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Dr. Lawrence
Dr. Lawrence, OB/GYN
Category: OB GYN
Satisfied Customers: 853
Experience:  Board Certified OB/GYN and accomplished educator
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I miscarried following IVF last month at 6 days + 1. Now it

Resolved Question:

I miscarried following IVF last month at 6 days + 1. Now it seems I have conceived spontaneously within days of miscarrying. We had sex (the only time in the past two months due to treatment/miscarriage) on 23 November so I thought I was 5 weeks + 2 but today when I had a scan the doctor said I had a sac but no embryo showing so I am only 4 weeks. As this isn't possible I'm now terrified that this pregnancy is failing as too. The doctor seemed to disbelieve that I could be so sure of when I conceived (I know I could have ovulated on 22 November or later (up to 26 November as the sperm could have survived that long) but I'm definitely not only 4 weeks. I'm due to be scanned again a week but I'm wondering if it's possible for this to be a viable pregnancy even though nothing but the gestational sac is currently visible?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. Lawrence replied 2 years ago.
Dr. Lawrence :

Hello, and thank you for your question. I will be happy to assist you. Answers are for educational purposes only.

Dr. Lawrence :

What was the date of your loss?

Dr. Lawrence :

If you only had sex on 11/23/14, then it is possible that the ultrasound will show what it did. It is within the margin of error of the ultrasound.

Dr. Lawrence :

I agree to repeat the ultrasound in one week. That will show you if there has been any interval growth between then and now.

Dr. Lawrence :

Also, you can check HCG levels now and two days later to see if it is rising appropriately. That will at least give you some information in advance of the next ultrasound.

Dr. Lawrence :

But it is not impossible that the ultrasound is showing that you are 4 weeks and 1 day....because it is within the one week margin of error. The only way to know for sure that it is a viable pregnancy is to do the tests and give it time to see how it progresses.

Dr. Lawrence :

I wish you the best and hope that it is viable and that you just caught it very early.

Customer: I miscarried (started bleeding) on 7 November. Based on when we had sex I think the range of how pregnant I could be now is 5 weeks + 2 to 4 weeks + 5. Also the Mean Gestational Sac measurement today was 4.7 mm
Dr. Lawrence :

Have you had any bleeding or cramping now?

Customer: No.
Dr. Lawrence :

Great. It is still possible that the ultrasound is within the margin of error. It is just too soon to make a definitive assessment. Repeating the ultrasound in one week will be very helpful and then again a week after that to potentially see a heartbeat. In the meantime, the blood tests will demonstrate whether you are showing rising HCG levels. You could also check a progesterone level and that can give you information as well. Less than 5 is very concerning for an impending loss.

Customer: My progesterone was 75.5 on 10 December and my hcg went from 311 on 9 December to 486 on 10 December. But I might get more hcg tests this week. Thank you for your answer - one final question, is the progesterone of 75.5 incredibly high and why could that be?
Dr. Lawrence :

That is good....

Dr. Lawrence :

Progesterone is released from the corpus luteal cyst in your ovary supporting the pregnancy.

Dr. Lawrence :

Over 25 is considered a good sign for a developing pregnancy.

Dr. Lawrence :

So far so good.....time will tell how things progress.

Dr. Lawrence :

All the signs so far are good.

Dr. Lawrence :

I will keep my fingers crossed this week for you.

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