8w, small gestational sack with fetal pole. worried

[Zoerina]

Hi everyone,I'm super new to this and unsure whether I am doing the right thing, but here it goes...

I previously had pregnancy loss at 8weeks exactly a year ago. I conceived through an IVF process and the lab report indicated that it was due to a chromosome abnormality, Patau Syndrome to be exact.

Two months ago, I did a frozen embryo transfer and 2 weeks later at 4weeks, my bHCG showed 75mIU/ml. Low but the doctor was certain that I was pregnant. This level was almost the same as my first pregnancy.

At 6 weeks, I did a vaginal ultrasound and the gestational sac measured 10mm. The doctor said it was a good size.

I read that the gestational sac should increase by 1mm a day but when I went again for a vaginal ultrasound two weeks later (8 weeks), the sac was only 13.5mm. The doctor did see a fetal pole during the scan. But he did not measure the fetal pole neither did he said anything about a heartbeat.

I read through many online forums and now I am paranoid about the gestational sac being small for 8 weeks, and that the doctor didnt say anything about the heartbeat. Should I be worried? Or that seeing the fetal pole should already be a good sign even if there is no mention about the heartbeat.

Next visit should be in 2 weeks time (10 weeks) where the doctor intends to check on the heartbeat. 2 weeks seem to be sooo long....Any thoughts on this?.. would love to read something to keep me sane...

[to_have_fun08]

Don't know about who big the gestational sac, but at 8 weeks there should have been a HB. I would think your dr. would comment if there wasn't. Hopefully you will get all your answers at your next u/s.

[Zoerina]

Hi,

Thanks for the info. I read every where that the hb can already be detected by week 6. Makes me wonder why my doc didn't even zoom in during the ultrascan to look at the hb. Do you think I should go to another doctor to have another ultrasound?

Not knowing is causing stress. But I'm also scared to find out..

[Sdtryingagain]

Hi Zoerina-- hang onto hope! there are tons of stories like this of people who have happy healthy babies who don't start off on a path that is completely reassuring. In medicine everything is not black and white unfortunately. Having a HB at 6 weeks if very reassuring, but not having one by then doesn't always mean that things will not turn out well. Your bean is growing on the slower side, but it doesn't mean there is not hope. growing is growing and unless things stop growing there is still hope!

I do think that waiting 2 weeks is torture though, I would be all over calling my office and begging for an u/s in 1 week. I would also let your RE know the info you'd like more info at this visit tell him the things you want to know (heart rate, measurements etc) At some offices the results might every be immediately available, you can ask for a copy of the report

[Zoerina]

Hi Sdtryingagain,

Thank you for your encouraging words. I went to a community clinic this morning, the doctor there feels that I should just wait out as what my primary doctor has asked me to do... so more waiting... one week down, one more week to go...

and the doctor even asked me to stop reading online forums... too much information only managed to make me more confused...

oh well... still praying for the best... will update if there is any news next week tho... thanks again for your kind words.. god bless...

[Sdtryingagain]

Hang in there zoerina- it certainly won't hurt to wait longer and the longer you wait things will be more definitive. He's probably right in general regarding the forums out there. Since there are a lot of forums out there with misinformation. My experience on this one (in general) has been pretty different. There is always a a range in people but I find it pretty remarkable how informed some of the ladies are here. Many of the old timers have switched over to a Facebook group but some will still peak in now and then to say hello.

So I can can keep you company while you wait. Have any fun plans until then?

[Zoerina]

Hi,

Just thought of keeping everyone (or anyone) updated on the progress. After 2 weeks of wait, I finally did an ultrasound scan last week. I was entering my 11th week. The doctor did a vaginal scan, and immediately said "there is a problem".

He saw a pool of blood in the uterus. And when measured the gestational sac, it has shrunk from 13mm to 10mm - a size usually seen during a 6w pregnancy. Obviously then, the fetal pole was not even looked for, let alone a heartbeat. He concluded that a miscarriage would be inevitable and he estimated that I would start to bleed externally early this week. And so i did, yesterday.

Since the sac was still too small, the doctor didnt want to do a D&C. He prefers to just let it bleed and come out naturally. Apparently this would make the body heals faster. And since this is my second miscarriage, I am familiar with what I am in for. I've got 2 weeks off from work and a whole bunch of pain killers. But I'm at my office desk right now cause I think staying home doing nothing would be a mental torture.

Anyway, I opted not to send the tissue sample of the embryo to the lab. I dont see how the results would be much use. We are almost certain that it is due to some genetic abnormality, just like what happened in my first miscarriage (trisomy 13 - patau syndrome). Our next course of action is to do a Kyrotyping test for both parent, to determine if either one of us is a carrier of any genetic abnormality. If the results are not to our favour, it would only mean that any of pregnancy may result in a unhealthy baby. Probably adoption would be the next course of action. But if both of us are okay, we will still keep on trying... may it be IUIs, IVFs or any other assisted methods...

If we do go for another round of IVF, the doctor recommended a pre-diagnostic test, known as PGD. It can segregate the good embryos to be put back in me and discard the bad ones. Its not 100% full proof tho, but the chances are good enough in my opinion. Of course, the main challenge would be the cost of this test. It is as expensive as the IVF itself (about $6000). Something that we have to think about first.

For the time being, I am more focused about getting healthy again. Hopefully my menstrual cycles will get back to normal soon. And with God's help, may be I can conceive naturally who knows.....

thank you for your time to write me the encouraging postings below. I do pray for your wellness and wish you all the best in your pregnancy.

[Sdtryingagain]

Thanks Zoerina, for letting us know how you are doing. I'm so sorry to hear the news. Big, big hugs to you! I've only had one miscarriage and it was super early (chemical pregnancy after an FET) even that was hard so I can only image how hard it is to have a later loss and it being your second one. Ivf is such a huge emotional (and financial) investment that a loss is all the more devastating. It sounds like you are coping well though, I'm a big fan of distract the mind approach to getting through. It sounds like you are evaluated all your options, Pgd, adoption or I supposed embryo adoption too. I'm sure once you are through this it'll be easier to decide where to go from here. Who knows maybe just a few months "off" from thinking about all of it might be good (though I've never been good at that myself). If you decide to cycle again, come and post on the 2013 cycles thread so we can cheer you on! I have a friend who is doing iui and trying to adopt at the same time so you can always do more than one thing at once.

[brit1612]

Sorry to hear that it ended with a miscarriage. I sadly know exactly what you are going through....but I can say that after 3 early miscarriages, we now have two miracle little boys! You seem to be considering your options so I thought I would add another to your list. We concieved our miracles using donor embryos, it is fairly inexpensive and you still get to carry the baby etc. Just thought I would share because when we were considering our options we had never even heard of donor embryos.

Praying for a natural miracle for you!

[Brendon77]

Don't worry, you should follow the doctor's instructions and you will go quickly recover.

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