Complicated shock conception after infertility

[BadgerOwl]

Hi,

NC as hugely identifying.

I was diagnosed with a triple infertility whammy three years ago: endometriosis, blocked tubes and low egg reserve.

Extremely fortunate that our first round of IVF worked and we have a toddler. Over the last few weeks we started the ball rolling to try and conceive a second DC with IVF. We’ve paid for the round and have the medication all ready to go at home.

I was due to attend the clinic at the beginning of my cycle to hopefully be given the all clear to get started on injections. I had spotting late on Wednesday, my ‘period’ arrived the following morning but was very unusual - only light, and I suffer with heavy periods usually. Friday morning the same, I don’t know what came over me but I took a pregnancy test (expired leftovers from when we had our first IVF round).

An hour before I was meant to get on the way to the clinic I was looking at a positive pregnancy test. Utter shock and disbelief.

The curveballs are that I was told it was impossible for me to get pregnant naturally, but if by some miracle I did, I’d be high risk for ectopic. And the bleeding.

I’ve been seen in the EPAU, pregnancy can’t be found anywhere at the moment. Have had bloods and need to go back in 48 hours for more.

If it’s an ectopic pregnancy and I need medical management we can’t get on with IVF for 3 months and I’ve got time sensitive issues. I really don’t want surgery as I’m awaiting another endo op and worried about more scar tissue and adhesions. Pregnancy tests are getting darker but the bleeding is continuing on/ off so can’t imagine a happy ending.

I just feel so foolish and that I’ve let myself down.

You haven't let yourself down and hoping for you there is a happy ending to this. ❤️

"High risk of ectopic" doesn't = "this pregnancy is ectopic". It's not strange that they can't see anything on the scan this early.

Very best of luck and wishing you strength to ride out whatever comes.

Thank you both. The EPAU did say that it’s not surprising they can’t find anything yet, it’s just going to be a difficult week or two living with the uncertainty.

You wouldn't see anything on a scan at that stage anyway. I had a scan at 5 weeks (it was an abdominal scan for OHSs but they checked my womb too) and you couldn't see anything. That is my now toddler.
They told us our chances of conceiving are very low because partner has extremely low sperm count and low in every parameter and I have PCOS. First baby IVF and I'm now 10 weeks pregnant naturally by some miracle (or luck). fertility can't always be explained, sometimes it's just random the way it happens.
Also your tubes can clear even if previously blocked.

Thanks for your reply Elisabeth and congratulations on your pregnancy. It was the consultant registrar who suggested the scan - they were looking for fluid to suggest where the pregnancy is rather than expecting to see anything more at this stage.

At my lap no dye spilled out of either tube so I’m amazed we’ve conceived and will be even more amazed (and very grateful) if the pregnancy is viable.

Endo increases the chance of bleeding - I bled a lot during pregnancy. So don’t assume anything rn. Try to relax

@BadgerOwl Really praying everything is ok for you 🙏 are you having bleeding still? X

Thank you Ozanj and Elisabeth for your good wishes.

I didn’t know that about endo. Still bleeding, more than spotting but nothing like my usual periods. Back at hospital in the morning for the second set of bloods. If the HCG has doubled then a scan will be booked for a week later. If it hasn’t then they’ll talk about other options.

So, my HCG has risen 146% in 48 hours, the next step is a scan in a weeks time. Not looking forward to the wait, will need to keep busy. Bleeding still the same.

I hope the scan brings reassurance next week. HCG rise seems very positive.

Good luck OP

Thank you both

Really hope the bleeding stops for you , it's horrible being in limbo but HCG rise is positive x

Thank you Elisabeth. Feeling quite detached and low about it all today. I’ve looked up the guidance at my local hospital for pregnancy of unknown location and it says once levels are 1500 on HCG they expect to see if the pregnancy is in the uterus.

If my levels double I’ll reach that threshold on Friday. So don’t understand the logic in dragging the wait out for me until Monday. I’ve spoken with a nurse at the EPAU and they are sticking to the protocol of scanning me a week after the second blood test. Yet when my GP spoke with the gynae registrar they said they wouldn’t stick to the protocol with me given my history. Apparently the EPAU is nurse run and I can’t run my questions past a doctor as I’m technically not under the care of a doctor?

The guidance also says the threshold for offering medical management is HCG below 1500. I raised this with the nurse too who said they can still offer the injection beyond this level (?), but I’m worried that will be reneged on, or why else would it be in the guidance? I’m certain I wouldn’t want surgical management.

I haven’t got confidence in them so feel like just not going back at all and letting nature take it’s course.

Hi I wasn’t sure whether or not to post as both my pregnancies have resulted in mmc believed to be chromosomal so nothing to do with the fact I’m classed as infertile. Also triple whammy completely blocked tubes (wanted to remove) pcos and endo. Just gone through my most recent last month other was around six months after my ds was born conceived through ivf. Only viable pregnancy I bled through more than spotting and what I thought at the time was a full bleed yet here he is. I know the wait is torture and preparing for the worst is sometimes easier but I’ve read a lot of positive stories and I kind of have one of my own. The nurses believe the tubes have cleared or at least one clearly has. Best wishes x

Hi Jingle, sorry for my late reply, I’ve only just seen your message. It’s so interesting to hear from someone else with a blocked tube diagnosis. I’ve read that sometimes pregnancy can stretch the tubes and free up blockages. Who knows if it’s true?! Wishing you the best of luck for the future.

Just to update the thread:
The latest with me, after advocating for myself, the consultant agreed a third HCG test. I calculated that my levels would be over the threshold for medical management before the scan date so they agreed to move it forward one day. Even then it would have been borderline. To my shock a sack and yolk sac were seen in my womb.

I’m still having a mixture of red blood and spotting and am now halfway through a torturous two week wait for another scan. Quite dismayed that this sorry mess has dragged on for 3.5 weeks. Feel totally detached from the pregnancy and just want this over with. Also feel let down by the hospital and don’t want to go back to their care.

I don’t think saying ‘sometimes you bleed and we never know why’ is good enough really. There must be an underlying reason and it’s how bothered they can be to find out.

I had a similar bad experience with the EPAU in my first pregnancy. After my third episode of bleeding they shrugged their shoulders. It was only because I asked to see a doctor that I was found to have a cervical ectropion which at least gave me an answer that time.

Hi @BadgerOwl there can be lots of reasons why you would bleed in a viable pregnancy. I know you've been told that, but don't write this one off yet!
I hope things turn out well for you.

Thank you

This sounds promising ! Have they checked your progesterone ? Maybe when you have the next scan (if) everything is ok then you could discuss going on that to support your pregnancy. Like you say there must be a reason for the bleeding if it's still happening xx

How heavy is the bleeding? I bled this pregnancy from 5 weeks to 9 weeks, no reason could be found but i put it down most likely to cervical ectropian because i've had that on and off for years before getting pregnant. Since 9 weeks i've had no bleeding/spotting at all, i know how worrying it is i thought it was over for me so many times, but it really doesn't always mean something bad

Hope you're ok @BadgerOwl x

I had a massive blood loss at 14 weeks, but ds was fine (if early!) So there is no rhyme of reason to what our bodies do.

My fingers are crossed for you

How are you, OP?

I bled in early pregnancy, also felt like I’d screwed up. We were doing ivf with donor sperm for genetic reasons. Also had the meds in the fridge ready to go, and I found out I was pregnant. 1k worth of meds went in the bin unfortunately, but on a positive note the pregnancy was successful.

after your latest update about a yolk and sac being seen, I would be cautiously optimistic. Dare to believe it might be ok, we are all rooting for you.

I also have 1 tube, endometriosis and premature ovarian failure and had an own egg natural conception after my 5th IVF cycle had worked (donor eggs) my eldest was only 7 months too!

Thank you all so much for your kindness and compassion, talking to me through this stressful time.

I had a scan yesterday which showed an embryo with a heartbeat. Incredibly shocked and trying to get my head around it. Measuring spot on for dates so seems this may have a happy outcome.

This time, they spotted a subchorionic haematoma which could explain the bleeding I’ve been having. Not sure why it wasn’t spotted on the previous two scans.

Pleased to hear so many of you have had successful pregnancies after problems like this. It does give me hope.

@anicecuppateaa So glad to hear you had a successful pregnancy in the same situation. The meds were £1400 and I think the clinic will deduct around £500 for the scan we had with them before this happened. At the moment I feel extremely foolish and guilty, knowing this money could have been spent on my existing DD, but I’m hoping I’ll come to peace with that in time. If the pregnancy works out, I’m sure I’ll feel better about it all.

Thank you to everyone again. I’ll try to update in a few weeks or months. I know when I was searching for answers it seemed that continual red bleeding was a terrible sign, so I’ll try to give a conclusion to anyone who comes across this thread in the future.