrieval process three times now.

Jean Ann: I will just add that for anybody that’s getting close to age 35, 35, you can get a blood test that will give you your AMH number. It basically tells you how many eggs, roughly, you have left. It’s a very good indicator or whether IVF is going to be a breeze and you’ll just have to do that once, or if your egg yield is going to be low and you’re going to have to do it multiple times like me. It is also a good predictor of if you will have to do IVF at all because the same number is also a good indicator of whether or not you will naturally be able to get pregnant. It’s a very easy first step.

Did you know about this AMH (or Anti-Mullerian Hormone) test before starting the IVF process, or did you learn about that after?

Jean Ann: Actually, someone at work told me about it. Because I was like, “I don’t think I want kids for a few years,” and this very matter of fact 40 year old man was like, “How old are you?” And I said, “35.” And he was like, “Just go get your AMH number. My wife had a low AMH number and it took us 5 years of trying and then we ended up adopting.” I was like, oh, my gosh!

And then I got the test, my AMH number was bad, and, indeed, it took me multiple times to do IVF. So I feel like this AMH blood test is pretty much free information.

A lot of healthcare providers might say no to that sort of testing, but I always suggest that people go to their provider and just insist on it. So, through this process, who was supporting you along the way? Obviously, you had each other. Was there anyone else in your life who was particularly helpful during this time?

Becca: Each other, for sure. I’m not a big oversharer, but it’s been really helpful for me to share, because what I’ve found is that as soon as I start talking about it, everyone has either a similar story themselves, or their friend does, or their sister does. So when I had my miscarriage, it was really helpful for me to tell people about it – even at work – and then people would share these success stories, and that made me feel better. And it was similar when going through IVF. I would talk about it with my friends, and they all had someone they knew who had been through it. At the time, I was really the first of my very good friends who was having a lot of trouble getting pregnant, and I felt a little bit alone, so their IVF success stories were helpful for me.

Jean Ann: But since then, now we know several people who’ve been through this.

Becca: We know people who’ve had miscarriages, been through IVF, and now I’ve been able to help them because we have this success story. So, for me, I would tell anyone who’d listen! And that helped me a lot.

Jean Ann: Then you had a pretty good pregnancy.

Becca: Yeah, and the IVF really worked well for us. We did an egg transfer, and I got pregnant on that first one, and then I had a pretty good pregnancy.

Jean Ann: And you have to give yourself these progesterone shots for the first 12 weeks.

Becca: No one talks about this!

Jean Ann: No one talks about this, but these are actually really terrible shots. And every night for the first 12 weeks that you’re pregnant—

Becca: You give yourself a progesterone shot in the butt.

Jean Ann: That was probably the worst part.

Becca: I think some doctors will allow you to do a suppository instead. So I went, like, running in after three nights of shots and was like, “Give me the suppository!” And they were like, “No, we highly recommend the shots.” They wouldn’t do it. So you’re giving yourself shots for 12 weeks. So much worse that the two weeks of IVF shots! It’s so much longer! So you’re basically so sore in the butt for the entire first trimester. But once we got through that, things were okay.

Jean Ann: Smooth sailing.

Becca: Yeah. I had a lot of heartburn, and that was my main symptom really.

Jean Ann: Then because you were a geriatric pregnancy, they told us that they wouldn’t let you go past one week over your due date. So we got an induction date for almost a week past your due date.

Becca: Yeah, 5 days past my due date they scheduled us for an induction. We went in, I got induced, and like these things do, it took forever to get a room, it took forever for the induction to start.

But then, like, once it started, it really started.I had pretty strong contractions for a long time, for like 15 hours. But I really wasn’t dilating. So, it was kind of sad, I kept having these big contractions and the doctor would go away and then come back a couple hours later to check my cervix and every time I was like, “Oh, I think I’m making progress!” and then she would check and be like, “Nope, still 3 cm. You’ve barely made it to 4 cm.” So I just wasn’t dilating. And then at some point, in about hour 16 or 17 of labor, I got a fever, and they said we’ve got to do a C-section. So we went in on a Thursday night, that Friday night at 11:30 p.m. she was born via C-section. And she was great!

Jean Ann: There’s so much pressure to not have a C-section and to be able to breastfeed right away and all this stuff, and, like, if you walk out with a healthy baby, that’s the goal, that is 100% success. I feel like people shouldn’t put that much pressure on how they want everything to turn out.

I know. There’s so much pressure for birth to be this perfect experience, just as planned. And I remember, too, even with me, I had a C-section, just feeling guilt, feeling like a failure, and realizing that, like, my baby’s awesome, and I really don’t care about how I got her! Do you remember what the first couple of days after Roz was born were like?

Becca: It’s funny, it’s such a blur. And I remember at the time saying to myself, I’m totally lucid and I’m recovering fine and I’m gonna remember all of this. And now I realize I don’t remember much of what those days were like!

I remember stumbling out of bed in the middle of the night and either feeding or pumping, and I remember napping a lot. Because I was recovering from a C-section, I needed a lot of help both during the days and the nights. So luckily I had Jean Ann to help, we had family, we got some help for me during the day when she went back to work. We were fortunate to be able to do that because I couldn’t lift the baby, but it’s all such a blur.

I do remember her being so cute. Like everything she did was so cute. I would feed her, and she’d fall asleep on me right after, and it was the cutest thing I’d ever seen! This weekend, actually, I saw a picture of Roz from her first few weeks. And I remember at the time looking at her and thinking, My newborn is so cute! She doesn’t look like a weird scrunched up newborn like every other one! She’s a perfect baby! And, like, five months later I realize that she definitely looked weird! But you just don’t see it at the time.

You do have an exceptionally cute baby! So what is it like now versus what it was like then?

Becca: I just feel like we’re getting more into what our life will look like for the next few years. Those first few weeks in my maternity leave I just kept thinking about how it was a temporary time – and it was wonderful, and I really enjoyed it – but now we’re trying to figure out what our real life looks like. Like how we manage the jobs and the baby, how we manage finding time for ourselves, how we manage time for the extended family who wants to visit. So, it’s different – I’m much more lucid, I’ve recovered from the C-section, all of that kind of blurriness is gone – but I’m in this, like, this half-place where I feel like, we don’t quite have enough time for everything. And I don’t know if this is just what the new normal is, or if we’re still figuring it out. So that’s kind of the phase we’re in now.

I feel like our journey has taken a lot of different turns. And where we are now – we’re so so happy and so lucky that we have this wonderful healthy baby – but it took a while. And it took a lot of different types of interventions, and along the way there were times when it felt like it wasn’t going to happen, but now she’s here, and she’s perfect, and it makes the last two and a half years feel like a blur, like just a blip. So it was all worth it.

Jean Ann: But at the time, it was tough. It can be very tough.

Becca: Yeah, and I guess some advice we would give is to try to release some of the expectations that you have and some of the perfection that you’re striving for, because you really just don’t know how things will turn out. Like, you might not always be able to hit that exact timing for getting pregnant that you want. Or we thought we wanted a boy, but we obviously love our baby girl! It turns out it doesn’t matter. So just to try to release some of that, to the extent that you can, because the journey is hard enough.

Pregnancy test facts…and fiction

Here are some of the more commonly-held beliefs about taking a home pregnancy test, some of which are fact; others, fiction.

Fact or fiction? Your body starts making hCG after implantation.

Fact! After the fertilized egg implants, the placenta starts producing hCG, the pregnancy hormone. A woman’s hCG levels rise very quickly in early pregnancy, but the amount of hCG that a woman has can vary, depending on the individual. Some women have a lot of hCG right away, while others’ bodies take a little longer to start making noticeable amounts of hCG. This is why testing after a missed period can produce more accurate results.

Fact or fiction? Antibiotics can interfere with pregnancy test results.

Fiction. Certain fertility drugs that contain hCG could affect the results of a pregnancy test, but according to the Mayo Clinic, antibiotics or other hormonal medications like birth control pills don’t interfere with the results of a home pregnancy test.

Fact or fiction? You can use an ovulation test like a home pregnancy test to pick up your pregnancy early.

Fiction. In theory, you could, but it wouldn’t be worth the time or money. Basically, home pregnancy tests look for levels of hCG in a woman’s urine, and ovulation tests look for levels of luteinizing hormone (LH) in urine. Both hCG and LH show up nearly the exact same on an ovulation test, so if a woman has enough of either hormone in her body, an ovulation test could technically detect the hCG and show that she is pregnant.

The reason why you can’t use an ovulation test in place of a home pregnancy test is because home pregnancy tests are much more sensitive to hCG. Unlike ovulation tests, home pregnancy tests can pick up on the pregnancy hormone much earlier than ovulation tests. If you use an ovulation test to check for pregnancy, you have a much higher risk of a false negative (and honestly, who wants or even has time for that?).

Fact or fiction? A blood test is the only way to confirm 100% if you are pregnant.

Fiction. It’s true that blood tests are more accurate than home pregnancy tests, but only slightly. Blood tests have an accuracy rate of 99%, compared to the 97% accuracy rate of home pregnancy tests that use urine. If you get a positive pregnancy test at home, your provider will likely perform another urine test in his or her office, along with an ultrasound to confirm your pregnancy.

Fact or fiction? Tests that use pink dye are better than tests with blue dye.

Both? There’s not a ton of scientific evidence about this, but many women report that blue dye fades and blurs in a way that makes it much harder to read on a pregnancy test. No matter what test you use, if you get a positive, make sure to test again a few days later, and then schedule an appointment with your provider.

Sources

• “Pregnancy Test.” MedlinePlus. US National Library of Medicine, Oct 2016. Web. Accessed 8/18/17. Available at https://medlineplus.gov/ency/article/003432.htm.
• Liza Torborg. “Mayo Clinic Q and A: Ovulation predictor kits can be useful for couples trying to conceive.” MayoClinic. Mayo Clinic Foundation, Sep 2015. Web. Accessed 8/18/17. Available at https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-ovulation-predictor-kits-can-be-useful-for-couples-trying-to-conceive/.
• “Getting pregnant.” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. Web. Accessed 8/18/17. Available at http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940?pg=2.

Are you pregnant or is your period just late? Here’s how to tell

Learn more about actual pregnancy symptoms before you start getting concerned.

The science behind symptoms

Pregnant or not, your body starts releasing progesterone after you ovulate. This hormone keeps getting released and is at its highest point around five to seven days after ovulation. If a woman is pregnant, her body continues to produce progesterone in high amounts to help sustain the pregnancy. If she’s not pregnant, her progesterone levels decrease, and she’ll start her menstrual period.

Thanks also to progesterone, the symptoms of early pregnancy and your period are nearly identical. Cramps, fatigue, dizziness, breast tenderness – all early signs of pregnancy, but also possible signs of your period coming.

What about light spotting a week after ovulation? It could indicate implantation bleeding, but most women don’t experience this symptom and spotting can happen for other reasons.

What about nausea? This symptom is typically attributed to hCG, the pregnancy hormone, but it can be caused by other things, too (including PMS).

In the weeks between ovulation and a pregnancy test, many women “symptom spot”; that is, they take note of certain physical symptoms and think that they are definitely signs of early pregnancy. Is symptom spotting so wrong? Absolutely not, and it can even be kind of fun, as long as you know that only a blood test can tell you for sure if you’re pregnant.

Is there anything I can look for?

Probably the most reliable physical symptom of early pregnancy is a missed period. Noticing that your breasts are getting increasingly sore, or experiencing symptoms that you don’t usually get around the time of your period, are also signs that you could be pregnant. But again, a blood test will be the best way to know for sure.

Final thoughts: things to keep in mind

The bottom line is that without a blood test, it’s nearly impossible to know for sure whether you’re pregnant or experiencing a late period. Even home pregnancy tests can sometimes give a false negative, if taken too early, so it’s really smart to wait to take a test until or after your expected period.

If you’re paying attention to your symptoms, just know that it can get a little stressful for some women. So if you find yourself symptom spotting, try to be aware of how often you do it, and how you feel – does it distract you or stress you out? If it starts to get emotionally taxing for you, look for ways to stop paying attention to your symptoms.

Finally, make sure you’ve scheduled a pregnancy blood test, and keep taking your prenatal vitamins! Whether it’s sooner or later, when you get that BFP, you’ll be glad you did!

Sources

• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. Web. Accessed 8/3/17. Available at http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940.
• Lori A Bastian, Haywood Brown. “Clinical manifestations and diagnosis of early pregnancy.” UptoDate. UptoDate Inc., Jul 2017. Web. Accessed 8/3/17. Available at https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-early-pregnancy?source=search_result&search=waiting%20for%20pregnancy%20test&selectedTitle=1~150.
• “Morning Sickness: Nausea and Vomiting of Pregnancy.” ACOG. FAQ126 from the American College of Obstetricans and Gynecologists, Dec 2015. Web. Accessed 8/3/17. Available at https://www.acog.org/Patients/FAQs/Morning-Sickness-Nausea-and-Vomiting-of-Pregnancy.

No period, not pregnant: What does it mean?

The rollercoaster of emotions that come with taking a pregnancy test is often stressful, but don’t give up just yet. Here’s what it means to have no period for a while and still not be pregnant.

Reasons why a test could be wrong

Here are a couple reasons why you may have received a false negative.

• Taken before the first missed period: Pregnancy tests work by detecting levels of human chorionic gonadotropin, hCG, a hormone that the body starts to make when an egg has been fertilized. Because the tests look for the presence of this hormone, it is possible that they miss the hormone in the very early stages of pregnancy, mainly in the days leading up to the first missed period. For the most accurate readings, it’s best to wait until at least the missed period, if not a few days after.
• Fluids diluting urine: Yes, you should still be drinking lots of water! But taking a pregnancy test later in the day can sometimes mean that urine is diluted and hCG is more difficult for the test to detect. The hormone levels are highest in the morning too, so for the most accurate results try to take the test as early in the day as possible, preferably right after you wake up.
• Test directions not followed correctly: We don’t mean to suggest that you would miss a step . . . but could you have missed a step? Some tests require waiting a specific amount of time before reading the results. Pregnancy tests also have an expiration date, so we recommend buying new ones as opposed to using old ones that could be in your house.

Final thoughts

Ultimately, it’s always a good idea to read and closely follow the directions on home pregnancy tests, even if you consider yourself a pro by now. There’s also always the possibility that the negative test is accurate, and your period is simply a few days late. Home pregnancy tests are great, but after a positive result, it’s still important to visit your healthcare provider for a blood test to confirm.

Sources

• “Pregnancy test.” MedlinePlus. US National Library of Medicine, Oct 4 2016. https://medlineplus.gov/ency/article/003432.htm.
• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940.

What happens after a miscarriage?

The process of recovering from a miscarriage can be made even more difficult by the fact that certain experiences aren’t talked about as much as others. Here are five things you might experience after a pregnancy loss, and ways to handle them.

1) Seeing babies or other pregnant women might be really difficult for a while.

After experiencing a pregnancy loss of any kind, it can be difficult for women to see or hear anything related to pregnancy and babies. Things like seeing a baby bump or hearing women talk about their pregnancies might make you feel sad, angry, or might even make you start to cry. This might catch you off-guard, but it’s a completely normal reaction when you take into account the fact that you’ve been through a traumatic experience, and being reminded of babies can make you revisit that trauma.

Consider writing in a journal as a way to get these feelings out. If writing doesn’t appeal to you, find someone who you can talk to who has been through a similar situation, or who understands that these responses are an acceptable and natural part of the grieving process.

2) You and your partner may grieve in different ways.

Two people can react to the same situation in completely opposite ways, and this is especially true for something as intense and devastating as grief. Perhaps your partner needs to talk a lot, and you don’t. Or maybe it’s the opposite and your partner shuts down whenever they are sad. It’s possible that your partner feels as though they need to be strong for you so they push their grief aside completely.

No matter your grieving styles, you’ll be able to get through any pain you’re both feeling by communicating with one another. Ask each other questions. Be sensitive to the answers, and respect each other’s boundaries. Be gentle with yourselves and with one another. Remember that healing will take time for both of you.

3) People might say things that are hurtful or offensive to you.

Grief is an extremely difficult thing for people to deal with, and most people won’t know the right thing to say to you. You might hear things like, “at least you weren’t further along,” “at least you don’t have to buy maternity clothes!” “it was God’s will” or “everything happens for a reason.” Other people may tell you life goes on or that you’ll feel better soon. While they come from a well-intentioned place, these comments can be hurtful and cause you more pain when you least expect it.

No matter what anyone says, you should never feel wrong or foolish for caring as much as you do. Anyone who has been through this kind of experience could tell you that your feelings are entirely appropriate, and there is no wrong way to grieve. You don’t need to listen to or believe people who say things that make you feel bad, or even mildly annoyed. If you find yourself in a conversation with someone who is making you uncomfortable, let them know you appreciate their support but that you would rather talk about something else.

4) You might feel a need to memorialize the loss.

Some women mark their pregnancy loss with a special ritual that helps them celebrate and remember the babies that they loved, and will always love. After all, when our loved ones pass away, we have certain personal and familial traditions that we undergo. But in the United States at least, miscarriages have largely remained private and unceremonialized, which can contribute to women and their partners feeling restless, or like they have to move on faster.

Women who are searching for a way to memorialize their baby may want to look into the Buddhist tradition of mizuko kuyo. This is a ceremony offered by more and more American Zen Centers. Some women might also find comfort in writing letters to their babies, planting plants or trees in honor of their babies, or purchasing customized jewelry to remind them of their babies.

5) You might blame yourself or feel like you are a failure.

Many women feel as though the loss of a pregnancy was somehow their own fault. They may get mad at themselves or their own bodies. They may start to obsess over every little thing they did, ate, or felt – searching for the moment they could have prevented the events that unfolded. But the truth is, miscarriages can happen to anyone. They are more common than anyone talks about. You are not the failure, and you are not to blame.

Sources

• “Miscarriage.” PlannedParenthood. Planned Parenthood Federation of America Inc, 2016. Web.
• OBOS Pregnancy and Birth Contributors. “Miscarriage in the First Trimester.” OurBodiesOurselves. Our Bodies Ourselves, Apr 9 2014. Web.
• “Miscarriage.” MarchofDimes. March of Dimes Foundation, Jul 2012. Web.
• “Pregnancy loss: How to cope.” MayoClinic. Mayo Foundation for Medical Education and Research, Jun 25 2016. Web.
• Elizabeth Leis-Newman. “Miscarriage and loss.” APA. American Psychological Association Monitor on Psychology. 43(6)56. Web. June 2012.

How to time your pregnancy test properly

Here’s what you should know about this timing – and the science behind our recommendations.

First, understand how home pregnancy tests work

In the earliest stages of pregnancy, a fertilized egg will begin to implant in the uterine lining. This happens around four to six days after conception. Once implantation starts, the placenta starts producing human chorionic gonadotropin (hCG), the pregnancy hormone. Home pregnancy tests work by determining if there is hCG present in urine – and, as you might know, home pregnancy tests ask you to pee to a stick to measure this.

Because hCG doesn’t show up until after implantation begins, if you don’t wait a few days to make sure the embryo has had a chance to implant, there’s the chance of getting a false negative – meaning that the pregnancy test reads as a “negative” even though pregnancy has occured. Implantation usually happens six to twelve days after ovulation, so the absolute earliest that you can test for pregnancy is a week after ovulation. For even more accurate results, it’s preferable to wait a few extra days so that levels of hCG can rise to more detectable levels. Waiting a few days after the first day of a missed period usually guarantees the most accurate results from a home pregnancy test.

Utilize Ovia Health to help with pregnancy testing

When it comes to pregnancy test timing, you probably know it’s best to take it at least one or more days after your next period is due. But your menstrual and ovulation cycle can fluctuate every month, meaning certain days of your cycle might change on a monthly basis and make it harder for you to know exactly when it’s time for you to take a pregnancy test. The US Department of Health and Human Services reports that nearly 20% of individuals who are pregnant get a false negative, because they’ve miscalculated their period or it arrived later than expected that month.

This is where tracking is helpful. Different ovulation symptoms can suggest that you’re in a certain part of your cycle. For example, in the luteal phase, which is when the egg implants and your body starts making the pregnancy hormone, your body releases progesterone, which can affect your moods, breast tenderness, and cervical mucus. Spotting might happen as a sign of implantation bleeding, too. These kinds of symptoms tell Ovia what phase of your cycle you’re in.

When you log your data consistently, Ovia takes all of the information you provide, like your period dates, cervical fluid consistency, basal body temperature, symptoms, and moods, and uses it to predict when you’re ovulating and when is the best time to take a pregnancy test. If Ovia tells you to test on a day that’s different from what you expected, this could be because of natural fluctuations in your cycle, as well as symptoms that suggest to Ovia that you’re at a different day in your cycle than you previously thought.

Other things to consider

Cycles fluctuate month by month, and it can be difficult to know for sure when one phase of your cycle ends and another begins. And if you’re patiently waiting for some positive news, we know you can’t get it soon enough – so we’re here to help. By consistently logging your symptoms and moods, you’re providing Ovia with important information that will help us predict the best – and most accurate – day for you to take a pregnancy test.

Sources

• “Home use tests: Pregnancy.” FDA. US Food and Drug Administration, Jun 5 2016. Web.
• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2 2015. Web.
• Connie Matthiessen. “Week 01 to Week 04 of Pregnancy.” HealthDay. HealthDay, Jan 20 2017. Web.

1. Everything in moderation

There’s no need to completely eliminate any type of food — especially if it brings you joy. In fact, eliminating entire food groups, or macros like carbs can rob your body of essential nutrients. And restricting favorite foods can actually lead to feeling out of control around that food which is harmful to your relationship to food. Intuitive eating is a great alternative approach to restrictive eating or dieting. You can depend upon your body to tell you which foods you need and how much is enough. It takes practice, but can be a very freeing philosophy around all foods. 

2. Keep hydrating

The more hydrated you are, the more hydrated your cervical fluid is, making it easier for sperm to travel through your cervix and into your uterus and fallopian tubes. This is especially important when you’re exercising, and/or living in warmer climates. If it’s difficult for you to drink water, try adding a squeeze of lemon or orange into your water, or get some flavor drops. It can be motivating to get a water bottle with goals written on it according to times of day. Eating foods that are high in water content, like grapes, cucumbers and celery, will help with your hydration as well.

3. Limit trans fats

Trans fats play a role in causing infertility for some people. In one study, those who ate 4 grams of trans fats a day (as part of a daily 1800 calorie diet), had an increased risk of irregular ovulation. If you don’t ovulate, you can’t get pregnant, so it’s best to avoid these when possible. Trans fats are primarily found in fried foods, some commercial baked goods, and some margarines. Alternative sources of fats you can turn to are olive oil, avocado, and fish. 

4. Boost protein

Protein is an important macronutrient for hormonal regulation as well as blood sugar stabilization. It’s a good idea to have a variety of protein sources each day, like lean meats, fish, eggs, and dairy products like yogurt. If you’re finding it difficult to prepare protein-rich meals, try occasionally adding whey or plant based protein powder to a smoothie or shake.

5. Decrease refined carbohydrates

Carbohydrates get a bad rap. But let’s face it, they are our bodies’ main energy source and we all need carbs in our lives. They also help us feel satisfied. Eating refined or simple carbohydrates causes a greater increase in blood glucose levels (and thus in insulin levels) than complex carbohydrates do. So, refined or simple carbohydrates can negatively impact ovulation.

Some of the most common simple or refined carbohydrates include white bread, and foods with added sugar, including juices made from concentrate. Alternatively, complex carbohydrates energize your body while also providing fiber and starch. These are foods like fruit, vegetables, beans, and whole grains. So try swapping your bagel for some whole grain toast, or your pasta for some whole wheat pasta or chickpea pasta if that feels right for you. 

6. Fill up with fiber

Fiber is excellent for regulating blood sugar and maintaining a healthy gastrointestinal (GI) system. It helps move waste through our bodies effectively and contributes to healthy cholesterol levels. It’s a good idea to have about 25 grams of fiber everyday. Fruits, vegetables, nuts, and beans are excellent sources of fiber. 

7. Choose full-fat dairy

Full-fat dairy foods provide the building blocks for the hormones necessary for fertility: estrogen and progesterone. Hormones require cholesterols (fats) from our diet in order to be made. If your diet is lacking in fat, you may not be able to make the hormones necessary to have a regular menstrual cycle and thus, ovulate and get pregnant. So add in some yogurt, whole milk or cheese to be sure you’re getting what your body needs!

8. Be mindful about alcohol

Enjoying a cocktail once in a while or a glass of wine with your meal is all part of balance. And there isn’t any solid evidence that occasional social alcohol use is associated with infertility. However, moderate alcohol intake (3-6 drinks per week) or more can significantly increase your risk for infertility. Enjoying a mocktail every once in a while can help get you ready for eliminating alcohol altogether once you get that positive pregnancy test!

9. Start your multivitamin

A multivitamin helps you achieve the recommended daily amounts of folate (folic acid) and iron. Both are essential micronutrients in the early stages of pregnancy. In fact, having enough folic acid on board at the time of conception through the first 8 weeks of pregnancy is associated with a significantly lower risk of baby having a birth defect called spina bifida. Often, people find out they are pregnant too late to take action on this, which is why it’s a good idea to start your prenatal vitamin around three months before you anticipate conceiving. 

Reviewed by the Ovia Health Clinical Team

Read more

• Nutritious salad dressing options
• Investigating the 2,000 calorie diet
• 6 ways to get more greens into your diet

Sources

• Katz DF, Slade DA, Nakajima ST. “Analysis of pre-ovulatory changes in cervical mucus hydration and sperm penetrability.” Adv Contracept. 13(2-3):143-51. Web. June – September 1997.
• Lee CH, Wang Y, Shin SC, Chien YW. “Effects of chelating agents on the rheological property of cervical mucus”. Contraception. 65(6):435-40. June 2002.
• Harvard School of Public Health. “Changes to Diet and Lifestyle May Help Prevent Infertility from Ovulatory Disorders”. Harvard.edu. Harvard School of Public Health. October 31, 2007.
• Jorge E. Chavarro, M.D. et all. “Protein intake and ovulatory infertility” Am J Obstet Gynecol. 198(2): 210.e1–210.e7. March 2011.

Pregnancy implantation signs and symptoms

Timeline

The first difference is in the timing of the symptoms. Implantation happens any time between about 5-10 days after you ovulate, while PMS usually sets in closer to two weeks after. So if symptoms start and it feels a little early to you for it to be menstruation, it might be a successful implantation.

Cramping

Mild cramping can be a sign of successful implantation, as the fertilized egg attaches to your uterine lining. These cramps don’t happen in every case, and they’re not, on their own, enough to say for sure that implantation has happened. When they do occur though, they’re different from menstrual cramps in that they only last for short periods of time, rather than continuously like menstrual cramps. The pain they cause also tends to be much more mild than that from menstrual cramps.

Spotting

Implantation bleeding produces a lot less blood than a menstrual period. Instead, it’s more like spotting, and is more likely to range from pinkish to brownish, instead of red like menstrual blood. If you have heavier-than-period bleeding, especially with extreme cramping, you should contact your healthcare provider.

Soreness

Both implantation and PMS can cause soreness in your breasts. The two types of soreness won’t necessarily feel that different from one another, but soreness from a period will usually go away after a few days, whereas soreness from implantation might stick around through your pregnancy. In fact, the elevated presence of progesterone and other hormones during pregnancy can cause several different changes in your breasts. Another change that you might notice around the time of implantation is a darkening of your areolas.

Other signs

There are other signs of implantation that don’t correspond to menstrual symptoms, like nausea and morning sickness, increased urination, and, of course, missing your period. Since everyone’s body is different though, you may not notice some or all of these signs. At-home pregnancy tests can provide a bit more confirmation, though they won’t reach their full accuracy until around your expected period date.

Sources

• “Is It Implantation Bleeding — Or Just My Period?” WhattoExpect. What to Expect, Apr 12 2016. Web.
• Margaret Scott. “Signs Of Successful Implantation: Why It Is Important To Stay Optimistic.” ImplantationSpotting. All About Implantation Bleeding, 2014. Web.