A 5mm pregnancy sac at 6 weeks is impossible, right?

[TheBirdintheCave]

Wondering if there are any sonographers on here who might be able to help me out or people who have had similar stories.

Basically, I’m supposed to be 7 weeks pregnant and had a scan at the EPU yesterday because of some brown spotting. All seemed fine with the bleeding. The sonographer couldn’t find a uterine cause for it, there was no bleeding around the pregnancy sac, my ovaries or anywhere else.

This was the only good news.

She then described what she could see. She said there was a pregnancy sac present with a yolk sac inside and ‘maybe the beginnings of an embryo’. She then mentioned that the pregnancy sac only measured 5mm.

The next piece of info I got was that I did not ovulate from the side I thought I did which blew my ovulation date out of the water (as I went by a sharp pain in my right-hand side, when apparently I ovulated from my left as that’s where the corpeus luteum is)

Based on this and the last time we had sex, I told her that I could be as early as 6 weeks and she seemed to suggest that these measurements were consistent with that date. She prescribed me some progesterone pessaries and told me to come back for another scan in two weeks.

When I got home I searched for 5mm pregnancy sac and was able to ascertain in about three clicks on Google that this was not an ok measurement for 6 weeks.

The only caveat to this is that I have a tilted uterus and know that this makes it harder to take accurate measurements even with a transvaginal scan. My son was measuring as a week behind at a seven week scan (though we saw him and his heartbeat) but had ‘caught up’ by his 12 week scan.

In my mind there are two options here. The first and most logical:

The pregnancy stopped progressing at five weeks.

Or:

I am six weeks pregnant and the measurements were just wonky. This theory does get bonus points for making sense of my scant pregnancy symptoms (My nausea has been barely there but has felt worse over the last few days. Though on a bad note, my breasts were sore but aren’t really anymore since yesterday). It would also explain why I had an extremely faint positive test at what I thought was 14dpo but could actually have been 9dpo.

She asked me to go back in two weeks for another scan which again I agreed to but now it just seems like a waste of two weeks that I could have spent getting my cycle back and preparing to try again. At 35 I really can't afford to waste a month or more. We also have male factor fertility issues so it’s highly unlikely for us to get pregnant at the best of times. This one was another miracle in our eyes.

What should I do? I don’t know whether to bother with the pessaries. Will they delay the miscarriage or will it happen regardless? I’m afraid they’re going to give me fake symptoms and I might be tricked into thinking it’s all ok. I just wanted a definitive answer but came out with a different problem altogether ☹

Why has she given me hope in an obviously hopeless situation? It just seems extremely cruel.

It's two weeks, kindly you are being ridiculous. What if it is a viable pregnancy, you are willing to take pills to end it because it might be a miscarriage? Two weeks will not make any difference to your chances of conceiving again.

@streamee It's just the worst :( Sorry you had to go through that too.

Growth isn't linear. It is stressful but the best thing to do now is try to take your mind off it and go back in two weeks.

I'm sorry op but there are positive stories it can still be viable. You have obviously convinced yourself otherwise. Two weeks time you could be told good news sorry but I would have to give it two weeks as hard as it might be .

[quote TheBirdintheCave]@streamee It's just the worst :( Sorry you had to go through that too.[/quote]
I wouldn't wait two weeks, one week is enough to show progress.

Two weeks is just too tortuous imo.

Hope you're ok (and hoping for a good outcome for you)

I’m sorry you are going through this OP.
They have procedures they have to follow, for obvious reasons. The procedure is a 2 week wait between scans to be able to diagnose a miscarriage. They can’t just ignore these procedures… they’re in place for a reason.

It is hard but you do need to wait and see- it is possible the measurements are out.
I've had the 2 week wait before a scan to confirm miscarriage so I have been there - but I lost bright red blood (and later a clot). I was told I was most likely going to have a miscarriage but needed to wait because they don't know for sure. They aren't giving you false hope- they just don't know.

Maybe ask for more advice on the medication but you still need to wait.
35 isn't that old and waiting 2 weeks isn't going to make much difference to you trying again if you need to.

Ok so finally some updates. The EPU have said we can come in at the weekend so my husband doesn't have to take time off work and I can give them all of my questions then. I feel a bit better now. Only two days to go until I can try and get the medicine I need then hopefully by next week it will all be over and I can finally start again.

@Ducksurprise I'm autistic and in my mind I'm taking the most logical route. If the measurement is truly 5mm (five weeks) and there is barely an embryo there then it is impossible for that pregnancy to continue as I can be no earlier than 6 weeks. There is no chance of viability.

If I wait the two weeks then I will be 9 weeks pregnant before they even start the process of ending it and if that takes a week then that's six weeks in total of wasted time. I knew from the start when my tests were so faint that this pregnancy wasn't going to work out but no one would listen to me or give me blood tests so that I could prove the HCG wasn't doubling. It's been a maddening experience.

Also, your name made me laugh so thanks for that :)

@konasana What do you mean by 'growth isn't linear'?

OP please, please - this pregnancy might be viable - mine was! Pregnancy, babies, fertility all of it is NOT an exact science.

I had a look through some medical journals after I posted last night (my weird hobby) and there seems to be a huge variation of what is deemed a 'normal' sac size at 6 weeks - ranged from 3mm up to 10mm.

I'm not saying it will work out, but it's definitely not over yet!! 💐

@WutheringCripes Really? I'd like to see those if you have any links to hand :) All I've seen online suggests that 5mm is too small for 6 weeks and that the average size is 12mm.

Hi OP,

I suffer from ADHD and severe anxiety - these things can be hard for me too. I'm compulsive and want to know answers straight away but obviously this doesn't always happen .

I was 100% sure of dates with my first baby and went for my 6 week scan privately - the baby was there and had a healthy heartbeat but was measuring 5w 3 days!

Second baby (current pregnancy) and I was adamant I was 6 weeks at least! Blazing pos tests and 3+ weeks on a digital. Went for a scan and even with an internal the scanner basically couldn't see anything...she said 'there was something happening in my uterus' could only see a sac and nothing else at all. She thought I was less than 5 weeks if it was even to be viable. I was pretty upset and thought the worst instantly. Fast forward to my 12 week scan and I was measuring only 2 days off my initial guess of 5 weeks when I found out. I'm now 30 weeks.

My fingers are crossed for you

Sorry the last bit should have been - I was 2 days off my original guess of 6 weeks not 5 x

Hi OP, I'm really sorry you're going through this.

I suffered from recurrent losses and so I understand how impossible it can be not to obsess about this stuff.

That said, I agree with everyone who said you should take the progesterone and wait it out.

On the one hand you are saying you're not very fertile and this was probably your last chance, and on the other hand you're saying you want what is basically abortion medication to flush this embryo out so you can start trying again sooner.

Waiting two weeks to see what is going on will feel like an eternity, I know. But in the grand scheme of things it will make no difference to whether or when you have another baby. Say you're right and this embryo isn't viable, you take progesterone for two weeks and then you have to have medical management for a miscarriage. At least you'll know you gave this little embryo every possible chance.

I'm not sure they would actually give you the medication in this situation anyway. To have medical management of a miscarriage you need to have two scans a decent length of time apart to confirm that there has been no growth and there is no heartbeat, unless the embryo is clearly big enough that there should be a heartbeat, and there isn't.

I'm not sure how it works when you are requesting a medical abortion, but I'm pretty sure you don't just turn up, ask for the pills and get sent away again. It wouldn't be instantaneous. And until they are able to confirm via two separate scans that this definitely isn't a viable pregnancy, you would be seeking a medical abortion, not having medical management of a miscarriage.

So as hard as it is, take the progesterone and wait it out.

@BelleBox19 I'm glad to hear things worked out for you :D Interesting to know that it can happen in some cases.

@babyjellyfish There isn't even an embryo there. It's just a gestational sac and a small yolk sac :( She said there was something that could be the beginnings of an embryo but that was it.

And yeah this could well be the last time I'm pregnant but there's no point keeping a non-viable pregnancy inside me. Waiting won't make it start developing again and nor will progesterone. I'm still taking it even though it makes me feel terrible.

"She said there was something that could be the beginnings of an embryo but that was it."

So op she said there might be the beginning of an embryo, but you have written this off as non viable.

@brainhurts Yep because at 6 weeks it should have been visible, right?

At 6 weeks my son (the actual embryo not the sac) was measuring 5mm and he had a heartbeat.

Hi OP. I had an early scan at 6 weeks and my sac was 5.5mm. there was absolutely nothing inside the sac - no yolk or fetal pole. They couldn't say for certain it was even a sac!

Turns out, there were 2 babies developing and I'm expecting twins. We couldn't even see one of them yet!

I wouldn't write this off yet.

Op I just think you are very much jumping the gun . As you said this could be your last chance so why not give it every chance ? Two weeks might seem a lifetime but equally it might become a life .

@Trinxsy Wow, twins! That must have been a huge surprise. Technically they’ve marked me as two weeks behind as I was scanned at 7 weeks post LMP though I could only realistically be six weeks at the earliest.

I dunno. Did they do a transvaginal for your scan?

@brainhurts I do get what you’re saying. I just know how annoyed I’ll be if we do wait the two weeks and everything is just the same (which it is 100% certain to be). I’ve already cancelled the 12 week scan and booking in appointment.

Hi, it's good that you will be able to go in to EPU at the weekend and I hope they are helpful. The only thing I would say is to be aware from my experience of a mmc they are very cautious to determine a pregnancy as non viable which I guess makes sense - last summer at the 12 week scan I found I just had a sac with no further development (I hadn't had an earlier scan). They arranged me to re-scan me after a week, saying it was possible that I had got my dates very wrong (unlikely to be out by over a month!). Wishing you all the best.

@Greymalkin12 I would have kicked up such a fuss if they’d said that to me. How heartbreaking for you! :( Really sorry you had to deal with that.

It was upsetting but I guess my take away was they didn't really think that the pregnancy was viable, and I doubt that they could have really thought that my dates were out that badly, but protocol meant they had to do a second scan (in my case my body took matters into its own hands the day before the second scan). I know you feel it is impossible that yours is viable, but hoping against the odds for a good outcome for you, or at least a reasonably quick conclusion to the current situation x

@TheBirdintheCave They did do transvaginal, yes. They still marked me down as having a pregnancy of unknown location even though we saw a sac.

It's a really frustrating, stressful situation and it happened to me twice in a row - first ended in MC but I was supposed to be 7 weeks and I was measuring at around 4 which would have been impossible for when I got a positive test.

I hope you do get your answers soon, it's horribly anxiety inducing.

Hi OP, I’ve had recurrent miscarriages and been told my eggs are shot after disastrous IVF attempt. I have also been naturally pregnant 6 times and am currently 17 weeks at 38 years old (and have a toddler). These things aren’t so easy to predict and no doctor on earth no matter how brilliant can tell a woman whether she will be able to conceive. So much of the process is still a mystery to science.
This time is NOT wasted in my opinion for two reasons. One, you know you can conceive naturally, and there’s no reason lightning won’t strike again. And two, this is a difficult, painful life experience that is now part of your life story and your history. I hope my own experiences taught me something about who I am and about pain and empathy. You will come through the darkness, I promise. Stay strong xx