Pregnancy in unknown location, private clinic vs NHS, help!

[BananaHammock23]

I recently miscarried at 5+4. The pregnancy was the result of a frozen embryo transfer that I had via a private clinic (I’m not eligible for NHS funding). I had two blood tests for HCG, the first was 172, then 48 hours it dropped to 73, so I knew the miscarriage was coming.

My clinic did a courtesy scan following a big bleed to check everything had come away. The scan took about 30 minutes and was 3D and 2D, and revealed I had retained products in my uterus and cervix. The clinic advised that there’s not much they can do, but that I need to speak to my EPU.

I went to the EPU and they also took bloods and scanned me (in the maternity unit, surrounded by expectant couples). Their scan took 2 minutes, and there’s a lot of ‘couldn’t see due to gas’ on the report… Their HCG results came in at 164 (rising from last week!), and their scan says there’s no evidence of retained products so they’re treating it as pregnancy in unknown location. I have to repeat the blood test tomorrow.

The problem is, the 3D scans from the clinic are pretty clear that there are retained products. My HCG is evident of retained products. But the NHS are refusing to even look at the private clinic’s scans. They’re refusing to acknowledge the previous HCG tests because they weren’t done by them. I’m beside myself and want all of this to be over but I feel like I’m stuck between a rock and a hard place.

Does anyone have any experience of RPOC or PUL? What can I expect to happen next? Any advice gratefully received. Thanks for reading <3

I’m really sorry you’re going through this.

Sadly the nhs won’t take a lot of notice of private clinic scans so will want to repeat the scan themselves. They will want to do their own tests to check everything. My sil went through something very similar. The private clinic gave detailed reports but with the nhs it took 2-3 weeks for them to confirm it was a miscarriage with retained products and she underwent a surgical removal. It’s horrible when you want it over and done with but they want to be certain of everything.

@Hiddenvoice thanks for your reply. It's somewhat reassuring to know this isn't an isolated case as I feel really frustrated at the minute.

I understand the NHS having to do the investigations again, but it's frustrating that they're not picking up something that the clinic can see on a more sophisticated scan. I feel desperately worried that I'm going to get an infection, or it'll be left too late and then surgery will lead to scarring hindering my ability to conceive again. I'm just beside myself.

@BananaHammock23 so sorry you're going through this. Surely it's not possible to have a pregnancy of unknown location after an embryo transfer though because it was put directly in your uterus! It wasn't fertilised in your fallopian tube so can't be there (or have floated off elsewhere). Did they know that it was IVF?? Also, did they do a vaginal scan? It should have been at such an early stage and wouldn't have thought bowel gas would be problem with that view. What's their plan? Are they going to do another scan and bloods? Hopefully you'll see someone more helpful next time ❤️

@Lily124 thanks! I thought the same re it being put directly in my uterus but apparently, although uncommon, ectopics can happen in IVF pregnancies.

It was a transvaginal scan. They've taken blood on Tuesday which confirmed my HCG is the same as it was 2 weeks ago, so there's clearly something stuck.

They're repeating bloods tomorrow to check HCG again.

I suppose the issue is that my clinic are saying it's clear there's retained products in my cervix and uterus, but the NHS are saying they can't see that at all. That means they won't treat it.., it just seems impossible.

@BananaHammock23 interesting, I just assumed it would stay in the uterus when put there! I really hope you get some more answers from them tomorrow/someone a bit more helpful that will take more consideration of the stuff from the private clinic. Must be so frustrating being in limbo

Just wanted to update this thread in case anyone searches and finds it. I had laparoscopy this morning to investigate as HCG was continuing to rise slowly. They found that it was ectopic rather than RPOC. They removed my tube. I feel strangely more positive as I know it wasn’t a problem with me or even the embryo, just one of those things.

@BananaHammock23 so sorry you've been through all that, glad it's all sorted now. Wishing you a speedy recovery ❤️

@Lily124 I was advised of an etopic following an embryo transfer by my fertility clinic so it's obviously not uncommon. Strange isn't it. I had no idea prior that ectopic from ivf was a possibility since it bypasses the fallopian tubes.

@BananaHammock23 so sorry to hear what your going through. Sending you lots of well wishes