First Trimester Uterine Bleeding in IVF Pregnancies

Did you go through IVF treatment and experience bleeding in your first trimester? 

First trimester uterine bleeding is a common occurrence in IVF pregnancies. The positive news is it has not been found to be associated with an increased incidence of adverse outcomes such as miscarriage. General statistics for vaginal bleeding in the first trimester is an occurrence rate of one-fourth of pregnancies. About one-half of those who bleed will end in miscarriage. One study looked at IVF pregnancies in particular and analyzed 157 pregnancies over a two-year period that were followed until delivery. All patients were advised to report any incidence of bleeding even if it was light or moderate. 67 percent of patients reported bleeding in the first trimester. I was caught off guard by how common this occurrence was. Studies have found that those who go through infertility are not at an increased risk for miscarriage in the first trimester compared with women who conceive naturally. This was reassuring for me to read.

I fit with this statistic as I, too, endured bleeding in the first trimester, spotting in nature, and lased a few days. However, the bleeding returned for me at 32 weeks and landed me a helicopter ride, hospital stay, and living 120 miles from my home for four weeks. I will write a blog on this someday! Because of this experience and my medical training, I have created an entire 1:1 coaching program for those pregnant after infertility. To learn more, use the button below to book a call with me!

Common Causes for First Trimester Bleeding

Medications: bleeding from the medications or the medication applicator touching the cervix. A common medication is progesterone. 

Polyps, fibroid, or other growths on or in the uterus or cervix that become irritated and bleed. 

Implantation bleeding: This occurs when the embryo implants.  Typically it does not last more than a few days and is lighter than a normal period. The blood is often paler than menstrual blood, pink, rusty brown. 

Sub-Chorionic Hemorrhage: Occurs when the placenta partially detaches from where it was implanted in the wall of your uterus. Subchorionic hematomas are formed by the abnormal accumulation of blood between the placenta and the wall of the uterus. These can vary in size from small to large.

Vaginal infection: Common ones inlcude chlamydia, gonorrhea, or herpes.

Irritation: Things such as intercourse, physical exam, or anything irritating the cervix.

Carrying multiples carries a greater chance of bleeding in the first trimester.

Sometimes there is no explanation for why the bleed has occurred. Unfortunately, The cause can also indicate a distressed pregnancy, ectopic pregnancy, or miscarriage.

What should you do if you experience bleeding in your first trimester?

Please contact your OB GYN with any signs of bleeding during pregnancy. Often times they will order a transvaginal ultrasound to look for the baby’s location, heartbeat, and size. Sometimes they will order lab work to look at HCG levels and progesterone levels. They may also review your blood type because if you are a Rh negative, you will most likely need to get a RhoGam injection. This injection will prevent your body from making antibodies to babies positive blood type. The good news is most people are Rh positive and do not need a RhoGam injection.

If the bleeding is heavy or has any other symptoms such as pain, fever, chills, or vomiting, you should go to your nearest emergency room. I once heard the saying, “one woman’s spot is another woman’s clot.” Typically heavy bleeding is soaking a thick menstrual pad every hour for more than 2 hours consistently.

Most of the time, the bleeding is ok, and the baby is fine but even knowing that still leaves us feeling fear and anxiety. You have been through so much leading up to this pregnancy.