Had first ultrasound today, but possible problem

Hello to the group - any advice or experiences would be greatly appreciated!
I went for my first transvaginal ultrasound today - I'm 6w5d after IVF/ICSI
(retrieval was June 18, transfer was June 21). They saw the yolk sac and
the fetus, but could not see the heartbeat. They told me the fetus looked
about 1/2 a week smaller than expected. They said it was possible that the
embryo implanted late, which would explain the smaller size and could also
explain why they can't see the heartbeat yet. The other possibility is that
the fetus was growing okay at first, and then stopped growing. My doctor
said that if the ultrasound looked this way last week, she wouldn't be
worried, but for the dates I should be, it was somewhat concerning.

My serum HCG at 2 weeks was 106. I had another HCG a week after that
because I was concerned about some cramping I was having. It was 2,076,
which was an appropriate rise. I haven't had any spotting or other problems.
I am obviously pretty worried by all of this. My next ultrasound is
scheduled for Monday. They didn't mention doing any more blood work. Has
anyone else had an experience similar to this? It's going to be a long wait
for Monday.

"medgirl" wrote in message
...
Hello to the group - any advice or experiences would be greatly
appreciated!
I went for my first transvaginal ultrasound today - I'm 6w5d after
IVF/ICSI
(retrieval was June 18, transfer was June 21). They saw the yolk sac and
the fetus, but could not see the heartbeat. They told me the fetus looked
about 1/2 a week smaller than expected. They said it was possible that
the
embryo implanted late, which would explain the smaller size and could also
explain why they can't see the heartbeat yet. The other possibility is
that
the fetus was growing okay at first, and then stopped growing. My doctor
said that if the ultrasound looked this way last week, she wouldn't be
worried, but for the dates I should be, it was somewhat concerning.


Was it an abdominal ultrasound or transvag? I don't think its overly
concerning not to see the heartbeat at 6 weeks. I think it can take up to 8
weeks to get a good shot of the heartbeat, but I could be wrong. I hope
everything works out ok!

Denise

medgirl wrote:

Hello to the group - any advice or experiences would be greatly appreciated!
I went for my first transvaginal ultrasound today - I'm 6w5d after IVF/ICSI
(retrieval was June 18, transfer was June 21). They saw the yolk sac and
the fetus, but could not see the heartbeat. They told me the fetus looked
about 1/2 a week smaller than expected. They said it was possible that the
embryo implanted late, which would explain the smaller size and could also
explain why they can't see the heartbeat yet. The other possibility is that
the fetus was growing okay at first, and then stopped growing. My doctor
said that if the ultrasound looked this way last week, she wouldn't be
worried, but for the dates I should be, it was somewhat concerning.

My serum HCG at 2 weeks was 106. I had another HCG a week after that
because I was concerned about some cramping I was having. It was 2,076,
which was an appropriate rise. I haven't had any spotting or other problems.
I am obviously pretty worried by all of this. My next ultrasound is
scheduled for Monday. They didn't mention doing any more blood work. Has
anyone else had an experience similar to this? It's going to be a long wait
for Monday.



I think not seeeing a HB at 6w5d isn't too unusual. Glad to see the
hCG numbers rising well. FWIW, we saw my daughter's HB transvaginally
at 7w4d (and my doctor really pushed for me to wait until 8
weeks just so we would see it).

Good luck!

Mar

"Denise Anderson" wrote in message

Was it an abdominal ultrasound or transvag? I don't think its overly
concerning not to see the heartbeat at 6 weeks. I think it can take up to
8
weeks to get a good shot of the heartbeat, but I could be wrong. I hope
everything works out ok!

It was transvaginal. Thank you for the good wishes. I am praying that it
was just too early for whatever reason - unfortunately, it's not like
there's any doubt about the dates since it was in vitro fertilization.

On Wed, 21 Jul 2004 11:25:44 -0400, medgirl wrote:

My serum HCG at 2 weeks was 106. I had another HCG a week after that
because I was concerned about some cramping I was having. It was 2,076,
which was an appropriate rise.

That is definitely a good sign. Your rates are doubling rapidly, which is
always good.

I am obviously pretty worried by all of this. My next ultrasound is
scheduled for Monday. They didn't mention doing any more blood work.

Did they do a progesterone level? That would be the only alternative
option.

Has anyone else had an experience similar to this? It's going to be a
long wait for Monday.

My first time around they didn't find a heartbeat at 7w with abdominal
u/s, couldn't even find an embryo. Luckily at 8.5w all was well. With
vaginal u/s they can detect things much earlier, a heartbeat is generally
found between 6 and 7w. In that period even a day can make a difference.
So not finding it, is not yet a major concernt.

A mismatch by a couple of days is not uncommon, even in normal (non-IVF)
pregnancies, since implantation can sometimes be delayed by up to a week.
That would make you effectively 6w and a few days, which is the lower
limit for finding a heartbeat in any pregnancy.

I wish you best of luck with the wait till monday. At least they should be
able to give you some definite answers then. I sincerely hope that all is
well. Things look good, but unfortunately, life gives us no guarantees...

--
-- I
mommy to DS (July '02)
mommy to three tiny angels (28 Oct'03, 17 Feb'04 & 20 May'04)
guardian of DH (33)

"Ilse Witch" wrote in message
On Wed, 21 Jul 2004 11:25:44 -0400, medgirl wrote:
I am obviously pretty worried by all of this. My next ultrasound is
scheduled for Monday. They didn't mention doing any more blood work.

Did they do a progesterone level? That would be the only alternative
option.

They didn't. I am on daily progesterone shots since the IVF, but they've
never actually checked any levels.

My first time around they didn't find a heartbeat at 7w with abdominal
u/s, couldn't even find an embryo. Luckily at 8.5w all was well. With
vaginal u/s they can detect things much earlier, a heartbeat is generally
found between 6 and 7w. In that period even a day can make a difference.
So not finding it, is not yet a major concernt.

A mismatch by a couple of days is not uncommon, even in normal (non-IVF)
pregnancies, since implantation can sometimes be delayed by up to a week.
That would make you effectively 6w and a few days, which is the lower
limit for finding a heartbeat in any pregnancy.

That helps some to hear. It seems to me that even with all of the timing
and knowing the dates involved with IVF that it could be possible for things
to be off a little bit, and from what you're saying it wouldn't take much at
this stage, since it is so early.

Thanks to you and the others who have responded for the good wishes.

m

Sorry, no advice, just wishing you good luck for Monday.

Cathy
EDD 8 Dec 04

"medgirl" wrote in message
...
Hello to the group - any advice or experiences would be greatly
appreciated!
I went for my first transvaginal ultrasound today - I'm 6w5d after
IVF/ICSI

Congrats on your pregnancy, and best wishes!

(retrieval was June 18, transfer was June 21). They saw the yolk sac and
the fetus, but could not see the heartbeat. They told me the fetus looked
about 1/2 a week smaller than expected.

I don't think it's unusual not to see a heartbeat at 6w5d (roughly 4w5d
after conception/IVF). With my first pregnancy, we saw a sac of appropriate
size but no heartbeat on a transvaginal u/s at 5w6d, but they weren't
concerned; we saw the heartbeat on a transvaginal u/s at 7w6d, and that baby
is a healthy two-year-old now. With my current pregnancy, we saw the sac,
the fetal pole, and the heartbeat at 6w4d on an abdominal u/s, and we were
able to hear the heartbeat with the doppler that day too. They were
surprised that we could see and hear the heartbeat, so I think it's a ymmv
thing about the heartbeat that early, depending on how high-tech the machine
is, how good the u/s technician is, and where the baby is implanted. Fwiw,
the sac measured something like 7w1d, and the baby measured something like
6w1d, which apparently isn't unusual, and they decided I was 6w4d based on
the measurements, which is exactly right. I think half a week is not a
concern. ISTR that it needs to be off by a week before it's a problem, but
I'm not totally sure so don't quote me on that. Anyway, I'm just rambling
to say that all pg's are different, and it sounds like everything could be
just fine.

My serum HCG at 2 weeks was 106.

I'm guessing that's 2w after the IVF, so roughly the same time as you would
have expected your period? If so, I think that is a good number, though IDK
specifically what they want to see for IVFers. It sounds like the HCG is
risking nicely though. Cramping this early is normal; with both
pregnancies, the ligaments stretching have caused some fairly bad cramping,
bad enough that I kept expecting to see my period. They've settled down now
(11+ weeks), but they come back if I'm really dehydrated.

Good luck!


--
-Sara
Mommy to DD, 28 months
And Someone Due in February 2005

On Wed, 21 Jul 2004 19:30:27 -0400, "medgirl"
wrote:


They didn't. I am on daily progesterone shots since the IVF, but they've
never actually checked any levels.

Some clinics don't do P4 levels with IVF, since it's not known for
sure whether the progesterone from the injections is actually "picked
up" in the blood work... I do feel for you with the shots (I *hated*
PIO more than anything).

I wish you the best of luck. I don't think it's odd to have not seen a
h/b at 6.5 weeks. I know the docs do want to see a h/b by about 7
weeks, but even with IVF, implantation can happen a little late. A day
or two is a lot at this stage of the game.

I'm sorry you're in limbo. We did a total of four embryo transfers (3
IVF/ICSI and 1 FET), and it's hard enough without throwing these
worries into the mix. It's a very good sign that your hCG level is
rising so nicely, and 106 was a great starting point. Best of luck.
Please keep us posted!

--
Paula
Mom to Olivia and Cassie (b. 4/8/03 @ 26 weeks)
^Grace^ (b. 5/16/02 d. 5/17/02) and ^Adam^ (b/d. 5/17/02)

On Wed, 21 Jul 2004 19:30:27 -0400, medgirl wrote:

They didn't. I am on daily progesterone shots since the IVF, but they've
never actually checked any levels.

Pfew, that doesn't sound like fun. But I guess with the shots your
progesterone levels should be OK and that's why they didn't check.

That helps some to hear. It seems to me that even with all of the timing
and knowing the dates involved with IVF that it could be possible for things
to be off a little bit, and from what you're saying it wouldn't take much at
this stage, since it is so early.

It's actually from IVF pregnancies that they found out that implantation
can take some time. It is like the embryo puts itself on hold until it
found a good site to implant. They compared u/s dating in early pregnancy
to the time the fertilized egg was inserted, and found that sometimes it
can be off by a week.

--
-- I
mommy to DS (July '02)
mommy to three tiny angels (28 Oct'03, 17 Feb'04 & 20 May'04)
guardian of DH (33)