Rising hcg but no fetal pole... anyone BTDT?

[Anonymous]

My hcg has been doubling almost perfectly, up to about 50k now. Based on my LMP I am 6w5d weeks but because I ovulated later in the cycle I'm probably closer to 6w2d. Had my first U/S today because of a history of ectopic pregnancies, it showed a gestational sac and a yolk sac but no fetal pole. She said everything still looked really small and to just come back in a week for a recheck, but I'm feeling so discouraged because I feel like with an hcg of 50,000 you should see a heartbeat already, and if not then at least the fetal pole. I feel so nauseated and tired and angry all the time, just like a real pregnancy... has anyone had a similar experience of rising hcg, normal pregnancy symptoms, and it ended up being just an empty sac? Or, better yet, that the heartbeat just showed up later than usual??? My doctor was way to noncommittal for me.

[Anonymous]

I don't want to scare you unnecessarily, but with an HCG of 50,000 it's virtually inconceivable that you wouldn't see a HB if everything was normal and if your OB practice uses up to day transvaginal u/s equipment. In one NIH study of u/s technology, every patient with HCG of 10,800 had a visible HB. Now, if you're talking about an abdominal u/s or old equipment, possibly a different story... Although I'd still worry about the lack of a fetal pole post-6 weeks.

https://www.ncbi.nlm.nih.gov/pubmed/2660539

[Anonymous]

I’m so sorry you are going through this.

[Anonymous]

Same happened to me. I was 6w5d - no fetal pole. Went back in a week and everything was there and even measuring a few days ahead. I am now 15w. Don't be discouraged!

[Anonymous]

Anonymous wrote:I don't want to scare you unnecessarily, but with an HCG of 50,000 it's virtually inconceivable that you wouldn't see a HB if everything was normal and if your OB practice uses up to day transvaginal u/s equipment. In one NIH study of u/s technology, every patient with HCG of 10,800 had a visible HB. Now, if you're talking about an abdominal u/s or old equipment, possibly a different story... Although I'd still worry about the lack of a fetal pole post-6 weeks.

https://www.ncbi.nlm.nih.gov/pubmed/2660539

I mean it was definitely transvaginal. I don't know the age of the equipment, doctors equipment always looks ancient to me. She just kept saying the sac looked so small that it was possible it was hidden and not visible yet. But yes, I read that same study, I was hoping someone had some personal experience one way or another.

[Anonymous]

Anonymous wrote:Same happened to me. I was 6w5d - no fetal pole. Went back in a week and everything was there and even measuring a few days ahead. I am now 15w. Don't be discouraged!

Thanks. I hope that's the case. Was your HCG also rising normally prior to the U/S?

[Anonymous]

Anonymous wrote:I’m so sorry you are going through this.

Thanks. I just keep thinking, if I am vomiting and getting irrationally angry at my son for a pregnancy that's not even real, I'm going to be even angrier than my hormones are already making me.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Same happened to me. I was 6w5d - no fetal pole. Went back in a week and everything was there and even measuring a few days ahead. I am now 15w. Don't be discouraged!

Thanks. I hope that's the case. Was your HCG also rising normally prior to the U/S?

Yes. It was doubling as normal.. I had a transvaginal ultrasound but the pole wasn't there or they couldn't find it. When I came back in a week, the doctor said that it was either too early or technician did a crappy job the first time.

[Anonymous]

If your uterus is tilted, it's very possible for it to not show yet.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Same happened to me. I was 6w5d - no fetal pole. Went back in a week and everything was there and even measuring a few days ahead. I am now 15w. Don't be discouraged!

Thanks. I hope that's the case. Was your HCG also rising normally prior to the U/S?

Yes. It was doubling as normal.. I had a transvaginal ultrasound but the pole wasn't there or they couldn't find it. When I came back in a week, the doctor said that it was either too early or technician did a crappy job the first time.

I'm hoping it's something like this, the doc kept being like "it's just so small it's hard to see anything if it's just tilted the wrong way or something, but the yolk sac is a great sign!" all optimistic. I mean she is a fertility specialist (since I had multiple ectopics prior to this) so I'd think she'd be good at finding babies on ultrasound, but she was also very unwilling to give me bad news which I was pretty much asking for.

[Anonymous]

OP where did you go? I went to Columbia Fertility in Foggy bottom at 5w+ (Possibly close to 6 week) with a perfect doubling hcg and the same hppened to me. Doctor said it was too early to see anything and to come back in 2 weeks. Ended up having some cramping and went to the GWU ER where they have great us a few days later and saw baby and heart beat.
BOth transvaginal. My doctor’s us was just not very good. Good luck!

[Anonymous]

I have been there so many times OP. A history of losses and eventually stopped getting early ultrasounds (declined to see an RE with my last successful pregnancy so I just went in at 8 weeks with my regular OB). My mantra with the early bloodwork and ultrasounds was to trust in my body (and stay off Dr Google). Eventually it worked out for me.

Best of luck. I hope it works out.

[Anonymous]

I had this happen with my first. No fetal pole seen at 6 week-ish. They sent me for a hcg test and my levels were sky high. A few days later, they repeated it and all looked fine. I know that wait can be difficult, but don’t worry yet!

[Anonymous]

Anonymous wrote:Same happened to me. I was 6w5d - no fetal pole. Went back in a week and everything was there and even measuring a few days ahead. I am now 15w. Don't be discouraged!

This happened to me, but I had no clue what the HCG levels were at the time.

[Anonymous]

Anonymous wrote:I have been there so many times OP. A history of losses and eventually stopped getting early ultrasounds (declined to see an RE with my last successful pregnancy so I just went in at 8 weeks with my regular OB). My mantra with the early bloodwork and ultrasounds was to trust in my body (and stay off Dr Google). Eventually it worked out for me.

Best of luck. I hope it works out.

OP’s post mentions a history of ectopic pregnancies. With that history, waiting until further along (I.e. 8 weeks) is a bad idea. The earlier an ectopic is caught, the better.