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Ivf - first scan empty gestational sac

35 replies

West8690 · 15/11/2022 12:15

Hi, I'm feeling at a complete loss and wondering if anyone has had a similar experience or can offer any insight, good or bad.
I went for my initial scan yesterday and the consultant said they only saw a gestational sac, no yolk sac or foetal pole. I should have been 7w + 1 but was also told the sac was measuring about 5.5w. They said it was unlikely the pregnancy would progress and I had hcg done, repeating them tomorrow.
However, When I got my initial hcg done after the 2WW they came back low and it took an additional 5 days to get over the 200 mark, so I don't know if that could have set things back.
I'm just wondering if anyone has been through anything like this and if I should just admit defeat and give up hope or hold on. I feel empty and emotionally drained.

OP posts:
amoobaa · 04/12/2022 22:38

Started having cramps. More bleeding… and a clot. Such a tough process with so much waiting.

Sending hugs and hope for the future, to everyone going through this process.

It feels bizarre that I still have another scan at the clinic. Really need closure now.

West8690 · 05/12/2022 09:12

I'm so sorry. It's awful isn't it. I've been bleeding now since Wednesday, I just want it to be over. I'm back for another scan this Wednesday and to discuss next steps, it all just feels surreal. It's like waves, up and down all the time xxx

OP posts:
amoobaa · 05/12/2022 10:35

Hey, I hear you. I feel the same.

You’ve described exactly how I feel… up and down… up and down… like waves on a never ending shoreline.

You think you’ve seen the storm, the lightening takes your breath away… streaks across the whole sky… the thunder rolls as close as it can get, shakes your whole body, the heavens open and you think… this is it, it’s going to pour.

But instead it just gets very dark and the thunder ebbs away, you can hear it rolling in the distance but it’s suddenly really far away and it’s stopped raining. The sun even peeks through the clouds and your left wondering what’s going on. Is this happening? Or isn’t it?

I’ll probably look back on this in a few months and think it was all so obvious is retrospect. And that I was being impatient… it was only a few weeks.

But right now, every day feels like a month!

I have a scan tomorrow at my clinic.

My gestational sac is measuring small, but it’s growing.

It’s like torture because on the one hand I know this is what happens with a blighted ovum- the sac and placenta grow but the foetus never develops. So there is no reassurance from the sac growing.

Yet on the other hand, there have been cases, albeit rare, where (even with IVF/ absolute definite dates etc) the baby hasn’t been picked up on transvaginal ultrasound until much later on… definitely past the 7/8 week mark, and they catch up and a healthy pregnancy evolves. WTF!?

And they are not allowed to diagnose blighted ovum unless the empty gestational sac has definitely stopped growing, or… if the empty sac is growing still then it needs to be a certain minimum size before they officially diagnose blighted ovum.

And mine isn’t big enough yet. It’s still small and it’s still growing.

So I’m wondering whether they are going to send me away again tomorrow, to keep waiting… purely on the basis that the empty sac isn’t big enough to diagnose blighted ovum.

The outcomes are swilling round in my head constantly and it’s so hard to concentrate on anything else…

Is it a blighted ovum?

Is is a very late developer and will it miraculously develop and I’ll hear a heartbeat?

Will I miscarry randomly and unexpectedly on my commute to work?

Do I have to worry about a molar pregnancy?

Is all the bleeding just coming from a polyp they noticed on my cervix during the transfer?

I know the most likely scenario is that I am miscarrying slowly and it’ll be a blighted ovum. Especially as I’ve now had craps and passed a clot.

But I can’t seem to shake the little thread of hope that keeps weaving around the unlikely idea that I’m just bleeding from a polyp and the baby is in there, developing behind schedule.

Based on all my scans so far, the gestational sac should be measuring about 6 weeks tomorrow. And that’s the time we should be seeing a fetal pole, yolk sac and heartbeat.

So although the other day I was in complete acceptance that I was miscarrying and was so strict with myself about accepting it... I’ve been in no man’s land so long I can think straight anymore and all I can think is… unless I miscarry, or go for a scan and see a large empty gestational sac or no gestational sac, or a deflated gestational sac… or an empty gestational sac that has stopped growing… or is still empty at 12 weeks… then I don’t have a definitive answer.

There have been times I have almost hoped it would be bad news because no news was almost more unbearable. And I just want to heal and move forwards and re-start ivf (there’s the time pressure of that too!)

Of course, I know the probability of this being a positive outcome is nowhere near as high as the probability of a miscarriage. But I’m just going to have to wait and see.

The thought of having to wait longer than a couple more weeks is horrific though.

I’ll update here after my scan tomorrow. I stopped bleeding aflyer I passed the clot. So confusing.

Here’s hoping you get some peace and some definitive answers on Wednesday.

I hadn’t realised you were being told to wait again… it’s so hard isn’t it.

Sending hugs and strength xxx

amoobaa · 06/12/2022 19:18

Had my scan today. Should be 8 weeks exactly. The gestational sac is still small but still growing and still empty. It’s now measuring 15mm I think.

I have been told it’s a missed miscarriage and instructed to stop all my medication and go to the EPU. They have advised me to only have a D&C as a last resort so I’m waiting for it to start naturally.

Really scared about how painful it will be. Worried it will suddenly happen at work or on my commute to work.

Hope everyone else is doing ok xx

West8690 · 06/12/2022 19:23

I'm so sorry for your loss, I had hoped for good news for you.
I was in a lot of discomfort but i had mild cramps all day the day it happened and my bleed didn't actually start until the evening. Are you able to take any time out or work from home?
Thinking of you and sending lots of love xxx

OP posts:
Waitwaitwait22 · 13/12/2022 16:46

Hi girls I’m in a similar situation as you’s . I’ve had my transfer on the 4th November. My levels were low at start and they told me it was a chemical. Stopped my progesterone and a week later had appointment with epu and my levels went up so they were concerned it was ectopic and didn’t see anything on scan. Was in 3 times that week and my levels doubled every time . Then 2 weeks later which was yesterday back for scan and she seen a sac but was empty.I’m now back next Wednesday to see if anything changes. This whole pregnancy for me has been draining so far and with being told the whole time it’s not looking good but things seem to be progressing has been very stressful and I’m not enjoying it at all.
this is my first so it’s not a great start. I’m glad I can now rule out ectopic but there still telling me dates from ivf aren’t matching to the size of sac and it possibly won’t be viable. I just don’t know what to think anymore

Waitwaitwait22 · 13/12/2022 16:48

I will add the sac yesterday was only measuring 5weeks 2days

West8690 · 17/12/2022 10:39

I'm so sorry you're having to go through this too, it's such an awful situation.

I've finally stopped bleeding after 2 weeks. Got to take a HPT on Wednesday, if it's negative we can go back in Jan to discuss next steps, if not I'll have to go in for d&c. Praying I don't need to, just want it to all be over so we can start to try and move past it xxx

OP posts:
amoobaa · 17/12/2022 17:15

@West8690how are things? When I went to the EPU a week ago, they scanned me and confirmed I was miscarrying but protocol meant they had to do a confirmation scan a week later (I’d already had a scan plus a second confirmation scan a week later, at the ivf clinic) but the EPU had to do their own.

The second confirmation scan at the EPU was booked for yesterday (Friday). At that stage they were going to give me a choice of options to manage the miscarriage.

However, on Thursday morning (alone at home with my 21 month old son) I popped to the loo for a wee and suddenly, with no warning and no pain at all, I started bleeding profusely. I mean I couldn’t get off the toilet I was bleeding so much. I won’t go into too much detail as it was pretty graphic but I remember being told if I was going through more than two or three pads in a couple of hours then that was too much and to seek medical help- I was completely soaking through 3 maxi incontinence pads every 15 minutes.

I called 111 but was on hold so long that I had to hang up and call 999… as I was getting nauseous and dizzy.

They said they were under so much pressure that the ambulance could be several hours. But to call back if things got worse. Which they did.

I started losing my vision if I stood up and the bleeding was continuous. I was passing clot and after clot after clot. The size of eggs. Then my ears started ringing and I was terrified of passing out on my own with my toddler (everyone I called was at least 1.5 hours away).

So I called back 999 and was put on hold. At this point my breathing was really fast and I think they realised this wasn’t a normal miscarriage. The paramedics arrived in about 15 minutes.

Luckily a neighbour was in and could look after my son whilst I was wheeled off to A&E.

By the time I got there I was a right mess. They wanted to scan me to see if there was pregnancy tissue in my uterus that my body was trying to expel by bleeding. If so, they would have to take me in for emergency surgery to remove it in order to stop the bleeding. They hooked me up to IV fluids and made me nil by mouth, in case.

However, when they saw the extent of my bleeding (they used a speculum three or four times to force me open and use a long thin instrument to try and help the tissue and clots to pass through my cervix, as they hoped clearing out anything that might be stuck would stop the bleeding) they soon realised it wasn’t stopping. It just kept going again each time they did it.

Then when they got the results of my blood tests, showing my haemoglobin was so low that they couldn’t risk waiting for a scan and they rushed me straight into theatre.

During surgery (under general anaesthetic) they had to give me a blood transfusion.

When I woke up they had to give me another blood transfusion. But the bleeding stopped and I was able to sleep overnight whilst they monitored me. My blood pressure was very low and my iron is still very low.

I’m back home now with loads of iron to take.

My throat is incredibly sore from being intubated but I am so grateful to be alive.

I guess I’m writing this because I learnt some stuff I really wish I’d known:

  1. heavy bleeding can be really serious, in my case it was life threatening, and if in doubt seek medical attention!
  2. I was told there is actually no such thing as D&C in the uk anymore!? They said they no longer carry out procedures that involve any sharp instruments or any ‘scraping’. Instead they use a blunt tube like instrument with a hole on the side of it and it actually uses suction to remove the contents of the uterus- they rotate it around your uterus and they said this carries very little risk of leaving scar tissue compared to the old D&C method that’s still routinely used in other countries. The gynaecologist was frustrated that I’d been told I would have a D&C if I chose the surgical route and felt that the term shouldn’t be I circulation anymore. Still trying to get my head around that!

If I’d known that and if circumstances had been different I might have opted for a surgical procedure much earlier.

Anyway, I’m safe and back at home with a stash of iron, on bed rest (impossible with a toddler!) and I look like I’ve been punched hard in both eyes.

This all happened on nurse strike day, when the NHS was under even more pressure than it usually is and I was taken care of by so many incredible people. I 100% back the nurses striking and owe my life to the amazing people who took charge of my care that day.

Sending love and hugs xxx

amoobaa · 07/02/2023 08:11

Just thought I’d update this thread for anyone in this situation right now, as I found it really helpful when I could read old threads and see the outcomes.

my iron levels have crept back up with lots of iron supplementation. So I’m now heading into another round of IVF.

I hope everyone who is hoping and waiting gets good news x

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