There was nothing there on the ultrasound screen, just my beautiful uterus – empty. There was the teeniest tiniest black spot that may have been the beginning of a sac, but it was so small my Doctor was not certain. She didn’t need to say anything for me to quickly realise that I was not one of the lucky 1%. My doctor checked my ovaries: my right one is still hyperstimulated from the IVF and I had some VERY big follicles/cysts (but this is normal for after IVF and of no concern, but may explain any pain I may have here), my left ovary too was swollen, but not as bad as my right one.
What does this mean? It was difficult for my doctor to say without knowing what my beta test results are. If my hCG levels are continuing to rise, it is likely that I have a tubal pregnancy (ectopic pregnancy – a pregnancy that grows outside of the uterus). If my hCG levels are falling, then it will be safe to assume that I have a chemical pregnancy* and the little black spot on the screen was indeed huckleberry.
My symptoms have been spotting dark brown blood since Friday, general abdominal pains all day Monday, my spotting surprisingly stopped today (Tuesday). I have had some pains specifically on my left side, although not overly sharp pains, and I pointed out to the doctor (doctors – there were 2 others in the room with her) where this was….yeh, about where my ovary/fallopian tubes are.
If this is a chemical pregnancy then the doctor will prescribe me some medication (a vaginal pessary, I cannot remember the name of it) to help my body along with expelling the uterine pregnancy. If this medication doesn’t work, or my hCG levels come back higher with a likelihood of a tubal pregnancy, then I will be prescribed Methotrexate (an intramuscular injection – YEY another injection, of course!!!). I want to avoid taking this drug because it will mean we are not allowed to conceive for at least another 3 months because the chemical can stay in the body and harm a developing embryo. But at the same time, we don’t want to wait and see for too long because there is a chance my tube could rupture and I would lose a fallopian tube. I have read that even after being given the shot their tube still ruptured because it was left too late.
So I was asking you to hope with me that I didn’t bleed, but now I want to bleed….please, please body, just bleed!!! I think this will be one of those times when I cry tears of happiness when I start to bleed full flow! I know it will also be sad at the same time….choo choo, all aboard the emotional train wreck!!!
I mentioned that there were two other doctors in the room, one was ‘shadowing’, the other was a fellow (no not a chappie you silly Brits!!!). The fellow interjected and answered some of our questions, he was clearly very knowledgeable, but there was a lot of bouncing around between them. Chris was getting frustrated with the information we were receiving, they were talking to us as if we were medical professionals. It took 5 minutes of Chris’s continued questioning to get the doctors to say that despite the miscarriage being bad (and sad), what we were seeing was ‘normal’ or ‘common’. What they really needed to start out with was – don’t worry, there is nothing seriously wrong with you, chemical pregnancies happen frequently with IVF (because they are transferring 2 embryos). I think I had a bit more knowledge than Chris and didn’t feel quite as frustrated because I had googled a lot on miscarriage, chemical pregnancy, blighted ovum and have read forums/blogs etc. So my lesson here is to share more of my ‘google expert medical opinion’ knowledge with Chris before these types of appointments.
We also discussed my hCG levels (49, 110 and 345) and my doctor did admit that my first hCG result of 49 was borderline low- to non viable. So why, oh why, did the other doctor (who did my IUIs) seem so happy and chirpy on the phone, proceed to tell me my progesterone and estrogen levels were excellent but fail to tell me my hCG level. All it required was this: “Congratulations Ms Dani, you are pregnant, but your levels were a little lower than average, we would like to see you again in 5 days just to make sure you levels are doubling nicely. Your estrogen & progesterone levels are excellent, so this is a good thing.” Expectation management is not a bad thing.
So – we have one big question answered, I feel a relief, albeit a sad relief – there is no viable pregnancy. The next big question we wait for an answer is – is this a chemical pregnancy or a tubal pregnancy?
*A chemical pregnancy is a clinical term for a very early miscarriage. It happens before an ultrasound could even detect a heartbeat (before the 5th week of gestation). This occurs when an egg is fertilized but it does not implant on the uterine wall. Chemical pregnancies are actually quite common, occurring in 50 – 60% of first pregnancies. There are many possible causes of chemical pregnancy – inadequate uterine lining, low hormone levels, luteal phase defect, infection, or other unknown reasons. The most common assumption is that they are due to chromosomal problems in the developing foetus. This can result from poor sperm or egg quality, genetic abnormalities from either mother or father, or abnormal cell division of the foetus.
The Great Pudding Club Hunt 
I am so sorry this is happening for you. I thought a lot about what I might do if I had a tubal pregnancy when my numbers were all wonky and personally I wouldn’t take that stuff unless they have actually seen something in the tube. The effects on the body can be very violent from what I have read from others. I don’t know how it all goes technology wise over thete but I was under the impression that you wouldn’t be able to see anthing on ultrasound until 6+ weeks and a much higher HCG. Crossing my fingers that the bleed starts if that is where this is all at. It is all just such a crappy experience and I am so sad you have had to go through it. Xx
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So after you made this comment I started to look a bit more into methotrexate, and you are right, I really need to be sure before I take it!!! I found out this afternoon that my hCG levels are continuing to rise – 686 😐 and still no bleeding. This totally sucks. I’m kind of over the sad and more into the mad stage now!
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Did it double? Or is that still a low rise? Oh I hope you don’t have an ectopic 😦
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So so sorry to hear this 😦 I hope they are clearer with your levels next time and they understand the impact miscommunication has in such a sensitive situation.
Bizarrely I was on methotrexate (tablets rather than injection, partly why we can’t try to have kids for the foreseeable) for my eczema. I’m not sure if they work the same and no doubt you’ve read everything but if you do have to take it (praying you don’t!) on a practical note be careful with drinking. I had one fruit cider and had excruciating pain, and then received my blood work to say it had damaged my liver. As you’ve been having pains and with IBS thought I should mention it, but praying you won’t need to know it out right. Love and hugs cuz xxx
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I had never heard of methotrexate before…it isn’t the nicest sounding drug for side effects, but it would be a better option than surgery. I will ask the doc about the IBS interaction (but first I will google it!!!). Thank you X
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I’m not sure what the difference is between the tablet and injection is but here is what I know from an eczema PoV. I hope it helps in some way :
It’s an immune system suppressant (hence used for atopic eczema) but can also be used for cancer patients, those that have received organ transplants, arthritis and bowel conditions. Essentially anything inflamed.
It is more hardcore than other immune system suppressants. When I was on it I only took it once a week as an example.
I had to have regular blood tests but that might be because of taking it regularly. Something to check as my frequency of blood tests was very different from Adam’s. These were to check my white blood cell count (ie not suppressing immune system too much) and to check my liver was ok (it was not)
As you say you should wait before getting pregnant after stopping taking it. I’d recommend against reading why but trust them on it.
We’re both on azathioprine now, a similar but less intense drug as a ‘steroid sparing agent’,Adam for his Crohns colitis so should you need to take it it may benefit your IBS
Obviously I pray it isn’t necessary but I hope that helps to some degree. The only side effect I had was my liver but I was on 2 drugs at once so that is likely why. The main negative is having to wait so long 😦 x
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So sorry to hear this 😦
You’re in my thoughts ❤️
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Im sorry. I totally know what u mean about praying not to bleed and now praying to bleed…I went through the exact same thing with one of our losses. I also wonder why doctors or nurses arent totally upfront w a low beta to begin with too. Our first IVF cycle the beta came back at 60 and the nurse seemed chipper. I didnt know any better at the time and figured we were home free. Sorry u experienced the same thing w your initial beta. Hoping things are as easy for u as they can be in this shitty situation XX
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Oh that is cruel for sure 😦 I would much prefer the cautious side of happy any day. I’m not sure we were really prepared for this (not that anyone ever really can be), but we didn’t even consider this as a possible outcome scenario. Thank you for your comforting words x
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I’m so sorry to read this. You’re in my thoughts and prayers
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I’m really sorry about your loss. I hope you do bleed soon and you get your next chance to try again soon if that’s what you want to do. This stuff is just the worst. I hope you’ve got lots and love and support around you right now to help you heal xx
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Thank you – we have lots of love and support from a far, and some near too, in fact it’s kind of over whelming – in a nice way. I feel lucky in this respect. I cannot imagine a couple going through this alone, it would just be terrible.
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Thinking of you every single day. I cannot even express how sorry I am that this is happening… I am SO sorry for your loss. I am hoping now for your sake that you bleed soon and can avoid any further issues/complications.
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Thank you Ana marie x
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Oh my gosh, I’m only just catching up on reading and I’m SO sorry to read this. I was so optimistic for you! I don’t know what to say apart from I hope that you don’t have the complications you’re worrying about. I’m sending you hugs x
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Thank you Nara x
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I’m happy you have an answer on viability, but just so sad that you’re having to go through this and that it’s raised yet another question. Sending you big hugs, Dani!
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