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Berghella V, et al., Does transvaginal sonographic measurement of cervical length before 14 weeks predict preterm delivery in high-risk pregnancies? American College of Obstetricians and Gynecologists. However, ultrasound determination of the date of ovulation has the same imprecision as does the ultrasound estimate of the gestational age and, therefore, a precise date of conception cannot usually be determined as with in vitro fertilization. In addition, although a woman is most likely to become pregnant if she has sex on the day of ovulation conception may also occur from live sperm still in her reproductive tract on the day of ovulation if she had sex for up to five days before ovulation [26,27]. Clinical management guidelines for obstetrician-gynecologists.
The timing of the "fertile window" in the menstrual cycle: day specific estimates from a prospective study BMJ 2000; 321: 1259-1262. Effects on the probability of conception, survival of the pregnancy, and sex of the baby.
Human Chorionic Gonadotropin Pregnancy Test Human chorionic gonadotropin first becomes detectable in the mother's blood and urine between 6 and 14 days after fertilization (3 to 4 weeks gestational age) [11-13].
The gestational age would, therefore, be at least 3 to 4 weeks at the time of a reliable h CG pregnancy test.
Twins When a twin pregnancy is the result of in vitro fertilization determination of gestational age should be made from the date of embryo transfer. Clinical management guidelines for obstetricians-gynecologists. Number 55, September 2004 (replaces practice pattern number 6, October 1997).
Otherwise "..avoid missing a situation of early intrauterine growth restriction in one twin, most experts agree that the clinician may consider dating pregnancy using the larger fetus." [22,23].
Doppler Ultrasonography The fetal heart can be heard using Doppler ultrasound by 10 to 12 weeks in most patients . Savitz DA, Terry JW Jr, Dole N, Thorp JM Jr, Siega-Riz AM, Herring AH.