Ectopic/low rise hcg

Heart123

hi everyone. I found out I was pregnant on Mother's Day weekend.  At 12 dpo, hcg was 54. At 14 dpo, hcg was 158. At 19 dpo, hcg only rose to 485 (76 hour doubling time). Today I am 6 weeks on the dot, ultrasound didn't show a gestational sac. Hcg is at 3700 (72 hour doubling time). No spotting, nausea, or cramps. 

I have already accepted the pregnancy is not viable. I am terrified it's ectopic.  Does anyone have any experiences with ectopic pregnancies and can share stories with me?

megstervt

Did they check for ectopic during the ultrasound?  I'm pretty sure they can see it doing that at 6weeks,  though I could be completely wrong.

Heart123

My ultrasound was done on my doctor's tiny old machine, so she looked around but couldn't really see anything at all. That same machine showed us a gestational sac with my last baby, so I don't think it's a case of not being able to find it. She says it could just be an abnormal pregnancy but not ectopic but I don't see how if there is no gestational sac. 

sarahufl

I had an ectopic. They were never able to ID it on an ultrasound. I was maybe 5 or 6 weeks? It was a suspected ectopic (bc of symptoms) but wasn't diagnosed for sure until I was in the ER with terrible pain and vomiting.

I had to have my left tube removed. I won't lie, it wasn't pleasant. But I did get pregnant again as soon as I was cleared to try after the surgery (I know that was a huge concern of mine and probably most people). 

What course of treatment did the doctors suggest?

penelope4612

I had an ectopic.  My HCG had a strange rising pattern (down, then up) which made them suspect ectopic.  They were able to ID it on ultrasound when my HCG was in the 600s but only because I was having localized pain.  I think they said it was <1cm at that point.  I got methotrexate but was able to keep my tube because it didn't rupture.

I believe you should see an intrauterine pregnancy on ultrasound with an HCG of 1,000-2,000.  Your HCG is much higher than that, and they can't find anything, so I think you're right to be concerned about an ectopic.  Is your doctor going to repeat the ultrasound with better equipment?  Ectopic does not always mean that it landed in your tube, so it could theoretically be anywhere in your abdominal cavity, but it's obviously better to find it now and treat it if needed (but of course you don't want methotrexate if there is any possibility that it is intrauterine).

Heart123

Thank you for the answers. I am worried about getting pregnant if I lose my tube. My left ovary is the dominant one and I ovulate mostly from it, so if the left tube goes, not sure how successful we would be.  I had a higher level ultrasound last night and they can't find the pregnancy anywhere. No fluid near the Fallopian tubes or anything like that. I felt horrible cramping and pain on 6 dpo, so I am pretty sure that I implanted sooner rather than later. 

My doctor is suggesting a d&c or misoprostol first, and if it hcg doesn't go after that, then the methotrexate. 

I I am seeking a second opinion from my actual ob today (I have been seeing an RE before). 

penelope4612

When my doctors office couldn't find the pregnancy (before I started having pain) they offered me an intrauterine biopsy which would tell them if the embryo was there.  If it wasn't there they were going to give me the methotrexate.  At that time it was already pretty obvious it wasn't a normal pregnancy.  But then I started having pain and went to the ER and they found it.  Good luck, I know it's scary.  FWIW, I have read that if you lose your tube, you still retain 70% of your fertility because sometimes the egg from the tubeless ovary will find its way to the other tube.

Heart123

I wish I was offered an intrauterine biopsy! That would make so much sense. the second doctor basically said the same thing - they don't know if it's ectopic. I am not having any pain in my tubes and they couldn't see any blood flow in there. So I can take the mtx shot or I can wait. Great. I love not having answers. 

sarahufl

I was given mtx first, then had to have surgery anyway (which sucked). Ectopics suck for many reasons, but one of them is that they are really hard to diagnose. I hope you get answers soon.

sweetyjenj

@penelope4612 what?????? How does an egg come out of a tubeless ovary and travel through the body to the other tube and get inside the other tube?? I don't doubt you, I've read some pretty crazy stuff, too, that is real, but it's just amazing to me that it's able to do that!

sarahufl

sweetyjenj said:

@penelope4612 what?????? How does an egg come out of a tubeless ovary and travel through the body to the other tube and get inside the other tube?? I don't doubt you, I've read some pretty crazy stuff, too, that is real, but it's just amazing to me that it's able to do that!

@sweetyjenj - your ovaries aren't connected to your tubes. I didn't know it was possible either, till I had a tube removed

penelope4612

Without actually doing any research, I would assume that the tubes secrete some type of hormone or chemical that attracts the egg, so when one tube is gone, the egg is attracted to the other tube.  How it makes it all the way over there, I don't know.  Pretty amazing.