The Fetal heartbeat detection rate (clinical pregnancy) card follows the step from an early positive pregnancy result to a confirmed clinical pregnancy. For each month of embryo transfer it shows what share of the transfers that produced a positive hCG test (hCG is the pregnancy hormone, measured in blood or urine) went on to a detected fetal heartbeat on a follow-up ultrasound scan.

A positive hCG test tells you a pregnancy has started. A heartbeat seen on a scan a few weeks later is what makes it a clinical pregnancy. This card measures how many of your early positives make that step.

There are three lines, plotted by the month the transfer took place:

The rate on the left axis is the heartbeat count divided by the positive test count for that month, so the two dashed lines are the numbers behind the solid one. Having all three on the card matters, because a rate on its own hides how few cases a month contains. Four positive tests and three heartbeats reads 75%, and so does forty and thirty, but only one of those months tells you anything. Check the counts on the right axis before you read a move in the rate as a change in performance.

Note that the axis title is repeated down the right-hand side of the card. The numbers along the right axis are counts, not percentages.

The most recent months always read low. The confirmation scan happens roughly three to five weeks after the hCG test, so for transfers in the last month or two the scans have either not happened yet or not been entered yet. In the card above, both counts drop to zero in the latest month. That is what an incomplete month looks like, not a run of failed pregnancies. Treat the last couple of months as provisional and expect them to rise as scans come in.

One thing to know about how the two halves are matched. A pregnancy scan is recorded against the patient rather than against a particular treatment cycle, so the card links a scan to a transfer by patient, using scans that fall roughly three weeks to three months after the transfer. For a patient with one pregnancy at a time that lands on the right scan. It is still a match on timing rather than a hard link, so read an individual point as an indication and open the patient record if a figure looks wrong.

Hover any point to see the exact figure.

The card sits on the Medical director dashboard, on the Clinical success tab, and responds to the filters at the top:

Two separate records feed this card, and it needs both.

The positive pregnancy test comes from the Outcomes tab of the patient's Cycle page. Open Add Outcome and pick the blood or urine hCG option.

That opens a lab report form. Enter the hCG value and set the pregnancy test result on it. A recorded positive here is what puts the transfer into this card's denominator.

The heartbeat comes from a pregnancy ultrasound scan recorded for the patient. The scan record captures, for each fetus seen, whether a heartbeat was detected.

This is the part worth watching. A scan that was performed but never entered, or entered without the heartbeat confirmed, reads here as a pregnancy that did not reach a heartbeat. So missing scan records are the first thing to check when this card looks lower than you expect, and a site that does its confirmation scanning elsewhere will show few or no detections whatever the real outcome.

In wawa, open Insights from the sidebar, then go to Standard Reports → Medical Director → Medical director. Select the Clinical success tab. The Fetal heartbeat detection rate (clinical pregnancy) card is on it.