9 weeks empty sac, management?

[hewegoagain]

Hi all,

On Friday I had some light spotting at 9+2 so went down to the ER for a scan 'just to be sure', fully expecting everything to be ok. I had a MC in June but I was feeling much better this time and at 9 weeks there's less probability that anything would be wrong. Fully expected to see my little baby with a happily beating heart. However was informed that the gestational sac was empty. The doctor was really keen to get me out of there and no fussed about answering questions, my crying seemed to annoy her. They've told me to come back on the 19th for a second scan.

I know my dates, I know when I ovulated, and I had a bfp on CD30. So I know that nothing will have changed.

My question now is, where do we go from here! I know I don't want 'expectant management', I'll be 11 weeks by then so not sure if that's even an option. But, will I be able to opt for a medical abortion (tablets) or D&C? If I am allowed to choose, which option is better? I have a 9 year old to care for and work. What is the recovery like for a D&C? It sounds like an awful procedure. Would a D&C delay us TTC again?

I think i'm focusing on this aspect because I really don't know what else to do. I'm so devastated. My MC in June was at 7 weeks but there was nothing to be seen on the scan, no sac or anything. Is there something wrong with me? I'm 36, are my eggs just rotten? Will my GP be willing to do tests at this point to find out? Or will I have to suffer through a few more heartbreaks before they'll even consider investigating? The doctor in the ER was so rude and uncaring (she told me I should be glad it happened now and not later on, and told me to stop crying), I'm considering taking out private medical insurance, at least that way someone might actually want to listen to me when I have questions and doubts 😔

Sorry about the rant, I feel so lost.

I'm so sorry op! The doctor sound absolutely heartless! What country do you live in? Just because you mention going to the ER and thats no normally an English term. Do you not have an early pregnancy unit were you live x

I live in Spain, so ER is the closest English term to what is the hospital emergency room. Pregnancy units aren't a thing here. We have midwife's at our local 'health centers' and then go to the hospital for ultrasounds etc.

I had a horrible doctor at the hospital for my last MC as well, again he really wasn't interested in me as a person and just wanted to get me out of there as quickly as possible. When I saw it was a women this time I thought the experience would be better, but it was actually worse. I understand that they are understaffed and overworked, but this wasn't an emergency room doctor, I was sent up to the maternity ward. I pity any woman who had the misfortune to be in labor that day if they were being seen by that horrible woman.

I’m so sorry to hear this, it’s so so hard.

I had exactly the same experience as you, scan at 9 weeks due to spotting and there was just an empty sac. I’d also had a MMC before this (found out at 12 week scan). I had to go for another scan in 2 weeks but found I miscarried naturally during that time. With the previous MMC, I had 2 failed medical managements so had to have a D&C, which was actually surprisingly fine so I’d definitely recommend that option. I had no pain afterwards and felt almost back to normal the next day, despite having a general anaesthetic.

I also wanted them to do investigations but they refused to do anything unless I’d had 3 MCs. I think all trusts are different though so you might be lucky.

Wishing you all the best.

I’m so sorry to hear this. I’ve been in the same situation and have had three miscarriages in total. With the first I miscarried naturally but I had an MVA (basically a D&C) for the other two. It was painful - I demanded gas and air and stronger painkillers the second time after really struggling with the first procedure - but the recovery was very quick both times - I actually went for a run the afternoon of the first one, although in retrospect I might have been a bit mental :/ not sure I'd recommend!

I’ve subsequently conceived again so it hasn't had an impact on an embryo's ability to implant; I’m not sure I'd want a third MVA if I’m unlucky enough to miscarry again as I think there is a risk of it leaving scar tissue that can make it harder for implantation to occur, although the risk is very small.

I don't know what the rules are in Spain but in the UK the NHS won't investigate possible causes until you've had three miscarriages. I had some tests done privately after the second one and have since been referred to the recurrent miscarriage clinic; having already ruled some issues out has speeded the investigations up a bit and also helped me feel like I was doing something, so if you can afford it I would recommend getting blood tests to check for clotting disorders privately.

Such a shit situation to be in; wishing you luck for the future.

@MarshmallowMeadow thank you for your comments. I'm so sorry for your loss, finding out so far along is awful 😔

Do you know if you have to wait longer to start TTC again after a D&C? I was told to wait 6 months by the doctors here after my MC in June but I think that's now an outdated believe in the UK and USA so we went back to trying after 2 cycles. I seem to conceive really quickly, first month with all 3 pregnancies, just wish I could hang on to them.

We'd like to get back to TTC as quickly as possible, as I'm 36 but is the 'waiting' period longer after a D&C as opposed to a natural MC or medical management?

That was another of the doctors rather nasty comments on Friday after I said we'd had a MC in June 'well you should have waited longer before trying again!' ☹️😡

Oh and I started TTC again immediately although it took a couple of months for my cycles to go back to normal. Had my second MVA in February and conceived again in August.

@itssquidstella thank you for your comments. So sorry for your losses.

For the most part the Spanish system seems to be inline with the UK (I think probably most of Europe follows the same guidelines), so I imagine it'll probably be 3 as well.

We'll definitely be looking into private coverage after this. Not least of all because that'll mean I'll be able to get scanned earlier to make sure everything is progressing as it should. To be honest the spotting I had was so little that I was in doubt as to whether to actually go to the hospital or not, I'm glad I did as I imagine finding out at 12 weeks is worse than at 9. I'd always sort of scoffed at 'reasurrance' scans up until now, but I completely understand now 😔

I feel the same as you about wanting to be proactive and trying to find out of anything is actually wrong or whether it's just terrible luck, so I guess private is definitely the way to go.

All the best x

@itssquidstella I did wonder about starting TTC again immediately after my MC in June but I was worried about not knowing when I was ovulating and what my cycles were doing and then getting anxious and obsessing over tests and dates and whatnot 😅. We haven't used ovulation strips or anything for conceiving as it seems to happen really quickly and I've just been relying on my FLO app.

I'm so sorry, that's devastating. And to have unsupportive care as well.

I went for the pills option, thinking it was less scary than surgery. I ended up wishing I'd go for surgery. It was more brutal and gory then I could have imagined. And then in the end it didn't work properly and I had to have surgery anyway. I very strongly advise that you go straight for the op, and take the general anaesthetic. I was on the phone doing a work call an hour after I woke up, no pain, barely any bleeding.

Sending you much love and luck for a speedy recovery and an easy pregnancy next time if that's what you want.

@LittleGwyneth thank you for your comment and sorry for your loss. It seems to be the concensus that the op is the better option if I'm given the choice. I'm still hoping I'll go naturally before next Tuesday and the question will be moot anyway. As well as that tiny part of me that is still hoping for some miracle and that she didn't scan me properly and we'll see something next week (it's a fools hope, but it's still there 😬).

Can I ask if your cycles went back to normal quicker after the op? After my natural MC it took about 6 weeks for my first period to come back.

I know this is repetition, but I second previous posters.

Firstly, I'm
So sooty this happened to you.

In my first pregnancy there was an empty sac at my 12 week scan. Utter shock.

I opted for medical management as I thought I should avoid a general anaesthetic. It did not go well. I ended up bleeding excessively until having an emergency D&C. I would never do medical management again.

Op every time. My recover was slow, but only because I lost so much blood and had to have a transfusion. Generally the recovery is ok.

I wish you all the best.

Sorry about the typos