21 replies to this topic

[Marie44]

Hi All - I'm new to posting on IVF forums. I'm having an urgent issue and don't know where else to turn for advice. I have just undergone my 1st IVF in May 2016 and had 2 positive betas. I had 2 embryos transferred at day 5 (blastocysts). I'm 33 y.o. My hubby and I have "unexplained infertility".

I should be 6 weeks and 1 day today. I went in for my 1st pregnancy ultrasound to check on my embryos. The NP couldn't locate any sac in my uterus. She then called the staff doctor to double check. He, too, couldn't locate either embryo anywhere! This was a transvaginal ultrasound. More staff came in the room and they all looked perplexed. They believe this "could" be either ectopic or early miscarriage, but don't know for sure.

They said my options are: (1) Manual Uterine Aspiration and maybe methotrexate if the MUA doesn't reduce my pregnancy levels. Or (2) Straight Methotrexate.

The advantage of option 1 is I'd be able to rule out if I had a miscarriage vs. ectopic pregnancy. I've been crying all day and need advice. Thanks in advance all.

Note - I have had the usual pregnancy symptoms (hunger, gassy, fatigued), but last night I had strong cramping on my left lower abdomen and left leg and light bleeding of what looks like old brown blood. I was lightheaded as well. On duty doc at UCSF advised I not go ER and wait for my ultrasound tomorrow (today). I feel fine today.

[quandry]

I'd have some serial betas drawn first, and see what your betas are doing. Then I'd have a repeat ultrasound. And then I'd make a decision.

[Marie44]

Thanks Quandry. I did have a 3rd beta drawn today which was at 1246. I'm scheduled for a 4th beta day after tomorrow. Will see how that goes.

[Hope15]

Hi Marie,
I had an ectopic pregnancy few months ago. I had lower adomenal pain that lasted a few mins two days before I was diagonosed at the emergency. I dismissed the pain atrubuting it to pregnancy cramping (since I did not know any better)... Since I was fine after a few mins, I thought everything was ok, sadly it was not the case.
Leading up to my hospital visit, I was really tired and, I had shoulder pain. My ectopic ended up on my ovaries. I was really lucky in a lot of ways if that's possible to say. I had surgery and ended up not taking methotrexate. If they give you methotrexate, it's recommended not to try for at least 4-6 months.

I really hope, and pray this is not the case for you. Sending you warm wishes. Feel free to contact me if you have questions.

[Marie44]

Thanks for responding Hope15. I too had shoulder pain which extended to my forearms and wrist. I feel I should have gone to the ER yesterday, but the on duty doc said to wait for my scan today. Oddly enough I feel fine today except for some very light cramping on my left side. I still find it so odd that the scan didn't show either embryo...

What type of surgery did you have, if you don't mind me asking? Perhaps I can suggest that to my RE. Thx again.

[quandry]

And is that up or down from your last one?

[Marie44]

@Quandary - It's an increase. My last beta was around 325 or so.

[quandry]

Usually you can't see anything on US till betas are over 2000.

[Marie44]

Oh I see. Thanks Quandary. I didn't know that. Curious how ER staff are able to locate ectopic pregnancies to treat them asap though if betas are low? Anyone know?

[Hope15]

Thanks for responding Hope15. I too had shoulder pain which extended to my forearms and wrist. I feel I should have gone to the ER yesterday, but the on duty doc said to wait for my scan today. Oddly enough I feel fine today except for some very light cramping on my left side. I still find it so odd that the scan didn't show either embryo...
What type of surgery did you have, if you don't mind me asking? Perhaps I can suggest that to my RE. Thx again.

By the time I was at ER, my ectopic had erupted so I had emergency laparoscopic surgery. It was quite traumatic.
My beta was 5000+ and they could see nothing in my uterus but could see blood filling up near my ovaries/ tube area.

Mind you each situation is different so please, take care.

[Marie44]

Omg Hope15... That must've been terrifying. I'm so sorry. Your beta was very high at that time. Hoping for the best for both of us! Have to stay positive no matter what.

[ilovemydogs]

How many days between your second and third betas?

So sorry you're going through this.

[Marie44]

Thanks ilovedogs, my 2nd beta was 6/1/16 and it was 314. Then my 3rd beta was yesterday, 6/8/16 at 1246.

[quandry]

So for your doubling time it is a bit low. They like to see doubling times at 72 hours or less and yours is at 84. Now that doesn't necessarily mean for sure that it's not going to stick but it can be less likely. Kmfx for you for a miracle.

[Marie44]

Thanks Quandary. I'm really hoping I'll just get my full period now that I've stopped my progesterone and other meds.

[quandry]

Until loss is confirmed I'm not sure stopping everything is the right way to go...

[Marie44]

That was my thought too Quandary, but my RE was quite positive this was not viable and instructed me to stop all meds. Hope he was right....

[CdnHockeyGal]

Marie - they really can't know if it was a viable pregnancy or not until a repeat u/s. Your betas are very high to be stopping meds. I'd encourage you to insist on a repeat u/s and discuss continuing meds until that time.

Nothing but time and a repeat u/s can diagnose viability.

[Hope15]

Maire44- how's it going? Any update yet? I'm wishing you all the best with this.

[Marie44]

Hi Hope15 and All - I went back for my follow-up beta and scan this past Fri., 6/10. Thankfully my beta went down to 526 (from 1246) that shows my body was trying to take care of the issue on its own. The fellows doing my scan found some tissue in my tube, which my RE apparently didn't see at my prior scan. Still no sac in my uterus.

So given my symptoms and this most current scan, I felt the best option was to take the methotrexate. Since my HCG level is quite low, the fellow felt it should reach 0 within a couple of weeks. Then my hubby and I will take a short break before trying a FET. I am also thinking of switching my RE within the clinic (UCSF) before moving forward with our FET.

Thanks everyone for your support. Good luck to you all as well!

[quandry]

Hugs. I think you made the right choice.

[Marie44]

Thank you so much, Quandary. *Hugs*