Becoming increasingly confused at just being left to “watch and wait” ovarian ectopic? Can anyone make sense of my medical notes?

[confused8890]

Cut a long story short, extensive history of gynae issues/endo/recurrent miscarriage. 2 living children.

Been on the pill since my 1 year old was 6 weeks old. After some weird symptoms found out I was pregnant, not sure how far along so called my local EPU and due to my history, they got me in for a scan 2 days later.

Sonographer didn’t mention anything whilst scanning other than it would be classed as a PUL (pregnancy unknown location) but I’ve had this before during early pregnancy, some I lost early on and 2 of them developed and are now my 2 children.

Nurse mentions that a mass was seen within my ovary, with unusual blood flow to it, took a blood test for HCG level, gynae dr came to see me, very blasé about the whole thing. Said if I get any shoulder tip pain or worsening stomach ache or bleeding to go to A&E straight away.

Had another HCG test 48 hours later and my hormone level has doubled. He called me today and was like ah it’s going the way a “normal” pregnancy would, completely dismissing that I’ve been bleeding like a heavy period for the last 10 days as my hormones are doing “what they need to do”. EPU calling me tomorrow to arrange another blood test.

I’m sat here feeling like a ticking time bomb because even if the pregnancy isn’t in my ovary, what is this mass in my ovary that has an unusual blood flow to it?! I’m 33, now I’m
thinking either my ovary will rupture from ectopic or I could have something sinister in my ovary that doesn’t even bear thinking about 😢

I’m so worried and confused, ovarian ectopics are rare which means there are not a lot of stories online I can comfort myself with.

Should I be pushing for a repeat scan ASAP?

Oh I can’t attach photos?

Medical notes

Is that an old report? It says your expected date of delivery (EDD) is September 2025? I am confused.

No I don’t know why it says that, maybe they out something random in as I don’t know when I conceived. I’ve attached the part of the report that says the date printed at the bottom.

This says the exam date. I’d never have noticed if you hadn’t of pointed it out!

This could be a Corpus Luteum cyst which is completely normal in very early pregnancy, blood does flow around it and its supports the pregnancy by releasing progesterone - I see a lot of them. It’s actually the follicle your egg comes out of. They are commonly suspected as Ectopic by some inexperienced sonographers. It will shrink in a few weeks time when the placenta takes over

Your blood work sounds encouraging - it’s doubled

The issue is you don’t know your dates. Ignore the bleeding for 10 days just for the moment -

You could just four weeks so a PUL & Corpus Luteum is completely normal. No gestational sack and positive test = automatic PUL if you don’t know your dates

The standard pathway is HCG bloods & repeat in 48 hours. Because it’s doubled in the last 48 hours and it’s looks like you’ve got a Corpus Luteum they have took their foot of the gas peddle.

Bleeding can occur at any point for a number of reasons during pregnancy and they don’t automatically mean miscarriage or ectopic - rather than me list them have a quick Google. Honestly it’s very common.

I’d wager they are assuming you are just very early, maybe a possible miscarriage ( could be a reason for the bleeding but not automatically) and they are informing you about the signs of ectopic pregnancy- which they have too because it’s a PUL

If you’re still being offered another HCG blood test you are still on their path way and being monitored. A repeat scan now may not show enough evidence as sizeable growth has not been allowed. BUT do ask when they ring about the bloods when your repeat scan is being arranged to assess the PUL, bleeding and possible mass ( most likely CP cyst) and if they say no - ask what the clinical reason is. NICE guidelines say that symptoms should take priority over HCG numbers

good luck x

Thank you so so much for this information.

I asked about this, I’ve been pregnant 18 times with 2 living children so know about the corpus luteum and I said “isn’t it just the corpus luteum?” And the nurse said “no it’s been seen separately to that” and claimed that the sonographer is one of their most experienced. I’m just so confused.

Ah I didn’t see your photos - two things stand out.

The EDD is last year - that’s clearly incorrect and either she has put it in wrong or she may have opened the wrong patient file or used a template - which is very common

Also - the wording is off - she identifies the corpus luteum clearly in the left ovary - but then later states suspected ectopic pregnancy in the left ovary.

So is she seeing two structures in the same area and if so why hadn’t she documented it properly? The wording does not confirm whether the sonographer saw two separate structures inside the ovary—the corpus luteum plus another mass—or whether the 13 mm structure could be the corpus luteum but was considered suspicious enough to raise an ovarian ectopic.

I’d be asking for a review of the scan tbh

This is a medical document and it needs to be better

Sorry my Internet is slow and I’m missing updates.

I’d still be asking for a review. It’s slightly concerning the consultant seemingly ok with your rising HCG levels as they alone do not make a suspected ectopic safe. A repeat scan in a weeks time may still not be enough time to spot any change so if you are still well they may scan you in 7-14 days - but monitor your HCG levels.

But ANY changes to your health go straight to A&E

I know it’s an awful time for you and I’m very sorry for your losses

What were your numbers? X

Thank you so much for all of the helpful information xx

@strawberry780384 then 774, 48 hours apart x

well It doubled so that’s good!

Any update? How are you? X