Skip to main content

Product preview · Fictional patient data

OvaFlow
Try the sandboxRequest a walkthrough

Stage 8 of 9

Pregnancy & OB graduation

About 9 to 14 days after embryo transfer, a pregnancy blood test (beta-hCG) checks for implantation. A positive blood test begins early pregnancy surveillance: serial blood draws when needed, active follow-up for any pregnancy of unknown location (PUL) until a scan confirms location and viability, luteal medication taper dates, and a formal transition packet to obstetrics where the fertility clinic remains responsible until the receiving OB team explicitly accepts care.

2 prototype walkthroughs
Watch the walkthroughSee the whole journey

From Fertility clinicTo Obstetric team

Referral sentThe fertility clinic is still responsible.

From Fertility clinicTo Obstetric team

OB acceptedCare moves only now, with any remaining frozen embryos still linked.

A referral that has been sent is still the fertility clinic's responsibility until the obstetric team accepts it.Fictional patient data

Both sides

One stage, seen from both sides

For the clinic team

What the team coordinates

OvaFlow tracks the positive beta, pregnancy of unknown location, viability and the luteal plan, and an OB transfer that counts only when the OB accepts.

  • Positive beta-hCG follow-up and luteal medication taper schedule with a named owner
  • Pregnancy of unknown location (PUL) tracked on an active surveillance list until definitively resolved
  • Accepted OB transfer that closes only when the receiving obstetric practice confirms acceptance, with remaining frozen embryos linked
  • Immediate suppression of celebratory prompts if early pregnancy loss occurs
Operational checks at this stage (3)
  • Keep every pregnancy of unknown location (PUL) on an active surveillance worklist with a named clinician and nurse owner until location and viability are resolved.
  • Suppress automated celebratory or weekly pregnancy milestones immediately if a biochemical pregnancy, ectopic pregnancy or miscarriage is recorded.
  • Hold obstetric graduation open ('Sent — waiting for OB acceptance') until the receiving obstetric team confirms acceptance, while keeping remaining cryostorage inventory linked to the patient.

People involved

For you and your family

What you experience

After a positive test, the clinic follows early pregnancy until your obstetric team takes over.

Questions you may ask here (3)
  • “Why do I need repeat beta-hCG blood tests and early ultrasounds at the fertility clinic before moving to my regular OB/GYN?”
  • “What does 'pregnancy of unknown location' (PUL) mean, and who is watching my labs while we wait for the next scan?”
  • “Who do I call if I have spotting or medication questions after my graduation packet is faxed but before my first OB appointment?”
Words you may hear (4)
Beta-hCG
A blood test that detects pregnancy.
Pregnancy of unknown location
A positive pregnancy test when an ultrasound has not yet shown where the pregnancy is.
Luteal support
Hormone support, usually progesterone, given around transfer and into early pregnancy as prescribed. It often starts before the transfer.
OB graduation
Moving care from the fertility clinic to an obstetric team. It counts only once the receiving team accepts.

Questions about your own treatment go to your care team. OvaFlow never gives medical advice. In an emergency, call 911.

Read the plain-language guide to IVF

See it

Walkthroughs from this stage

Recorded from an interactive design prototype. Every patient, clinician and clinic is fictional, and EMR screens are modeled reconstructions.

Prototype walkthrough · Fictional patient data

Handoffs and safeguards

Where work slips, and what holds instead

These are the moments the design is built around. Each safeguard stops or holds work; the decision stays with the clinician or the lab.

Where it slips today

  1. A pregnancy of unknown location (PUL) loses its named nursing and physician owner between serial beta-hCG draws and ultrasound.
  2. Automated congratulatory or weekly pregnancy prompts keep arriving after a biochemical pregnancy or early miscarriage is recorded.
  3. A graduation packet is faxed to the obstetric office and marked complete before the OB practice has accepted the transfer or confirmed a first appointment.
  4. Luteal progesterone and estradiol stop dates or prior PGT scope notes are omitted from the obstetric handoff summary.

What holds in OvaFlow

  • Right ownerSent isn't acceptedA referral or transfer of care counts only when the receiving team accepts it.
  • Right next stepRespectful prompt pauseAfter a loss or a chosen pause, routine and celebratory reminders stop.
All safeguards

Workflows here

Workflows at Pregnancy & OB graduation

Each row opens the capability. Point at, focus or scroll to a row to see it in a recording from this stage.

  1. Ownership & handoffsOffer is not accept. Work changes hands only when the next person says yes.Seen in: Frozen transfer, early pregnancy, loss and returning after a pause
  2. Sources & signed changesEvery instruction traced to its signed source, and every change carried to the work it affects.Seen in: Patient and clinic, side by side

Step-by-step timing & questions

How Pregnancy & OB graduation unfolds day by day

Early pregnancy care spans the first quantitative beta-hCG blood test, serial hormone checks, active surveillance of any pregnancy of unknown location (PUL), viability ultrasounds, luteal medication tapering, and an obstetric handoff that closes only when the receiving OB practice accepts.

9–14d to beta-hCG · Weeks 5–8 scans · Weeks 8–10 OB graduation

From first beta-hCG blood draw to accepted obstetric graduation

  1. 019–14d post-transfer

    Quantitative beta-hCG blood test

    Patient & family

    You come in for a morning blood test (beta-hCG) to check for implantation rather than relying on home urine tests alone.

    What holdsNamed owner for serial beta follow-up
    Clinic, EMR & lab

    Expected beta-hCG result is tracked to clinician review; repeat 48-hour blood draw and luteal medication continuation are scheduled.

  2. 02Weeks 5–6

    Placement scan & PUL watch

    Patient & family

    An early ultrasound checks that the gestational sac is inside the uterus; if it is too early to see, close follow-up continues.

    What holdsActive PUL surveillance until resolved
    Clinic, EMR & lab

    Any pregnancy of unknown location (PUL) stays on an active owned surveillance list until intrauterine viability or definitive resolution.

  3. 03Weeks 6–8

    Viability & luteal taper plan

    Patient & family

    Fetal heartbeat is confirmed on ultrasound, and you receive exact calendar dates for tapering estrogen and progesterone support.

    What holdsLuteal stop dates & OB packet ready
    Clinic, EMR & lab

    Clinician documents viability, luteal stop dates, and prenatal screening notes (including that prior PGT does not replace prenatal screening).

  4. 04Weeks 8–10

    Accepted OB graduation

    Patient & family

    Your fertility clinic stays your point of contact until your obstetrician or midwife confirms your first prenatal visit.

    What holdsFertility clinic owns care until OB accepts
    Clinic, EMR & lab

    Referral is marked 'Sent — awaiting acceptance' until the receiving OB office confirms acceptance; remaining frozen embryos stay linked.

A positive test opens active early-pregnancy tracking; if location is not yet visible on scan (PUL), surveillance stays owned until resolved, and graduation closes only when the obstetric team confirms acceptance.
Worked example: PUL active ownership, Sent ≠ Accepted OB handoff & linked cryo inventory
Worked example · West ClinicFictional patient data

PUL active ownership, Sent ≠ Accepted OB handoff & linked cryo inventory

What the patient sees

During early pregnancy monitoring, the patient sees exact luteal support taper dates and knows West Clinic still owns her care until her obstetric practice confirms her intake.

What the clinic team sees

On the clinician handoff board, a faxed obstetric referral stays in amber ('Sent · awaiting OB acceptance'). Only when the receiving OB practice confirms acceptance does the tether snap to accepted, while linking the patient's remaining frozen embryos to long-term storage.

Why it holds: No patient is dropped into a gap between fertility discharge and their first prenatal visit, and no celebratory prompt fires after a loss.

Where OvaFlow fits

How OvaFlow works beside the clinic's own EMR and lab

Coordination companion

What OvaFlow coordinates

  • Serial beta-hCG and active pregnancy of unknown location (PUL) follow-up ownership until definitive clinical resolution
  • Obstetric transition tracking where 'Sent' remains distinct from 'Accepted', with luteal stop dates and remaining frozen embryos linked
  • Immediate suppression of celebratory or pregnancy-week prompts when a loss is documented
System of record

What stays with clinicians & the EMR

  • Interpreting serial beta-hCG trends, diagnosing intrauterine vs. ectopic pregnancy, and managing early pregnancy complications
  • Determining luteal progesterone and estradiol taper schedules
  • Obstetric prenatal care, cell-free DNA or diagnostic prenatal testing counseling (SMFM #60), and delivery management
OvaFlow never prescribes medications, never triages symptoms, and never replaces the clinic's own EMR or electronic witnessing hardware.

Common questions at this stage

Questions from patients, families and clinic teams

View all 4 stage questions & answers
What is a pregnancy of unknown location (PUL), and why does it require active tracking?

As NICE Guideline 126 defines it, a pregnancy of unknown location (PUL) means a patient has a positive pregnancy test (beta-hCG) but no intrauterine or extrauterine pregnancy is yet visible on transvaginal ultrasound. Because a PUL can represent a very early normal intrauterine pregnancy, a failing pregnancy, or an ectopic pregnancy, NICE recommends active serial beta-hCG and ultrasound follow-up with clear symptom guidance until a definitive diagnosis is reached.

Sources: [13] NICE Guideline 126 (2026)

Why doesn't faxing records to the OB/GYN count as completing graduation?

Patients often experience a 2-to-4-week gap between their final fertility clinic ultrasound (around 8–10 weeks gestation) and their first obstetric appointment. If the fertility clinic closes the episode the moment a fax goes out, questions about tapering luteal progesterone or first-trimester bleeding have no clear owner. OvaFlow keeps the fertility clinic as the active owner until the OB practice confirms acceptance.

Sources: [14] SMFM Consult Series #60 (2024) · [18] ONC SAFER Guides (2025)

What needs to be in the handoff packet from the fertility clinic to the obstetric team?

SMFM Consult Series #60 recommends communicating the method of conception (fresh vs. natural or programmed frozen transfer, ICSI, donor gametes), exact embryo transfer date and embryonic age for accurate gestational dating, number of embryos transferred, luteal hormone stop dates, and whether preimplantation genetic testing (PGT) was performed—noting that routine prenatal screening and diagnostic options should still be offered regardless of prior PGT.

Sources: [14] SMFM Consult Series #60 (2024)

What happens to remaining frozen embryos when a patient graduates to obstetric care?

Graduating from active treatment with an ongoing pregnancy does not end the clinic's relationship with the family's vitrified embryos in cryostorage. OvaFlow links the graduated episode to the long-term cryostorage record so annual contact preferences and future sibling-transfer planning stay intact.

Sources: [16] ASRM Ethics & Practice Committees (2020–2021)

Clinical & operational sources for Pregnancy & OB graduation (4 primary guidelines)
  1. [13]
    NICE Guideline 126 (2026) — Ectopic pregnancy and miscarriage: diagnosis and initial management (updated June 2026)Active surveillance for pregnancy of unknown location (PUL) until definitive diagnosis, symptom escalation and compassionate loss follow-up.
  2. [14]
    SMFM Consult Series #60 (2024) — Management of pregnancies resulting from in vitro fertilizationStructured transition summary from fertility care to obstetrics, including embryo transfer details and prenatal screening counseling regardless of prior PGT.
  3. [16]
    ASRM Ethics & Practice Committees (2020–2021) — Disposition of unclaimed embryos (2021) & Cryostorage of reproductive tissues in the IVF laboratory (2020)Storage fee payment as active contact, multi-channel outreach before any unclaimed status, and holds on conflicting disposition instructions.
  4. [18]
    ONC SAFER Guides (2025) — Test Results Reporting and Follow-Up & Contingency PlanningClosed-loop tracking of expected diagnostic results from order to clinician review and downtime reconciliation.

Along the spine

Keep walking the journey

Plans can change at almost any point. See how a change of plan is handled.

See it with your team

Walk the handoff to the obstetric team with us.

We'll go through the prototype walkthroughs for this stage and the questions your team would ask first.

Request a walkthroughTry the sandbox