Embryo Transfer, IUI

What to Expect at Your First Pregnancy Ultrasound


2 min read

After you have a positive pregnancy test, the next step is your first pregnancy ultrasound (sometimes referred to as an OB ultrasound). The ultrasound helps to confirm that the pregnancy location and that it is growing as it should be. 


The first pregnancy ultrasound typically takes place around 6 to 7 weeks of gestation, which is usually 2 to 3 weeks after the positive pregnancy test. The wait between the pregnancy test and the first ultrasound can feel like forever when all you want is some confirmation that everything looks good and is growing like it is supposed to! Here is a look into what you should expect.

What is The Doctor Looking For?

During your first pregnancy ultrasound, your doctor or ultrasound technician will use a transvaginal ultrasound to look for a few specific things. The first thing that they will want to confirm is that the pregnancy is in the uterus and not in the fallopian tubes or anywhere else in the body, which is known as an ectopic pregnancy.

Ectopic pregnancies pose a threat to the person carrying the pregnancy as they grow larger. Depending on the gestational age of the pregnancy and its location, your doctor will recommend how best to treat and remove it with medication or with surgery. 

The next thing that they will do is locate the gestational sac, embryo, and yolk sac. Then, they’ll measure these structures to confirm that they measure appropriately for your gestational age. The next step is to look for a heartbeat in the embryo. The heartbeat typically starts to be visible around 6 weeks, but sometimes it is not seen until closer to 7 weeks. The heart rate at 6-7 weeks gestation is expected to be quite high at about 110-150 bpm compared to the normal adult heart rate of 60-100 bpm.

Lastly, your medical team will take a look at the rest of your reproductive anatomy (like your fallopian tubes and ovaries) to confirm that everything looks normal.

An ultrasound image of a 7 week and 4 day pregnancy

Next Steps

Following the first pregnancy ultrasound,  if everything looks normal for your gestational age, you will likely repeat at least one more OB ultrasound with your fertility clinic before graduating on to continue your care with your Obstetrician around the 10-12 week point.

If any of the pregnancy landmarks or structures don’t appear as expected (for example, the embryo is measuring small or the heartbeat isn’t seen) it is common for the doctor to have you repeat another ultrasound in a week or so to take another look. In this case, you may have more frequent ultrasounds prior to moving on to the care of your obstetrician. 

Getting to your pregnancy ultrasound is a big step and really can be the beginning of a whole new journey!