When to Perform Pregnancy Test After Embryo Transfer
Perform a serum β-hCG pregnancy test 9-12 days after blastocyst transfer (or 12-14 days after cleavage-stage embryo transfer).
Optimal Timing for Pregnancy Testing
The standard timing is 12-14 days after embryo transfer, as documented in multiple clinical protocols 1, 2.
For blastocyst transfers specifically, testing can be performed slightly earlier at 9-12 days post-transfer 3.
This timing allows for adequate hCG production to reach detectable levels while avoiding the anxiety and unreliability of earlier testing 3.
Why This Timing Matters
Day 12 post-transfer provides clinically meaningful prognostic information: a serum hCG ≥76 IU/L predicts viable pregnancy with good accuracy 4.
Testing at day 14 post-transfer shows that hCG levels >200 mIU/mL correlate with ongoing pregnancies, while levels >600 mIU/mL indicate high likelihood of multiple gestation 5.
Earlier testing (day 4 or 7) has lower predictive accuracy and creates unnecessary anxiety without providing actionable clinical information 6.
Critical Post-Transfer Management
Continue progesterone supplementation at 800mg vaginally daily without interruption until instructed otherwise, regardless of symptoms or pregnancy test results 3, 7.
Avoid early home pregnancy testing before the scheduled blood test, as it provides no useful prognostic information and increases anxiety 3.
Maintain all prescribed estrogen supplementation throughout the early pregnancy period 3.
Follow-Up After Positive Test
If β-hCG is positive, obtain a repeat quantitative β-hCG 3-5 days later to confirm appropriate rise 2.
Perform transvaginal ultrasound at 5-6 weeks gestation (approximately 3 weeks after embryo transfer) to confirm intrauterine location and number of gestational sacs 3, 2.
If a single β-hCG level exceeds 3000 mIU/mL, perform early ultrasound to assess for multiple gestations, even after single embryo transfer, due to risk of monozygotic twinning 3.
Common Pitfalls to Avoid
Do not discontinue progesterone based on negative symptoms or spotting before receiving physician instructions—hormone levels must remain stable regardless of subjective feelings 3, 7.
Do not test earlier than recommended (before day 9-12 for blastocysts or day 12-14 for cleavage-stage embryos), as this creates anxiety without clinical benefit 3, 6.
Do not assume a low but positive hCG is necessarily non-viable—male factor infertility and ICSI are associated with relatively lower hCG values in viable pregnancies 4.