As soon as the lady skips her period, we do a blood test, which measures the level of B-HcG (a hormone secreted only in pregnancy). Rather than a single value of B-HcG, serial tests give us more information about the progress of pregnancy. Simultaneously, there will be a few changes in medications; for example, some hormonal tablets are started to support pregnancy. Also, an injection that supplies B-HcG hormone is given every 5 days, as this hormone is important for the continuation of pregnancy.
If the B-HcG values increase progressively (usually three values are needed to conclude), that means the progress is good. However, if there is a decrease in value or if the values remain near the same, then it may either be a missed abortion or an ectopic pregnancy.

It has been widely reported that the incidence of miscarriage in pregnancies resulting from ART is higher than in spontaneous pregnancies. If the value increase is more than double the previous value, there are chances of multiple pregnancies. In natural conceptions, one in 80 pregnancies results in twins. However, in ART, the rate of multiple pregnancies is more than one in five. Apart from the increased rate of twins, triplets, and quadruplets, which are extremely rare in natural conceptions, they occur commonly in women undergoing ART.

As soon as the B-HcG levels shoot above 15000 IU or at 5–6 weeks of gestation, a transvaginal sonogram is done to confirm the pregnancy. At this stage, usually a foetal pole (baby) and cardiac activity (baby heart beat) can be seen on sonography.

This is the stage when all symptoms of pregnancy may be evident, like nausea, vomiting, mild on-and-off pelvic pain, breast tenderness, urinary frequency,gaseous distention, and constipation. Some medications may be required to tackle these symptoms. There is nothing to worry about even if the dietary intake does not increase, as during the first three months the requirement is less. The expected weight gain during the first three months is 0–2 kg.

All medications and injections are continued in the same format as before, and a dating sonography (which will give an accurate delivery date) is done around 7-8 weeks.

There is a slight higher incidence of bleeding in the first trimester in IVF pregnancies compared to natural conception. There is nothing to be worried about if such a thing happens, as most of the time, bleeding is controlled with medicines. Sometimes, unfortunately, it may end in abortion.

The same format of treatment continues until 11–13 weeks of gestation. During this time, the first abnormality scan (including nuchal translucency) is done. Also, blood tests like CBC, urine routine, TSH, vitamin D, blood group, and double marker tests are done to judge the risk of an abnormality in the baby.

After going through the reports, the injections and hormonal medications were stopped. Calcium and iron tablets are added at this point. After 13 weeks, we enter the second trimester.