Hcg and progesterone rising but no gestational sac


Dear ladies,

I havd referred to this forum umpteen times and seek your advice/experience on this.

I was very happy when my third IUI cycle (1st with injectibles) worked and I got B-HCG positive. My IUI was on 7/12 and HCG on 7/26 was 147, on 7/29 it was 475 and I was scheduled for first U/s on 8/6 however, I started bleeding the night before. The U/s showed nothing but a blood clot and I was put on bed rest. My HCG now was 6768. Bleeding stopped after 12 hours (bright red) and spotting also ended the same day.I returned to RN for 2nd U/s today I.e. 8/9 and the same thing happened …no gestational sac yet, just the blood clot while the HCG stood at 19442 now. Progesterone levels have been above 40 since 7/29. I’m continuing bed rest and browsing Internet for all possible reasons for this which is only making me all the more anxious and stressed. Could this be a molar or ectopic pregnancy? What could be the other possible reasons for our inability to see the sac even as the HCG progresses in the right direction?

Has anyone else experienced this before? I am dreading the worst.


I’m so sorry to hear this. Sounds like an ectopic. Did they check your tubes for signs of pregnancy in the tube?


Not yet. They only want me to wait to find if the pregnancy is viable or will miscarry.


If your HCG is 19442 you should be able to see a gestational sac in your uterus. I’m really surprised that your RE did not do a thural investigation via u/s. Are you in any type of discomfort, cramps?


I had some cramps before I started bleeding on 8/6. I feel whats more like ovulation pain sometimes…I did mention it to the RN today. She just said she was sorry that she didnt have answers today and asked to return 8/14 for U/s. She said the sac may be hiding behind the blood clot or may be I was going to miscarry.


Wow, this site has changed a TON since I last visited! All of my stuff is deleted. It that true fro everyone else? Why the change?

Anyway, Tamanna, I had almost the exact thing happen. My HCG kept rising and nothing was seen on ultrasound. I think in total I ended up having 5 transvaginal U/S looking for something. Nothing was ever seen in my tubes, uterus, or abdominal cavity. I was given methotrexate and despite 2 doses, my HCG was still climibing 2 weeks later. Another US again revealed nothing. We then had a D and C and the pathologist found not chorionic tissue (meaning no embryo). However, labs the next day revealed a HCG of under 300. So either there was tissue in there that was missed, or for whatever reason the ectopic finally dissolved.

Sorry, I know this is not what you were wanting to hear. But I did want you to know that you are not alone in this situation.


It’s been a long two week time since I posted this question. On 8/14 during my third u/s I asked the RN specifically that I needed answers. She could still not see a sac and because I persuaded to know what was happening and why wouldn’t there be a sac even at 20,000 HCG (it was around 39000 on 8/14) so I was re-checked by the doctor who concluded that it was an abnormal pregnancy, may be molar and recommended D&C. I was shocked but my husband decided to go ahead on the spot. He didn’t want my body to suffer for a child which was not there. I had D&C on 8/16 and to my dismay the U/S before the surgery showed that I was probably pregnant with twins, the normal sac collapsed much before but the abnormal kept the HCG levels going up. Essentially there was no blood clot, it was the abnormal sac :frowning: now, I am desperately waiting for the diagnostic results and hoping it wasn’t molar. My levels have not gone down very much in last one week they stood at 28000 today. Just waiting to hear for green signal to start trying again. Life is certainly not fair!


NurseNancy - I’d like to join your private FB group. Can you add me? [email protected]


I’m sorry to hear of your loss. It’s sad and disappointing. How are you feeling after the D&C? I’m sure your DH is taking good care of you. ((HUGS))