NHS early pregnancy unit and private clinic dating my pregnancy differently!

[littleshop]

Hello

First time posting here - thanks for having me!

So I’m in a bit of a pickle. I had a fresh 5 day blastocyst transfer on 18th January and got a positive pregnancy test on 28th January.

Had some very light brown spotting on February 12th so went in for an early scan to my private clinic on the 14th February (when they were dating me 6w+4). They couldn’t see anything at all other than a white mass they thought might be a collapsed sac. They were worried it might also be ectopic so they took a blood test and told me to stop progesterone, have a few glasses of wine and prepare to miscarry.

The next day the clinic call to say my HCG has risen quite a lot so they want me to come back in on the 17th for another scan. On this scan they find a small sac measuring 3.2mm in the middle of what was the white mass on Friday. They do another blood test - HCG still rising so they tell me it’s measuring at about 5 weeks when I should be 7, but it’s progressing so who knows. They want me to come back in 1 week.

I went back yesterday when I should be 8 weeks and the sac only measured 5mm. Still no heartbeat, yolk sac or fetal pole. They say it’s failed or is failing - explain my options in terms of miscarriage. I demanded another HCG test because I was so confused given when happened in the previous 10 days. It has risen but only to about 5000 when it was 2500 a week previously.

Today I went to my NHS early pregnancy unit as I decided I would like to medically manage my miscarriage. Before scanning me the consultant asked me how many weeks I was - when i told her 8 she advised me I am only 5 weeks and was dating it from the day after egg collection - not first day of LMP. She then scanned me and said what she saw was consistent with 5 weeks and she would like to see me again in 2 weeks time. She said as there is no bleeding she isn’t worried and she said I should definitely continue with progesterone until the next scan.

I am obviously very confused right now - the last few weeks have been an absolute rollercoaster. I am in complete shock that the NHS and my private clinic would date the pregnancy in a completely different way - has anyone else experienced this, or can offer in insight?

Sorry you’re going through this. I’m am by far an expert, but I would be inclined to trust the private clinic who know what they are doing, and your blood test results aren’t promising. If your levels were 2500 a week ago, they should be in the region of 20,000 by now (if you double every 48 hours) surely?

I'm so sorry you're going through this. My understanding, from going through ivf, is that you're correct. My experience was that they take egg collection as day 14 of cycle then count back to day 1 being equivalent to LMP and date from this. This may not match your actual LMP if you had a longer time on the stimulation drugs. Sadly not everyone understands the process outside of specialist fertility services. I hope that helps, although it means it's probably not good news for you

@TwinkleStars15 - I think you're right, they should definitely be higher than they are. Though I have been told that they slow down over a certain level, but I'm not holding out much hope for that being the explanation in my case!

@DaffodilSunshine - that's what I thought too! can't find anyone anywhere online suggesting that you can date a pregnancy from 'day 0' after egg collection. I'm not sure whether the person I saw today was trying to remain positive for me because she needs to have two scans (and they won't accept my private ones) to compare and she knows that waiting for 2 weeks until that scan will be an absolute killer. I'm not holding out any hope really - just feels like I'm massively in limbo for the next 2 weeks!

If the sac diameter is only 5mm they can’t call a miscarriage. Needs to be either 25mm and no fetal pole or a fetal pole of 7mm with no heart beat. BHCG should increase by 60% every 48hrs. But this is not a hard and fast rule. Have they seen a gestation sac and a yolk sac in the uterus. If they haven’t it could indeed be an ectopic. I would get yourself to your local hospital and been seen there.

Sorry just seen you have been to NHS. I’d go with what they have said, seems much more accurate advice.

NHS is really rigid about making you wait those 2 weeks, no matter when conception date was or how sure you are about it. I got told “we date from the scan and from the scan it’s a 5-week pregnancy”. It is a horrible limbo to be in, I’m really sorry

@Ladykluck that’s super helpful to know, thank you! It explains a lot.

@GoldenOmber yes I very much got the impression she was going by the scan to date it. However it’s weird that she said I was 5 weeks before she had even scanned me - after she scanned me she said what she saw was a consistent with a five week pregnancy. Who knows!