Why is doctor refusing to tell me I miscarried?

[Anonymous]

I am (was) nine weeks pregnant via ivf and had my ultrasound today. Doctor said no heartbeat and no yolk sac, only two large cysts. So I said "then it's a miscarriage, right? There is no more pregnancy?" And she said that it was an abnormal pregnancy, likely to be a miscarriage, but could possibly develop into a normal pregnancy and she wants a second ultrasound later to confirm. I'm completely baffled by this. There is no dating uncertainty since it was ivf. I'm wondering if there is some weird liability reason she doesn't want to tell me I miscarried? Or maybe she thinks it's possible there is a possibility that there is a fetus hiding behind the cysts but that seems unlikely. I just can't understand why the doctor is being so cagey and won't tell me I miscarried. If it's relevant, I love on Maryland and use Kaiser. I know I need a new doctor but for now I am just trying to understand why she would treat me like this Any thoughts are greatly appreciated.

[Anonymous]

I don’t have experience with this exact situation but just want to say I’m sorry you are going through this and in limbo. I do find it strange the doctor won’t diagnose it. I had a blighted ovum and i think it was around 7 weeks that they told me there wasn’t a fetus. The doctor told me right away.

[Anonymous]

Read the after visit notes in your chart. It may shed additional light. If she is asking for a second ultrasound doctor clearly isn’t truly ready to call it.

[Anonymous]

I'm sorry you're going through this.

I had two miscarriages with Kaiser (not ivf) and both times the doctor called a PA into the room and narrated to both of us her reasons for finding no viable pregnancy. I thought at the time it was to avoid any intimation she had advised an abortion. Just wondering if that could be a factor in your situation.

[Anonymous]

I too had 2 miscarriages at Kaiser in MD, and both times the various OBs I consulted told me directly that my fetus was not viable and that I was going to miscarry. My situations were very easy to diagnose, however. I was at about 7 and 9 weeks respectively, the fetuses measured 5 and 7 weeks, and both times there was no heartbeat, my hCG had already started to decline dramatically (my HCG was tracked for various medical reasons), and there was a clear line of sight on the fetus, no cysts.

Each time I was given all my options, and I chose to wait to naturally miscarry both times, instead of taking an abortion pill, or getting a D&C. Both times the D&C was mildly discouraged, as it can lead to scarring, but 2 options were given for it: in office with minimal pain meds (ugh!) and in surgery with anesthesia. For the second miscarriage, another OB I consulted because my regular OB was out, even sent me an informational video on my options. They were both really nice. The evening I went in for an urgent ultrasound, the techs got a third OB on the line to tell me I was miscarrying because there was no heartbeat. I cried, and the tech hugged me and was very kind.

Read your medical notes. A second ultrasound is usually done to confirm diagnosis if ever there is a doubt, as it appears there is in your case.

Many hugs, OP. I'm very sorry.

[Anonymous]

I'm sorry about this.
Which state do you live in?
I have heard that some doctors don't want to make an official miscarriage diagnosis because that might trigger an investigation -- i.e. right to life laws

[Anonymous]

Anonymous wrote:I'm sorry about this.
Which state do you live in?
I have heard that some doctors don't want to make an official miscarriage diagnosis because that might trigger an investigation -- i.e. right to life laws

Maryland, as per OP. There is no legal issue here. It's the large cysts that are probably creating doubt, and require a second ultrasound to confirm.

[Anonymous]

Likely to be one means exactly that. Hasn’t actually completed. You haven’t miscarried, you’re in the process of it. Not that it makes it better, but she’s being technical.

[Anonymous]

Miscarriage isn’t a medical term. It’s called spontaneous abortion. And not sure how that ties in if the fetus didn’t develop to begin with; I think they has a different term. FWIW I had several m/c in my history and honestly what it was called wasn’t a big focus for me.

[Anonymous]

I'm so sorry for your loss, OP.

[Anonymous]

That sucks, I’m sorry.

The doctor is surely just following the rules. Probably because the cysts make it hard to see, another ultrasound is necessary to confirm. I doubt it’s a judgment call, more of an if this, than that situation.

[Anonymous]

OP here. Thank you everyone for the kind words and thoughts. I went back to the fertility clinic today and they said it was clearly a miscarriage and they could not understand why the Kaiser doctor would think there was any chance of a viable pregnancy. I'm grateful that at least I can move on now and while I am pretty unhappy with Kaiser generally, at least I switched my Kaiser OB this morning.

[Anonymous]

OP, make sure you practice some self-care in the coming weeks. Get a massage. Sit in the sun for some Vitamin D. Go to bed early, etc.

Sending you virtual hugs.

[Anonymous]

I'm so sorry. I had a similar experience with a doctor a few years ago. In some ways, it helped me adjust to the news a bit at a time, rather than all at once.