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Ectopic? Viable? Brain knots...

low beta bleeding endometriosis progesterone ectopic

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#1 canteloupe

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Posted 24 August 2013 - 08:34 PM

Hoping someone might read this who has had similar results and can speak to our situation...Our doc wants to keep us on progesterone which I fear will help sustain what I suspect to be an ectopic implantation.

 

TTC 5 years. 

Summary ICSI #1 - ET mid August

Day 11 post 3 day transfer - light bleeding
Day 12 POAS+ & light bleeding
Day 13 light-moderate bleeding
Day 14 BFP - moderate bleeding and clots - First BETA 140
Day 15 heavy bleeding and mega clots - Second BETA 170
Day 16 heavy bleeding and clots
Day 17 moderate bleeding - Third BETA 150

Day 18 moderate bleeding (no progesterone)

Day 19 mod-light bleeding - Fourth BETA 210 (no progesterone)

 

After the 210 Beta, and even with all the bleeding the doc now wants me to go back on progesterone

 

Given all the cramping, clots/bleeding, the low and barely rising beta, my history of endo with scarred tubes/ovaries and zero body signs of pregnancy, I'd love to hope for the best, but think there's been implantation in a bad place. 

 

Has anyone had a cycle/know someone with a cycle that is in any way similar?  What was the outcome?  Our thinking is that I won't need the same amount of crazy drugs now as I would if this continues, and it is ectopic (and is helped along by the progesterone). 

Our hope is that this isn't a bad implantation and we don't want to jepoardize what could be...

 

Thank-you so much for any input!!

 

c


TTC ~ 6 years 

DX:   Endo Stage 4, only one functioning ovary/tube   MF - varicocele, low count/motility/morphology

ICSI:  Summer 2013 - bfp - heart.gif arrived Spring 2014 

nat FET:  2016 Jan 16 transferring 1...... Jan 30 - BFP

Beta 1 & 2 - 506/1003 

U/S - Feb 18/16


#2 smc1982

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Posted 24 August 2013 - 08:42 PM

I am sorry your are dealing with this uncertainty. I don't want to scare you, but your story sounds like exactly what I have just had to deal with. At 9 days past 3 day transfer I startd with a heavy bleed with clots, very much like my monthly period. 4 days later I went for a beta and it came back positive... 5 days later I was in emerge with severe cramping and another bleed. I had suspicions that I had an ectopic pregnancy, but my clinic would not offer me any support by further blood tests or bumping my ultrasound up. So instead I ended up in emerge for 10 hours and back everyday for follow up for 7 days. All I want to say is trust your gut! I kept on the progesterone, the on call gynecologist at emerge said it wouldnt do any harm until we figured out what was goin on with my body. I was 5 weeks when they diagnosed the ectopic and even then it was really hard to see on the ultrasound which was a transvaginal ultrasound. Good luck and please message me if you have any questions
  • Lisa1981 likes this
TTC 5 years
Hubby had varicocele surgery 5 years ago with little success so onto a FC
We have done 6 IUIs since then and I recently found out I have DOR and Insulin Resistance

5 x IUI - all BFN

July 25, 2013 - ER, retrieved 10 egg, 8 were mature and 7 fertilized with ICSI.
July 28 - transferred 2 grade 2 8 cell embroyos... Waiting to hear if the 5 others made it to freezing
July 31 - 4 frosties!! Yay
August 29 - ectopic :(
July 2014 - new clinic
Oct 5, 2014 - FET of a day 3 grade 3aa embryo - BFN
Dec 3 /14 - transfer of 1 Day 3 frosting - BFN
OCT 25 - transfer 2 day 3 frosties

#3 gracegirl

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Posted 24 August 2013 - 09:33 PM

I had a very similar story to yours except my first beta was really, really low (9) but after a few days, it really picked up. I ended up being diagnosed with an ectopic at 5.5 weeks.

 

I agree with smc, trust your gut.


  • Lisa1981 likes this

#4 amandaTTC#2

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Posted 24 August 2013 - 11:39 PM

The up and down betas are so heartbreaking. I had similar numbers to you and it was ectopic but not visible on ultrasound until about 6.5 weeks.

If you have pain in either side of your abdomen plead go to the ER right away. Otherwise it is a waiting game, seeing what the betas do and what can eventually be seen on ultrasound.
  • Lisa1981 likes this

Me: 32 SO: 32
Endometriosis - undiagnosed until laparoscopy in Jan 2012

No problems TTC #1, DS born in March 2008

TTC #2 since July 2009
Started seeing RE Sept 2010
Blood tests show I'm not ovulating, HSG shows right tube is blocked but hysteroscopy was all clear.

2010/2011
4 cycles clomid + TI = BFN
2 cycles clomid, repronex & progesterone + IUI = BFN

Diagnostic Laparoscopy tentatively scheduled for September 13th.

Lap cancelled 09/12/11 due to complete surprise natural BFP, Betas fluctuating, confirmed ectopic. Methotrexate on September 29th.

Diagnostic Laparoscopy rescheduled for January 10th, 2012. Right tube removed, too damaged from the ectopic to save. Lots of endometriosis found and cleaned up.

IUI#3 was a miserable failure. Did not respond at all to repronex. Taking a cycle off before trying Gonal-F

Another natural BFP on April 5th (SO's birthday)!!! EDD December 12th, Cole Marshall arrived December 8th, 7lbs 6oz!


#5 nervus optimist

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Posted 24 August 2013 - 11:49 PM

I'm sorry you're going through all this uncertainty.  it really is a wait and see situation, but as others have said... your fears are well founded.  my numbers were different than yours with my ectopic - started super low (7) then shot up pretty quick, and then I had spotting and then ups and downs in the numbers in the 4000 range.  with numbers under 1000 it is highly unlikely that they would see anything and be able to confirm ectopic on US.  That being said, as others have mentioned if you have pain just off to either side go to emerge.  The pain I had was quite mild, much less than I was expecting.  Also, if it is determined to be ectopic the doctors will push you to treat, likely with methotrexate right away.  know that, as with everything else medical, it is your right to choose and when you would like to do this.  for a variety of reasons it was my preference to refuse this treatment and hope to let things 'resolve' on their own, and it was only 2 weeks later when it still wasn't resolved that I agreed to the methotrexate.  

 

thinking of you

:flowers:


  • Lisa1981 likes this

I am 38, DH - 39
Genetic - IVF&PGD to prevent Genetic Disorder
IVF #1 - Nov/08 - MC @ 6 weeks, no embryos frozen
IVF #2 - Aug/09 - bfn
IUI #1 - Feb/10 - ectopic
PRIDE - Apr/10
Homestudy - July/10
Given the gift of donor embryos - Jan/12
Donor FET Jun/12 - 9 weeks - no heartbeat... MC
Donor FET Oct/12 - we're PG biggrin.png

===> Beautiful baby boy born 2013 babyboy.gif

Donor FET Oct/16 - chemical

April 2017 - surprise PG

===> Beautiful baby girl born 2017 babygirl.gif


#6 amandaTTC#2

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Posted 25 August 2013 - 12:00 AM

NO - that is a really good point about the pain being more mild than you would think. I put off going to the hospital because everything I read said the pain was so bad. But it never did get past mild.

Me: 32 SO: 32
Endometriosis - undiagnosed until laparoscopy in Jan 2012

No problems TTC #1, DS born in March 2008

TTC #2 since July 2009
Started seeing RE Sept 2010
Blood tests show I'm not ovulating, HSG shows right tube is blocked but hysteroscopy was all clear.

2010/2011
4 cycles clomid + TI = BFN
2 cycles clomid, repronex & progesterone + IUI = BFN

Diagnostic Laparoscopy tentatively scheduled for September 13th.

Lap cancelled 09/12/11 due to complete surprise natural BFP, Betas fluctuating, confirmed ectopic. Methotrexate on September 29th.

Diagnostic Laparoscopy rescheduled for January 10th, 2012. Right tube removed, too damaged from the ectopic to save. Lots of endometriosis found and cleaned up.

IUI#3 was a miserable failure. Did not respond at all to repronex. Taking a cycle off before trying Gonal-F

Another natural BFP on April 5th (SO's birthday)!!! EDD December 12th, Cole Marshall arrived December 8th, 7lbs 6oz!


#7 PickleS

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Posted 25 August 2013 - 09:36 AM

My 2nd ectopic had similar blood results to what you are describing... It was up, then down, then up.. Just all over..

Because I had already had one ectopic, my doctor had already been monitoring me quite closely. I went to Emerg, and they were able to confirm something in my tube close to my right ovary...

 

I tried methotrexate, but unfortunately it did not work and ended up with surgery to remove the tube... BUT, my first ectopic was resolved with one shot of methotrexate.. (no side effects, but they did have to give me the needle in my butt cheek which wasn't super pleasant..)

 

I hope for you, that it isn't ectopic, and that it is a viable pregnancy... In both my previous experiences my doctor advised me that if it's isn't meant to be it isn't, and that generally the pregnancy wouldn't have been viable even if it had made it to my uterus.. I don't know if that's true, but it definitely helped with coping...

 

All the best!


ME - 28 (Mild PCOS, Relative Tubal - Diagnosed Unknown)

DH - 36

 

2009 - Natural BFP, Ectopic: Right Tube

2010 - Clomid BFP, Ectopic: Right Tube - Surgery to Remove mellow.png

2011 - Started back on Clomid off/on for 3/mth intervals

2012 - Referral to infertility clinic, Initial Consultation

2013 - IVF #1

8/9 - Start Suprefact   8/20 - Initial U/S shows thin lining & lots of follicles (?),High risk OHSS

9/3 - ER, expected 25 eggs but only had 12... 9 Fertilized.

9/8 - Decided to Freeze! (5) - Day 5 blasts in the freezer for future FET !!

FET #1

10/9 - Natural Cycle, CANCELLED (11/18) (Lining to thin, no sign of ovulation)

12/9 - Medicated Cycle, CANCELLED - Cyst on right ovary

12/9 - Start BCP and hope cyst disappears


#8 SummerRain

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Posted 25 August 2013 - 12:54 PM

I had a ectopic last year. My beta was like urs, down then up then down. But since it is not over 1000, my doctor wasn't really concerned. I suspected an ectopic since I didn't have any pregnancy symptons I had before and I had one sided discomfort for a couple of days, then it became sharp pain. I insisted an ultrasound and found something in my right tube. I was sent to emergency right away.

So I'd suggest to keep watching ur beta and insist an ultrasound.

TTC from Aug 2011
DX: advanced maternal age & high DNA fragmentation

Nov 2011: Natural - Chemical pregnancy
Jun 2012: Superovulation - BFP; No heartbeat at 8 weeks, miscarried naturally
Sep 2012: Natural - Ectopic and Methotrexate shot

Mar 2013: IVF#1 - 10 eggs retrieved, 7 matured, 5 fertilized; 2 blastocysts (3BB & 2AB) transferred, 1 blastocyst (2BB) frozen - BFN
Jun 2013: Superovulation - BFN
Jul 2013: Natural - BFP; No heartbeat at 9 weeks, D & C


#9 canteloupe

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Posted 26 August 2013 - 02:54 PM

Thank-you all so much - your stories further confirm what I'm feeling. 

 

Just got my results from 5th beta today - 421, up from 210 two days ago, so I'm back on progesterone.

 

It is so interesting to see how many of you have endo as well.  Nurse insists the bleeding could be the loss of one of the two embryos and that the other could be fine yet.  How could this be with all the bleeding/clots for 2+ weeks, so early on?  I have an appt with a naturopath and my clinic has agreed to do an u/s at the end of the week.

 

I just came across some writings about Reproductive Immunology testing.  A book that goes into detail on this is "Is your body baby-friendly" by Alan E. Beer.  Anybody do any reading into this?

 

smc1982 - I am livid on your behalf that the clinic didn't do appropriate follow-up.  There is a pervasive attitude, I've felt, like we are the lowly public and can't speak appropriately to our own health/situation.  We are just as capable of reading scholarly journal articles and bringing them to our doc's attention.   Speaking to your Dx:  In addition to endo, we have male factor issues.  My hub has diminishing counts/bad motility/morphology.  His latest tests in the months before ICSI were 20, then 14, then 8 million.  The fertility doc at our clinic doesn't like anything naturopathic, so he cut out everything, but hub started eating raw cacao beans for some time (months) before retrieval and the day of retrieval, his numbers were around 40 mil.  We have no idea if there is a correlation, but I thought I'd put it out there.

 

SummerRain - Like you described, I don't have any preg symptoms either which is one reason I feel iffy about this all.  Clinic said they will continue beta and u/s to allay my concerns.  Do you know, would Emerge give the same metho dosage as the clinic?

 

AKScor - I am so with you on whatever helps the coping.  What your doc shared is one I will think about should it all go south.  I also encourage you to look into Reproductive Immune issues as maybe playing a part...(lots of blood tests - non-invasive)  If your clinic won't, see a reproductive immunologist - I'm looking into this now.

 

amandaTTC#2 - I have mild pain like you, so hoping they pick it up before a rupture...do you usually have to wait until 6+ weeks before anything can be seen on ultrasound?  If you are in pain, even mild, how can the ER docs see what the clinic u/s tech can't?

 

nervous optimist -  your username so aptly describes many of us!  You've given me confidence about not jumping to metho right away - I have an appt with a naturopath later today just to make myself feel I've looked at all routes.

 

gracegirl -  my gut is at odds with my doc.  What an awful position to be in.  Were they able to see your ectopic with the vag cam at 5.5 weeks ?  I hope you didn't have an ER story too.

 

Thanks all,

 

c


  • nervus optimist likes this

TTC ~ 6 years 

DX:   Endo Stage 4, only one functioning ovary/tube   MF - varicocele, low count/motility/morphology

ICSI:  Summer 2013 - bfp - heart.gif arrived Spring 2014 

nat FET:  2016 Jan 16 transferring 1...... Jan 30 - BFP

Beta 1 & 2 - 506/1003 

U/S - Feb 18/16


#10 gracegirl

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Posted 26 August 2013 - 03:56 PM

No--they couldn't see anything and it was clear there was NOTHING in my uterus. My progesterone was too low as well. My doc said the pregnancy was definitely not in my uterus and recommended treatment with methotrexate but he did give me the choice to wait. I didn't wait and that decision probably saved, if not just my life, my tube.


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#11 My_time

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Posted 26 August 2013 - 03:57 PM

canteloup, could it be vanishing twin syndrome???? Meaning, you had twins, lost unfortunately one (therefore the dip in beta and bleeding) and now your beta is back on track???

 

update: sorry now just read your last post and it seems as if your clinic is agreeing with me with the possibility of the vanishing twin syndrome. Stay on progesterone. Good luck for your ultrasound!

 

As for your questions with regards to the book; yes, I have read that book and am following it now (have done the immune testings and am receiving treatment under consultation with the AEB reproductive immunology centre. AEB center belongs to the writer of that book and although he has passed away his colleagues of the time (Dr Winger, etc) are still running this center with the same concepts. 


  • MB. likes this

Diagnosis: Repeated Pregnancy Loss + DOR + Advance maternal Age.

So far no luck with IVF attempts. Hope things take a turn soon.

 


#12 nervus optimist

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Posted 27 August 2013 - 08:57 AM

gracegirl makes a good point - there are definite risks to refusing or delaying treatment that should not be ignored.  always weigh all the information that you have, but know that you always have choices.

 

canteloupe - it is possible to have lots of bleeding and still have a healthy PG (especially if there is a possibility of a vanishing twin).  in 3 of my 4 PG I had at least some spotting, and this last PG, the only one that lead to a healthy birth, had by far the most amount of bleeding - massive clots, I was sure it was over, turns out it was a subchorionic hematoma.  with my first PG mild spotting, then a bit of red, then was diagnosed as a loss.  second had a tiny bit of spotting then diagnosed ectopic.  third had no spotting at all - seemed like everything was going great and it was an epic disaster.  so many people say that the most difficult stage of a cycle for them is the TWW, but for me it is the time between first beta and first US - there is so much potential yet so much uncertainty and things often don't turn out as they appear.  hang in there and be kind to yourself as you continue to wait for more info.  I'm glad your clinic is monitoring closely and definitely still remember that if you feel any pain, go to emerge just in case.  hope you get some reassuring news soon.

:flowers:


I am 38, DH - 39
Genetic - IVF&PGD to prevent Genetic Disorder
IVF #1 - Nov/08 - MC @ 6 weeks, no embryos frozen
IVF #2 - Aug/09 - bfn
IUI #1 - Feb/10 - ectopic
PRIDE - Apr/10
Homestudy - July/10
Given the gift of donor embryos - Jan/12
Donor FET Jun/12 - 9 weeks - no heartbeat... MC
Donor FET Oct/12 - we're PG biggrin.png

===> Beautiful baby boy born 2013 babyboy.gif

Donor FET Oct/16 - chemical

April 2017 - surprise PG

===> Beautiful baby girl born 2017 babygirl.gif


#13 SummerRain

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Posted 27 August 2013 - 12:51 PM

Hi Canteloupe, my clinic didn't treat me, they sent me directly to emergency to confirm and treat the ectopic. I think the dosage used in emergency was determined based on the size of the fetus and my beta. I remember it was around 70 and it was two shots at the same time.

But since ur beta is rising so there might be a chance of happy ending!

Good luck!

TTC from Aug 2011
DX: advanced maternal age & high DNA fragmentation

Nov 2011: Natural - Chemical pregnancy
Jun 2012: Superovulation - BFP; No heartbeat at 8 weeks, miscarried naturally
Sep 2012: Natural - Ectopic and Methotrexate shot

Mar 2013: IVF#1 - 10 eggs retrieved, 7 matured, 5 fertilized; 2 blastocysts (3BB & 2AB) transferred, 1 blastocyst (2BB) frozen - BFN
Jun 2013: Superovulation - BFN
Jul 2013: Natural - BFP; No heartbeat at 9 weeks, D & C


#14 canteloupe

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Posted 29 August 2013 - 10:24 AM

Thanks again all,

 

I have an u/s tomorrow morn to see what's what, early yet.  My last u/s showed very little uterine lining left, and we were told it was an early loss, so the rising betas are weirding us out.  Emos up and down and all over the place,

 

c


TTC ~ 6 years 

DX:   Endo Stage 4, only one functioning ovary/tube   MF - varicocele, low count/motility/morphology

ICSI:  Summer 2013 - bfp - heart.gif arrived Spring 2014 

nat FET:  2016 Jan 16 transferring 1...... Jan 30 - BFP

Beta 1 & 2 - 506/1003 

U/S - Feb 18/16






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