From IVF to Delivery: The Journey Doesn’t End With a Positive Pregnancy Test

“I have always been fascinated by pregnancy and childbirth, by the sheer complexity of how a pregnancy progresses from its earliest stages to the moment a baby is finally born. But watching it happen in real life is very different from reading about it or studying it.

I witnessed my first caesarean delivery with Dr. Shanujeet, Associate Director (Fertility) at Cloudnine Hospital, Chandigarh. I remember how patiently she explained the procedure to me as it unfolded. She was performing the caesarean while calmly walking me through what she was doing, answering my questions and explaining what was happening at each stage. At the same time, she remained completely attentive to the patient, who had arrived in the operating room visibly nervous but seemed to settle as soon as she saw her doctor.

There was something about that moment that stayed with me. The patient trusted her, and that trust carries an enormous responsibility. For the clinician, this is a medical procedure that requires precision and preparation but for the patient, it is the culmination of months of pregnancy, and in the case of an IVF pregnancy, often a much longer journey that began well before the pregnancy itself.

That experience led me to speak with Dr. Shanujeet about what this journey looks like from the other side of the operating table, particularly the anxiety patients carry throughout an IVF pregnancy and what it means for a clinician to eventually bring that pregnancy to delivery.

Her own connection with obstetrics began much earlier. At seven years old, she witnessed her first delivery with her mother, who was an obstetrician and gynaecologist. She remembers being awestruck by the fact that an obstetrician is, in a sense, caring for two patients at once: the mother and the baby. That early experience stayed with her and shaped her desire to become a gynaecologist.

Years later, when she performed her first caesarean herself, the feeling was very different. There was excitement, but there were also palpitations and the hope that everything would go well. The excitement came after the procedure was completed and the baby had been safely delivered. The experience had changed from the wonder of a seven-year-old watching a birth to the responsibility of a doctor entrusted with two lives. That distinction captures something important about the journey from IVF to delivery. The positive pregnancy test is not the point at which uncertainty disappears. In many ways, it is where a new form of uncertainty begins.

When a positive pregnancy test is only the beginning

For an IVF patient, the first positive pregnancy test can bring immense happiness, but it does not necessarily bring immediate reassurance. The next question is often the first ultrasound, followed by another question: is the pregnancy developing normally? Then comes the heartbeat, and with it, often, a wave of relief.

And then comes the next scan. Patients can become deeply anxious about these milestones. They worry about miscarriage, overthink symptoms, and sometimes find themselves unable to sleep because they are wondering whether everything is still okay. The pregnancy they have worked so hard to achieve can therefore be accompanied by an intense fear of losing it.

Dr. Shanujeet described approaching this anxiety by imagining herself in the patient’s position. For her, empathy is not something that can simply be taught; it is something that has to be present in the way a clinician approaches the patient. This matters particularly in the context of IVF in India, where the treatment can still carry stigma and where many patients reach an IVF clinic only after trying multiple other options.

By the time they sit across from a fertility or obstetrician, they are often not simply asking for medical treatment. They are asking for a chance at something they have already spent considerable time and emotional energy trying to achieve. That creates another layer of responsibility for the clinician.

The doctor becomes part of the journey

An IVF pregnancy is also a distinct clinical journey. Maternal age, underlying infertility, genetic factors, and the circumstances surrounding conception all influence how the pregnancy is assessed and followed. Certain complications, including hypertensive disorders such as preeclampsia, placenta-related complications, and congenital anomalies, require appropriate surveillance, and the clinical team determines the frequency and nature of monitoring according to the individual pregnancy.

For the patient, however, increased monitoring is experienced differently. Every additional scan can be both reassuring and anxiety-provoking. The appointment that gives a patient the reassurance she has been waiting for can also become something she begins worrying about days in advance.

This is where the clinician’s role extends beyond interpreting results. Dr. Shanujeet described her approach simply as TLC, i.e., tender loving care. When a patient is more anxious, she believes she needs to provide more of it, along with greater connection and accessibility.

Her view is that being available to patients is an important part of good healthcare. That perspective brought me back to the patient I had seen in the operating room. Before the procedure, she was nervous. When she saw her doctor, she seemed calmer. There was no complicated intervention behind that moment, just familiarity, trust, and the confidence that came from knowing the person caring for her was there.

For a clinician, that trust is an immense responsibility. For a patient, it can be one of the things that helps her get through the uncertainty between one milestone and the next.

From the IVF laboratory to the delivery room

Working around IVF also means spending a great deal of time thinking about the earliest stages of development. Embryos are observed under a microscope, their development is assessed, and decisions are made based on carefully defined scientific parameters. Pregnancy begins as something that can be measured through hormones, ultrasound findings and developmental milestones. But eventually, if everything progresses as hoped, it leaves the laboratory behind.

During my undergraduate years at the University of Guelph, I had performed human anatomy dissections, so I was familiar with the body from an academic and anatomical perspective. Watching a living human being give birth to another human being, however, felt completely different. In that operating room, science suddenly had a very tangible endpoint.

I watched Dr. Shanujeet carry out the C-section with the same calmness with which she had been explaining it to me. The anaesthesia, surgical, and nursing teams were each doing their part, and the focus remained on the safety of the mother and baby. Then the baby was delivered.

And then came the first cry. I got goosebumps. It was one of those moments where all the clinical terminology seemed to fall into the background. The embryo, the pregnancy test, the scans, the heartbeat, the months of monitoring and the anxiety that accompanied them had all led to this moment. There was now a baby in the room.

It also made the role of the wider care team much clearer. IVF is often spoken about in terms of fertility specialists and embryologists, but the journey does not belong to one clinician or one department. It moves through fertility care, obstetric care, anaesthesia, nursing, neonatal care and other specialties as required, with each team taking responsibility at a different point.

The patient, however, experiences it as one continuous journey. That is perhaps why the positive pregnancy test cannot be treated as the end of IVF care. It is a milestone, but it is also the beginning of a pregnancy that still needs medical attention, emotional support, and careful follow-up. From the first ultrasound to the heartbeat, from the fear of miscarriage to the reassurance of a normal scan, from antenatal appointments to the delivery room, the journey continues. And somewhere along that journey, the relationship between patient and clinician becomes part of the medicine itself.

As Dr. Shanujeet put it, ‘Excellent healthcare is accessible healthcare.’ By the time that first cry is heard, the laboratory is far behind. What began as an embryo has become a baby, and what began with a positive pregnancy test has finally reached the delivery room.”

Written by Dilpreet Banwait

Trainee Embryologist, Cloudnine Group of Hospitals

You can also read Dilpreet Banwait’s recent article: “Fertility Preservation in Pediatric Cancer – Thinking Beyond Survival” on Fertility News.