No pregnancy symptoms....??
12 Replies
hopeful DC - December 5

Dear Doctor,

I am 31 years old going through my first IVF cycle. I have PCOS (taking metformin), Adult onset Congenital Adrenal Hyperplasia (not taking steriods for this condition) and I recently had both of my tubes removed in preparation for this cycle. My retrieval was on November 21 with a blastocyst transfer on Day 5 with 2 1AA blastocyts. I have not felt any of the conventional symptoms that they describe on several websites and that my doc has told me to look out for. I am worried that I may not be pregnant because I do not feel anything unusual. When both my mother and sisters got pregnant, they had the classic throwing up and breast tenderness, etc. I do understand that there is not way of knowing until you take the test, but should I be concerned that I am not having any classic symptoms especially since the levels of HCG correlate with an increase in the pregnancy symptoms usually?

Secondly, if I had such "good quality" blastocysts for the transfer, what would be my realistic expectations for a positive pregnancy test? mY test is on Thursday and I am dying for any sign or symptom that this cycle worked. Thanks for your help!!! I look forward to your response.


hopeful DC


Barry Jacobs, M. D. - December 5

Not alll women begin having preganancy symptoms at the same point in pregnancy. It will even vary from one pregnancy to another for the same woman. Since I do not know the statistics for the program you are using, I cannot tell yo the potential for a positive pregnancy test. One point of importance, If you really do have the adult variant of congenital adrenal hyperplasia, you need to be on steroids NOW.
Good luck.


hopeful DC - December 5

Thanks for the information Dr. Barry. For the Adult CAH, they say that I have a very mild case, I have not presented with any of the classic symptoms aside from the elevated androgens (testosterone, etc). I do not have excessive hair and acne...actually i do not have any thick body have and I have never had acne and only experience pimples very every 6-8 months. For this reason, they believe it is a very mild case and feel that I would not need the steroids unless if my symptoms worsen or if I experience issues with fertility. This is my first time doing IVF. I am hopeful that my results will be positive on Thursday.

I also have acid reflux and have been having really bad reflux and heartburn and was told not to take the prilosec that I have been taking for years. I have trouble with swollowing now because of this. I know they say that heartburn is a pregnancy symptom, but i think that this has more to do with me not being able to take my meds rather than a possible pregnancy. Isn't it too early to experience this as part of a pregnancy symptom?

Thanks soo much for making yourself available to women like me. I am sure that the information you provide helps many women understand this crazy fertilization process. I deeply appreciate you taking the time to answer my questions and the questions of the other women.

-hopeful DC


Barry Jacobs, M. D. - December 5

If you have even mild CAH, and are not taking steroids at this time, and through your pregnancy, there is a significant risk that a new born girl will have ambiguous genetalia.
Good luck.


hopeful DC - December 6

This is shocking news to me. My RE and my endocrinologist both felt that i did not need to take steroids because I displayed not symptoms of the disease, only elevated androgen levels. I guess that i will discuss this with my doctors if the pregnancy test is positive. No one has mentioned this to me as a possible risk. Can you tell me where I can get more information about this risk?

THanks for your help.



Barry Jacobs, M. D. - December 6

The data have been in the professional literature for a number of years. The seminal work was done by Dr. Maria New, a past president of the Endocrine Society.


hopeful DC - December 8

Dear Dr. Barry,

I just got my bHCG results and it is positive....667. This is day 12 post the embryo transfer. What is a good range and how soon can they tell if its a twin? What method do they us to determine its a twin?



Barry Jacobs, M. D. - December 8

There is an extremely broad range fo the normal concentration of hCG in early pregnancy. The earliest way to tell if you have twins is ultrasound.
Good luck.


hopeful DC - December 12

How early can you do this ultrasound and determine if its a twin?



Barry Jacobs, M> D. - December 13

At about 6 weeks of pregnancy, you should be able to see a fetal heart on ultrasound.


Barry Jacobs, M. D. - December 15

It is too early to get a reliable pregnancy test. Even if you are pregnant, the concentration of hCG in you blood, and, therefore, your urine will be too low to reliably detect. The other issue is that you might still have a little of the hCG given to mature your eggs, and get a false positive. Please wait for about 2 weeks after retrieval to do the pregnancy test.
Good luck.


Barry Jacobs, M. D. - December 25

There are too many potential problems with eggs and sperm for me to know why you did not hace a successful pregnancy, this time. Also, I do not kow the quality of the embryos you have stored. As far as where to find information about adult congenital adrenal hyperplasia, it is extresively published in the professional liter ature. I am not sure what you can acccess through "Google Scholar" on line. Some of the sites require you be a subscriber to the journal with the original publication. If you have a specific question, I will try to answer.
Good luck.


Barry Jacobs, M. D. - December 26

I am sorry, but I am not sure which question you feel I did not answer. I have no way of knowing why your IVF cycle did not produce a successful pregnancy. If the embryologist doing the biopsy is as skilled as ours, I doubt that the problem was the biopsy. If you had good blastocysts on day 6, that is probably as good as day 5. Unfortunately, I do not have adequate information to provide a better response. Even if I had all the data, as your RE does, there is much we still have to learn.
Good luck.



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