please help me understanding- no HB, small, doc not too concerned

[Anonymous]

I've posted on here several times lately.

I just had an ultrasound at 6 weeks past the first day of my LMP. There was a "ring" and a sac in the uterus, but no heartbeat. Also the sac measured 4 weeks.

The last several periods I've had have been irregular (haven't had many as I stopped BF-ing recently). I also had beta tests - 250 about a week ago, and then more than doubling two days later, and doubling more than two days later again. The last (third) beta was 4 days ago.

I had no real information from the doctor except to tell me that I should be glad it's not ectopic (I've had one in the past) and if I do miscarry then it was probably a genetic defect which is better t o have taken care of now (WTF).

- Any sense of what is going on? He made it seem like a waiting game but I'm not sure I trust him. He also said "we treat the patient not the ultrasound" which made no sense either to me
- He wants me to return in 2 weeks to see if there is a heartbeat. I've had a somewhat tragic past with fertility so I'm really eager to do more if medically possible before then, even if it means paying out of pocket. Can I? I just want to not be in torture land if it's not possible.

[Anonymous]

OP here- one more thing:

If I am 4 weeks today and it's a viable pregnancy, wouldn't that mean I was 3 weeks a week ago? In which case, wouldn't we not see those numbers yet?

[Anonymous]

Are you the OP who posted about the doctor you didn't like? Because if so, your story has changed (heartbeat in other post, no heart beat in this one) hope you aren't trolling this board

[Anonymous]

I would say that as long as the numbers are doubling that is a good thing. You didn't mention a yolk - was there anything inside of the gestational sack? I'm not sure if the ring you're referring to is that white ring you see outside of the gestational sack or the yolk.

Usually at 4 weeks there is only a thickening of the uterus - if they were able to see the sack and yolk doesn't that mean that you're more along the lines of 5 weeks? Then I'd say you are fine...

Someone chime in if I'm wrong.

[Anonymous]

Good God, no I am the OP and I am not trolling. This is the first time I've seen this particular doctor. Frankly I'm about ready to slit my wrists from upset-edness and anxiety and this isn't helpful. (I'm guessing there is more than one woman who isn't a fan of her doctor).

[Anonymous]

Anonymous wrote:Are you the OP who posted about the doctor you didn't like? Because if so, your story has changed (heartbeat in other post, no heart beat in this one) hope you aren't trolling this board

I'm sure there are multiple women on this board that are around 6 weeks pregnant.

[Anonymous]

Anonymous wrote:Good God, no I am the OP and I am not trolling. This is the first time I've seen this particular doctor. Frankly I'm about ready to slit my wrists from upset-edness and anxiety and this isn't helpful. (I'm guessing there is more than one woman who isn't a fan of her doctor).

I am the OP of that other thread (I'm the one that commented asking about whether you saw the yolk). Some people on this board are really rude. I am sorry you are going through this and those comments are unhelpful, indeed.

[Anonymous]

I'm not sure what you're asking. Pregnancy is very much a waiting game. It sounds like it's too early to date the fetus accurately since your periods are irregular. What made you not trust the doctor? It sounds like another doctor with a poor bedside manner for patients who need a lot of reassurance.

[Anonymous]

I don't see what you're asking either. If your periods are irregular, you may be measuring behind or you may not. Can't know anything else at this point..

[Anonymous]

If it is really early in the pregnancy, it is difficult to know if it is viable or a miscarriage.

If you are four weeks, it's too early for a heartbeat. So it's really just too early to tell.

The fact that your cycle is irregular means that it makes it more difficult to tell if it is truly at 4 weeks or if you are at 6 weeks, but it stopped growing at 4 weeks and your body is going to miscarry (but just has not done so yet).

It is at this point a waiting game. Sometimes even when there is a miscarriage, the numbers still go up, because it takes the body time to realize what is happening (if that makes sense).

So the best thing is to go in for another ultrasound in a week. At that point, the doc will be able to see if the sac has grown, which would be a good sign. It still will likely be too early for a heartbeat (which is probably why your doctor said 2 weeks).

Most first trimester miscarriages are due to chromosomal abnormalities. It's the body's way of stopping a nonviable pregnancy before it goes too far. It is still upsetting and sad, but I think what your doctor was trying to say is that it is natural.

Try to relax. See if your doctor will let you come in in 1 week for another ultrasound to see if the sac has grown.

Best of luck. It's difficult to wait and see. I've been through 2 miscarriages. The second one involved some waiting to confirm it was really a miscarriage. I know how hard it is.

[Anonymous]

Thanks for the helpful responses.

I guess what I was asking is if HCG levels could have gone up last week and until a 4 days ago despite an un-viable pregnancy- sounds like they can.

Also asking how likely it is that I am a full 2 weeks behind- seems unlikely to me- but again I guess who knows.

[Anonymous]

Anonymous wrote:Thanks for the helpful responses.

I guess what I was asking is if HCG levels could have gone up last week and until a 4 days ago despite an un-viable pregnancy- sounds like they can.

Also asking how likely it is that I am a full 2 weeks behind- seems unlikely to me- but again I guess who knows.

17:04 here. I'm not a doctor, but just from my two miscarriage experiences, two different OBs told me that yes, HCG levels can continue to go up, even if it is unviable. And it is possible you are a full 2 weeks behind. If your cycle is very irregular, you may not have ovulated when you think you did. (Again, that's what I've been told by OBs.)

I'm sorry you are in limbo. I know how horrible it feels. The best thing is to try to focus on something else for the next week or two. Wishing you the best.

[Anonymous]

Thanks.

So- it seems like a yolk sac= the ring = it must be 5 weeks. Someone correct me? That seems concerning as I measured at 4 weeks (and have big babies from the start!)

[Anonymous]

You need to relax and wait for a repeat ultrasound. Things will be clearer in about 2 weeks. It's hard to tell what is going on so early in the pregnancy.

[Anonymous]

A day or two can make a big difference at this stage. I got an ultrasound at 5 weeks 6 days (basically the same time as you) and we didn't see a heartbeat. Of course I totally freaked out. Two weeks later, there was a heartbeat and all was fine (that's my now 2 year old). I know waiting is awful, but if your betas are doubling normally, I would try to relax. (Easier said than done, I know)