Now RE is warning of ectopic and met shot


#1

I went to see my RE today. Had ultrasound and bloodwork.
The purpose of the ultrasound was to rule out ectopic based on my beta below:
6/20- 85
6/24- 196.7 (doubling time: 79.65 hours)
6/26- 505.2 (doubling time: 35.15 hours)
6/28- 876.9 (doubling time: 60 hours)
7/1- 1943.7 (doubling time: 60 hours)
7/3-3100 (doubling time: 71.2 hours)
7/5-5211 (doubling time: 66.7 hours)

I am trying not to worry but you know I have to take her words into consideration. She even warned me of the met shot. I told her she better be 100% sure it is ectopic before she make me take that shot. There is no sign of optimism in her and yet before we start this IVF process she was all for keeping our minds in positive state. But anyway, like I said i am trying not to worry but she warned me of possibility of bleeding and rupture this weekend.

Good news is during the ultrasound she told me my ovaries are small (not swollen), no mass in my tubes and no fluid (blood) in my uterus. I guess it is a good thing that she is checking all these. There was also a small sac on top of my uterus but she said she wasnt sure if it was an early sac, whether the sac has just stopped growing or if it’s a pseudosac (fluid mass) due to ectopic. All of these suggest that i am not having an ectopic pregnancy.

Also the nurse said it’s good news that my P4 today is 20.90 indicating that ectopic doesn’t occur “elsewhere”. Dunno why she said elsewhere because we havent determined the location of this ectopic yet. Anything below 15 suggests ectopic based on my limited knowledge of internet research but dunno how they would even suggest that for me because I am on P4 supplementation.

But today my beta is 5211. So all they are worried about is my beta not doubling in 2 days and thinking it could be ectopic. I dont even feel like explaining to these professionals about what I read online about how the doubling time should slow down after a certain level. I am just going to get a second opinion when the time comes.

Anyway I just need to vent. I am still hopeful and praying that on Monday God proves my doctor wrong and the sac will grow and have yolk sac and fetal pole in it.


#2

Your betas are too High and won’t double every 48 hours it slows to 72 hours after it hits about 1500. How ma y weeks would u be ? I would expect a sac and yolk sac visable around 5 weeks for sure


#3

I dont know how to correctly calculate how many weeks i am. But my transfer of 6 day blasts was on june 10th. So it has been 27 days since June 10th. And add up 19 days from last period= 27+19= 46 days??? Is that right? So about 6.5 weeks. I dunno… But dr said it is too early to see a gest sac but there was a sac on top of my uterus she just wasnt interested to zoom in on it and look at it in detail. I guess Monday we will find out more. She was more interested in measuring my ovaries :-/


#4

Can you look for someone to give you a second opinion regardless of what she says. I wouldn’t wait for her final conclusion, I would start getting a second opinion right away. I am not totally understanding why they think it is an etopic. Like sorcet said, I thought the doubling slowed down after a while. Either way, I am praying that the RE is wrong and that everything is ok.


#5

I saw a HB at this time with both pregnancies seems odd to me she wouldn’t want to see the sac in more detail if there was a sac and yolk sac (you’re right about 6 weeks) then you’re fine if not it is def not too early to see a sac checked mine at just over 5 weeks are u doing a transvaginal u/s ?


#6

Gosh Alexi, I’m sorry that your betas have been irregular for you. I think its a little early to give up, but you also need to take your doctor seriously. My wife and I went through an ectopic recently, and we were very reluctant to take the meth shot. I remember hearing the nurse tell us, out of the blue, “Your betas aren’t doubling properly, so its probably an ectopic. Do you want the Metheltrexate shot today or tomorrow?”

Our first instinct was, of course, “how can you be so sure?” So we waited a little while, but fortunately for us, we DIDN’T wait until she started feeling pain. If we had, we could have lost her only good tube and ovary. That’s the problem with a prospective ectopic. If you wait too long, you could destroy what’s left of your fertility.

A second opinion is a good idea, but I think you want to take your doctor very seriously on this matter.


#7

Alexi- very sorry you are going thru this. Please take this very seriously. A ruptured ectopic is very dangerous. I went thru one last year while my OB was trying to figure out if I was still pregnant or not. I ended up waking up with pain and rushed to the ER. Listen to your body and any sign of disconfort/pain go to the hospital.


#8

It is a transvaginal ultrasound.

Well i dont have any pain. There is mild crampinng that i have been having since the day of transfer and it happens maybe once or twice a day. No bleeding

I dont mind getting the shot but she has to be absolutely sure. It is hard to terminate this pregnancy when I have waited so long for it. So no I will not listen to my doctor it is still her opinion based on non doubling betas but other things are still pointing to a viable pregnancy.


#9

[QUOTE=alexi]It is a transvaginal ultrasound.

Well i dont have any pain. There is mild crampinng that i have been having since the day of transfer and it happens maybe once or twice a day. No bleeding

I dont mind getting the shot but she has to be absolutely sure. It is hard to terminate this pregnancy when I have waited so long for it. So no I will not listen to my doctor it is still her opinion based on non doubling betas but other things are still pointing to a viable pregnancy.[/QUOTE]

Just make sure you go into this with the mindset that you are getting a well-rounded perspective. Sometimes, people can go “fishing for doctors” so that they can get the answer they want to hear. In this case, like wliss described, wishful thinking can come at a terrible cost.


#10

Thanks Demian. I think my doctor is looking at my ultrasound too to see make sure there is no implantation in the ovaries, tubes or anywhere strange in the uterus. She did not see any yesterday in these areas and no blood in the uterus. She did see a sac on top of the uterus. Her nurse has also contradicted herself first she said the numbers should double every 2-3 days and if you look at my beta they are within this range. Later (after the third beta) when she spoke to the doctor, the doctor said it needs to double every 2 days (48 hours). That is why I am doubting them. And thanks everyone else for your advice. I so want this baby so much and i will continue to pray and I pray that my doctor is wrong.


#11

This sounds very similar to my second ivf experience. My first beta didn’t double in the 48-72 hour time frame. But then it continued to go up after that. They did ultrasounds to roll out ectopic and saw a sac. The dr I had was a real jerk and just kept telling me it was too early to see a heartbeat etc. I went back each week and was told the same thing. Until week 8 there was a different doctor on call and she diagnosed it as a blighted ovum. The sac was growing but at about 5-6 weeks the baby stopped growing. I had a d&c then and it was discovered that the baby stopped growing of a chromosomal abnormality. (Nothing genetic just bad luck really). Anyway it was tough because it was obvious earlier on but the jerk doctor didn’t want to deliver the bad news. At least that’s what the other dr said. Apparently I wasn’t the first patient to have this experience with him. …

But I just wanted to share my experience with you not to be a downer but just to be realistic so you are not blind sided like I was. I hope and pray that you get great news today and that everything is fine with baby. Keep us posted!


#12

I would try and get a second opinion asap. Maybe you can get into your regular OB. Mine doesn’t take appointments so early in a pregnancy, but I had a possible ectopic and explained to him what was going on, and of course, he agreed to see me. I also had issues trusting the doctor who was doing my ultrasound clinic at the time. If possible, I would try and get in somewhere today. If it is ectopic, with betas at your level, you just don’t want to risk rupture. Ectopics can lead to damage to tubes, organs, and death. Hopefully you are right and it is not ectopic, but I just don’t want to see you not finding out he answer one way or another now. There is just too much of a risk.

I know how hard it is to take the shot. I had to take it for a pregnancy that I was not positive was ectopic (but I knew it was not viable based on my levels). The doctor told me it was, but b/c of issues I had with this doc in the past, I didn’t trust her opinion. I took the shot because I knew the pregnancy was not viable. I was still extremely hesitant and upset. In your shoes, you have betas much higher than mine were, I would get a second opinion asap. You seem to have questions regarding your doctor’s opinon and you really just can’t delay if there is an ectopic pregnancy.

Also, when she said “on top” of the uterus, did she mean inside the uterus? I just am not clear. Even so, it does not change my advice.


#13

Well,
I went to my ultrasound appointment today and the sac (dunno if it’s a gestational sac or a pseudosac caused by ectopic) and it is still empty and only grew from 7.5 mm on Friday to 9 mm today. So I think I lose my hope on this pregnancy. I was hoping maybe if there is a sac with yolk sac and fetal pole today (which should have happened by now) i can wait it out a bit. But it doesnt look good today. So I am ready to take the shot. I am 6 weeks 5 days today. What I dont understand is both of my blasts are chromosomally normal (CGH tested).


#14

Just wanted to say I’m so sorry you didn’t get the news you had hoped for. :pray: for you!


#15

[quote=alexi]Well,
I went to my ultrasound appointment today and the sac (dunno if it’s a gestational sac or a pseudosac caused by ectopic) and it is still empty and only grew from 7.5 mm on Friday to 9 mm today. So I think I lose my hope on this pregnancy. I was hoping maybe if there is a sac with yolk sac and fetal pole today (which should have happened by now) i can wait it out a bit. But it doesnt look good today. So I am ready to take the shot. I am 6 weeks 5 days today. What I dont understand is both of my blasts are chromosomally normal (CGH tested).[/quote]

I am so sorry this happened. I didn’t realize both of your blasts were normal. I don’t have a lot of knowledge on immune issues, but have you been tested for immune issues.

I don’t know where you are at now, but CCRM is a great clinic if you aren’t already going there you should possibly consider. They test for tons of things so maybe they could try and find out why this happened. I also heard that Dr. Braverman is someone great for immune issues, but I don’t have any personal experience wtih this topic.


#16

I consulted with Dr Carolyn Coulam for immune issues. She tested me for natural killer cells, reproductive immunophenotype and some other things I cant remember anymore. I am on dexamethasone this cycle since 1st day of cycle.

I don’t understand why this is happening unless there is a divine reason.

I asked my doctor if we can wait 2 more days and if the sac is still empty I will go ahead and take the shot. I am so heartbroken. Never got this far and finally when i get this far, the doctor is saying either ectopic or abnormal pregnancy as can be seen from the empty sac. My HCG still rises today it is 7300 something today up from 5211 on Friday. Why the sac is growing and HCG is still increasing i dont know.


#17

[quote=alexi]I consulted with Dr Carolyn Coulam for immune issues. She tested me for natural killer cells, reproductive immunophenotype and some other things I cant remember anymore. I am on dexamethasone this cycle since 1st day of cycle.

I don’t understand why this is happening unless there is a divine reason.

I asked my doctor if we can wait 2 more days and if the sac is still empty I will go ahead and take the shot. I am so heartbroken. Never got this far and finally when i get this far, the doctor is saying either ectopic or abnormal pregnancy as can be seen from the empty sac. My HCG still rises today it is 7300 something today up from 5211 on Friday. Why the sac is growing and HCG is still increasing i dont know.[/quote]

I am sorry to here this. Maybe you could post a separate thread on here and ask about nonimplantation of chromosomally normal embryos and see if anyone can offer some specific guidance.