# When will I stop feeling pregnant, start bleeding?



## LitMama (Sep 22, 2009)

Hello Mamas,

This is my first time round with this, and I'm confused about what's happening with my body and would love to hear some wisdom from any of you who have been here...

So, I'm about 5.5 weeks pregnant, but learned at 5 weeks exactly (last Thursday) that my betas had dropped significantly (by 50%). My betas had previously been good -- started low but had 24 and 48 hour doubling times until they caught up to where they should be. After the big drop (my 4th beta), I was told by both my RE and my acupuncturist that I would start to miscarry soon.

For a few days before my 4th beta, I had a whisper of mild cramping and a tiny amount of brown spotting (not even enough for a pad), which lasted 3 days. Both then disappeared and have not returned. The day of my 4th beta, I also had a lighter line on my home Hcg test strips (2 different brands). The next day, however, both brands of test strips started to get darker again and have continued that trend -- they are darker now than they've ever been. My belly no longer feels as pregnant (the feelings of pressure and crampiness are gone), but the rest of me does... I'm still constipated and my boobs still hurt so much they wake me up at night. Since the low beta, I've had twinges on the lower left side that are similar to ovulation or implantation, some quite strong.

There are zero signs of an impending miscarriage... no cramps, no spotting, etc.

I called my RE and told him about the twinges and the darkening tests strips, thinking it could be an ectopic. So, I had some more blood drawn today and will learn the results tomorrow.

So, I guess my questions are...

1) What else besides an ectopic could cause Hcg levels to drop and then potentially rise again? (of course, my only evidence that my levels could be rising again is based on home test strips, not betas). Does the test strips lightening and then darkening again signify anything or is that not a reliable indicator of anything?

2) When, O when, will the bleeding begin? How long will I be in limbo, waiting for the miscarriage to start? And how long will I feel pregnant? Is it typical to still feel quite pregnant after the lights have gone out, so to speak?

It's difficult to really process this emotionally when I'm not even sure what's going on physically. And then of course my DH and I are anxious to try again as soon as possible. My acupuncturist has given me some herbs that will help to start things rolling, but I stopped taking them when my test strips started getting darker again. If anyone has experience with acupuncture and herbs helping move things along, I'd love to hear about that, too.

Many thanks to anyone out there with experience and wisdom to share!

Blessings,

LitMama


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## RoseRedHoofbeats (Feb 27, 2008)

It's really hard to say when. I was 10 and a half weeks when I learned that my baby had no heartbeat and only appeared to be five or six weeks old. I'd had textbook pregnancy symptoms the whole time. I took blue and black cohosh, every four hours, for about 36 hours before I used Cytotec. I did notice it softened my cervix quite a lot (before I used the Cytotec I appeared to have passed a mucus plug) and I think it helped. I was just ready for it to be over. I was very happy with this option.

I would wait to see what your latest beta results are before doing anything. Ask your RE if Cytotec is an option for you. It can take a while for this to happen naturally- the corpus luteum that formed when you ovulated and the blastocyst that formed when you conceived your baby will produce enough progesterone to allow you to get to 10-12 weeks before miscarrying- that's why missed miscarriages (what I had) are so common.

Hang in there. We're here for you. There are a few long-standing threads, especially the miscarriage stories one, that can be really helpful.

~Rose


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## LitMama (Sep 22, 2009)

Thank you, Rose! It's super helpful to hear about your experience and what was helpful. I had heard about missed miscarriage but didn't realize a 5-week pregnancy could be sustained through weeks 10-12. I'll definitely ask my RE about cytotec. Did you have to wait to try again after taking it? I heard that it sucks all the folic acid out of your system.

Well, my situation is getting weirder... I just got yesterday's beta back and it's 912, which means it's doubling again. My hands are shaking as I write this! My low beta from 12/21 when they told me I would miscarry was only 94. I guess at this point it's looking like either an ectopic or a vanishing twin. I did wake up this morning with nausea, my boobs are even more sore and my lines are even darker. Wow, I had already given up and started to truly grieve... now I don't know what to think!


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## RoseRedHoofbeats (Feb 27, 2008)

Oh, man that can be a real roller coaster!! I hope that everything will be okay, or at the very least clear up soon! Once you're about six weeks they should be able to at least see a sac and fetal pole on an ultrasound.

I did not wait to try again after Cytotec- never heard anything about it upsetting your folic acid. It was a very easy miscarriage- I started bleeding about three or four hours after I took it and passed everything in one go later that night. Much, much easier than my natural miscarriage, where I bled and bled and bled for days and passed clots the size of my fist.

Fingers crossed!!!

~Rose


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## jenniferlynne (Jun 17, 2006)

I'm so sorry you're going through this.

Unfortunately, it can take a long time for a miscarriage to start naturally. I went in for spotting at 6.5 weeks and they couldn't find a heartbeat, but since it was still so early they told me to come back a week later. Still no hearbeat (7.5 weeks). I was told I'd probably miscarry in the next few days but nothing happened except some minor spotting, so I went back after another week (8.5 weeks). Still no heartbeat or change from the last week. Again, the doctor told me I'd probably miscarry soon, but when nothing happened after another few days I couldn't take it anymore and scheduled a D&C. The constant wondering if I'd start miscarrying at any moment was just too much for me and I wanted it to be over so I could move on.

The roller coaster of emotions is exhausting, so I hope you get some answers soon. Your HCG rising is a good sign. Maybe everything is okay. I hope so!


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## LitMama (Sep 22, 2009)

Thanks for sharing your experience, Jenniferlynne, it's really helpful to hear.

My roller coaster continues! Here's what I just posted in my TTC group:

*AFM*, my update is not a happy one. I had what I would call an ambiguous ultrasound this morning. My RE called it a bad ultrasound and is ready to call my pregnancy ectopic or simply abnormal but acknowledges that I might naturally still hold out hope, and so agreed to do wait on any treatment and do another sonogram on Monday. He thinks I'm 6 weeks (he actually asked me about my chart and used that as a guide, shocking!), and my beta from yesterday was 1550 so he expected to find not only a gestational sac and yolk sac but possibly a heartbeat. However, my uterus looks empty to him. My ovaries, tubes and surrounding area looked clear as well, but apparently that doesn't rule out an ectopic, as it could be too small to be seen. While he was poking around, I saw something that looked just like a gestational sac with two yolk sacs inside and pointed it out to him, so he explored it. He said it was possible it was a sac, but that it looked flattened or irregular to him. It was also in a place that was difficult to see -- in a cornate section of my uterus right next to my tube. I asked him if he had ever had a patient who presented with an empty uterus and then a sac was found later than expected, and he said yes. However, he was ready to rush me into methotrexate and a D&C. In fact, he told me to block out 6 hours on Monday so that if my ultrasound shows an empty uterus on Monday as well, I can have immediate surgery which he pointed out could save my tube and my life. He said that tubes generally burst by 7 weeks, so we have little time. I told him I refused to do a D&C without giving it more time and more sonograms.

In the meantime, this weekend I'm throwing a New Year's Eve party for my daughter and her friends -- and hoping I don't end up in the ER in the midst of it.

I don't know what to think of this... I have plenty of regular pregnancy symptoms and no ectopic symptoms. Of course I want to save my tube, but I certainly don't want to terminate a healthy pregnancy if it's just hiding from us at the moment. I wonder about getting another opinion? Has anyone heard of this kind of thing happening or been through it?


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## M Anna (May 27, 2011)

LitMama, I strongly urge you to explore this website: http://www.misdiagnosedmiscarriage.com/ I'm not saying that your doctor is necessarily wrong, but do NOT feel pushed into doing something before you are ready. Doctors are not infallable.


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## LitMama (Sep 22, 2009)

Thank you, Matushka Anna! That is a VERY eye-opening website! It definitely makes me want to press for more information and not rush into surgery. In fact, I've just scheduled an appointment with a different OB/GYN to get a second opinion tomorrow morning. I learned from her as well that there can be huge differences in the quality and resolution of ultrasound machines -- so I may also try to find a high powered ultrasound machine tomorrow, too. She told me a story of a patient whose pregnancy was written off as an ectopic and then a higher-powered ultrasound machine found a heartbeat.


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## M Anna (May 27, 2011)

LitMama, I really hope for the best for you!! Let us know what happens.


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## LitMama (Sep 22, 2009)

*Thank you both* so much for the support!









Today was grueling... I started the day off racing to my regular doctor to pick up medical records (no mean feat) to bring to my AM appointment for a second opinion with that highly recommended gynecologist. Her low-res u/s machine showed the same thing... no gestational sac, yet no indication of ectopic. She told me she thinks it's probably ectopic, recommended a shot of methotrexate today, and referred me for a high-resolution "formal" u/s at my hospital.

So, DH and I spent the whole day in ER having blood drawn, getting our formal u/s, waiting around, talking to lots and lots of docs and getting third and fourth opinions and agonizing over decisions. The formal u/s also showed no gestational sac, yet no indication of ectopic pregnancy. The ob/gyns we spoke with felt it's probably an invisible, asymptomatic ectopic but could also be an invisible abnormal intrauterine pg or even a so-far invisible normal intrauterine pg (though they felt that was highly unlikely). They felt strongly that we should wait a bit more, then come back for more blood work and u/s (on Sunday). They said that their "suspicion index" is very high that it's ectopic, but that when they look at my betas (now 2362) and my dates, I'm just now on the cusp of having a visible pregnancy. Thus, the agonizing wait. So, if Sunday's u/s still shows no gestational sac, the standard of care would be to first do a D&C which would terminate a possible abnormal intrauterine pregnancy but most importantly either confirm or rule out ectopic. The reason for wanting to confirm or rule out ectopic definitively is to possibly spare me the shot of methotrexate I would need for an ectopic (but not for an abnormal intrauterine) -- which is highly toxic, would make me quite ill, and and would also mean we would have to wait 3 MONTHS to try again (that sounds like the worst part to me). I've also read that it can do permanent damage to egg quality and ovarian reserve (although that's just anecdotal). So, I went into the hospital today firmly opposed to D&C and came out feeling like it could potentially be my friend. Of course, if the path results from the D&C showed there never was an intrauterine pg, then I would still need a shot of methotrexate. I called my acupuncturist in tears, asking about this, and she said I should take the shot, that she would support my eggs and ovaries so they would be safe and healthy despite the exposure to a toxin.

So here I am at home... head spinning, on pins and needles, terrified of a ruptured tube, and yet unable to pull the plug just yet. DH is more worried about my health than I am, I think... I just keep thinking, "what if there's a baby in there, hiding from us?" I know the chance is slim, and I'm sort of riding on a razor's edge here, balancing my own well-being against the possibility of a slowpoke baby.

But for now the plan is to wait, look again on Sunday, and possibly pull the plug then. I'm agitated and anxious and exhausted and so, so sad.

I'm feeling nostalgic for a simpler time... with my DD, I didn't even get betas and never saw a doctor until my 8th week. I sure wish I could have escaped that with this pg... if I had never done betas and seen that strange dip, which led to the first early u/s, yadda yadda yadda, I would simply be a joyously beaming pregnant woman awaiting her 8 week u/s. (Of course, I might also be a woman in emergency surgery for a ruptured tube...).

Thanks again... I'll send an update when I know more.

Happy New Year!


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## jenniferlynne (Jun 17, 2006)

Oh, honey, I am so sorry you're going through this.







The waiting must be agonizing. I don't know what to tell you about the shot since I don't know anything about methotrexate, but I can tell you that I had a D&C a couple of weeks ago for a miscarriage that just wouldn't start on its own, and physically it was no big deal at all. Of course that won't help you with an ectopic but at least know that if you have to have one, it may not be as bad as you think.

Keeping my fingers crossed that all goes well for you on Sunday.


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## LitMama (Sep 22, 2009)

We had a bit of good news this evening... my betas doubled! The doc I spoke to yesterday said if that happened, that would be "wonderful news" that would suggest a viable pregnancy, not an ectopic. We haven't seen or spoken to a doc yet about this today (waiting for a call this evening), so have no medical interpretation of the numbers (I just called and got them from the lab). I also did more sleuthing and found a medical journal article stating that the Hcg threshold for being able to see a gestational sac is actually 2,500-3,500, and at my last u/s I hadn't crossed that threshold yet.

Tomorrow we're scheduled for an u/s with the RE (I was wrong when I thought the u/s and possible surgery would be today), but we may end up canceling it, depending on how our phone call with a doc tonight goes. I'm hoping we can move now into "expectant management" (since my betas look good and I have no ectopic symptoms) and just do more betas until Thursday, when my original 6.5 week u/s was scheduled for.

Hope you've all had a lovely relaxing New Year's Day!


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## M Anna (May 27, 2011)

LitMama, that's wonderful news! KUP!


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## LitMama (Sep 22, 2009)

Thanks!!

Spoke to an Ob/Gyn last night about my results, so got some context. It all sounds good -- she said that my betas (now well over 4,000) are suggestive of a viable pregnancy, and that there's new evidence that there's much greater variance than previously thought about when a gestational sac should be seen. I also asked her about my very retroverted uterus, and she said that pregnancies are often seen quite a bit later in women with tilted uteruses. Vindication! I had asked my RE about this and he laughed it off. So I took the plunge and canceled my sono with my RE that was scheduled for today -- will try looking again later in the week for my babe. Still no ectopic symptoms, just feeling normal healthy pregnancy stuff.

If this does end up being a viable pregnancy, I'm definitely going to write up a post about the potential pitfalls of early ultrasounds so other women in my situation can know they're not alone and have choices when their Dr.s are recommending immediate surgery/shots!

Enjoy your day!


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## RoseRedHoofbeats (Feb 27, 2008)

Yes, if you have a tilted uterus it is CRUCIAL to get a transvaginal ultrasound instead of an abdnominal one. And even with that it takes longer to see everything that you would normally see. I have a very tilted uterus as well. Even at 12 weeks with my daughter, who was 100% healthy, they still had to use a t/v ultrasound to get a good picture.

Crossing my fingers for you!!!

~Rose


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## LitMama (Sep 22, 2009)

Thank you, *RoseRed*!

Wanted to give you all an update... I'm still in limbo. I had an ultrasound on Tuesday that ruled out ectopic, found a gestational sac but no fetal pole or yolk sac. There appears to be debris in the sac and fluid (maybe bleeding) in my uterus. My Ob/Gyn thinks probably blighted ovum, but is okay with waiting some more, especially since my betas are rising normally and are now above 6,000, and my progesterone is good. My TCM doctor says I still have a pregnancy pulse, and asked me to wait another week before taking any action. So, my D&C has been canceled and instead I'm having another ultrasound on Tuesday. Living with LOTS of ambiguity at the moment. Feeling very pregnant (nausea and super-smell is kicking in), but I know that's not necessarily reassuring.

Oh, I forgot the most amazing part of this... when I saw my new Ob/Gyn, she looked at my old ultrasound images before doing a new one. And immediately found the gestational sac -- which 3 or 4 doctors either missed or decided not to tell me about, thereby putting me through an unnecessary ectopic scare. I had actually seen the sac myself at my 5-week ultrasound (which at that time appeared to be fluid-filled, with 2 dots inside) and pointed it out to my RE, but he refused to examine it.

Thank you all again for your good ideas and support!


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## M Anna (May 27, 2011)

Litmama, I'm sorry for the continued ambiguity, but I'm very glad you didn't cave in to the original doctors!!! If there was ever any proof needed that no one is perfect!! Continuing to keep you in my thoughts and hoping for the best. KUP. (((hugs)))


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## LitMama (Sep 22, 2009)

Thank you all once again for the wonderful help and support!

More confusion... my Ob/Gyn is apparently still concerned about an ectopic (she thinks my gestational sac could be a pseudosac) and is now worried about a molar, as well -- I guess the fear of molar is based on my betas, which have been rising but in an "abnormal" way. I have another ultrasound scheduled for tomorrow, and a D&C scheduled for immediately afterward (which I can of course decline). Because of the fear of ectopic and molar, my doctor is really pushing for an immediate D&C (unless we see a baby!). She wants to get the pathology reports back as soon as possible so she can rule out ectopic and molar. She's also urging me to get closure quickly so I can try again sooner... I'm 43 and she seems focused on what she perceives to be my dwindling fertility.

I guess what I'm wondering now is...

I see other mamas on this board in the same situation who are waiting it out longer (and it sounds like their doctors are okay with that). If I still see no baby tomorrow (and I'm past 7 weeks with betas are well over 8,000, maybe as high as 10,000 by now), my doctor is going to push for an immediate D&C. Should I push back? Is there any benefit to waiting another week? Or is that just delaying the inevitable? I've been told that my hospital's equipment can detect a fetal pole and yolk sac at hCG levels of 1,500-2,000, so if I don't see anything tomorrow, is it time to give up and go for closure?

I don't want to do a medical m/c (cytotec) because my TCM doctor has asked me to avoid using chemicals if possible. She said she prefers a D&C (and she's also offered to needle me and give me herbs that will bring on a natural m/c if my doctor approves). But... I'm terrified of the prospect of developing Asherman's Syndrome.

I'm sorry this is all over the place... I had 3 hours of sleep last night and can barely string enough words together to form a sentence. But, this is all happening tomorrow and I'm hoping to get some input and guidance from mamas who have been there, before I need to dive in and make decisions.

Thank you all... I truly appreciate your wisdom and guidance.


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## DivineMrsM (Dec 19, 2008)

I am in the exact same boat as you and I gotta say, it sucks. I was 8w yesterday and my beta on Thursday last week was over 11,000. But the ultrasound from that same day showed an empty sac still and it measured 2 weeks behind at that point. I go again on this coming Thursday for another ultrasound. I had my betas done again yesterday, but I don't think it's helping me. If it's a blighted ovum, which mine very likely is, my betas will keep rising, as a PP said, I have 2 cysts that are keeping this thing going for me. If the next US is showing the same thing, I think I am going to schedule a d&c and just be done with this whole thing.

If you are not comfortable getting a d&c done at this point, I see no harm in waiting. I would and DO want to be 100% sure that this is over before you make any choices. I'm not quite there yet myself, so that is why I am hanging on still.

I hope you get your miracle!! It happens, so why can't it happen to us?! I'll be thinking of you!


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## M Anna (May 27, 2011)

I'm probably too late for you to read this before your appointment, but wanted to let you know I'm thinking about you. Make sure you're comfortable with the data before you make a decision (because you can't undo it). As long as you feel convinced, do whatever you need to do. ((((((hugs))))))


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## LitMama (Sep 22, 2009)

Thank you, *M Anna* and *DivineMrsM*. I agree that happy endings do happen and I hope you get yours soon!

As for me, it's almost over here... I went in for my ultrasound yesterday which showed a collapsed gestational sac and a lot of free fluid in my uterus. Also one of my ovaries is not looking so hot... it was surrounded by fluid and what may have been debris (both of which could indicate an already-ruptured ectopic -- I guess they can rupture without killing you, if they're in a location that allows that). The doctor was quite alarmed and felt that the sac in my uterus was probably a pseudo-sac generated by an ectopic (probably ovarian). What blows me away is that only 2% of pregnancies are ectopic, and only 5% of those ectopics generate a pseudo-sac and hide out. From the beginning, my case has been confusing to all the docs, lots of differing opinions and wows about how unusual my case is.

We had to make a decision quickly, and knowing for sure at this point there was no viable baby in there, and also that the docs desperately wanted tissue samples to send for analysis, we opted for D&C right then and there. I hadn't taken any medications beforehand (because I didn't think I'd actually be getting a D&C yesterday) and told DH confidently, "If I can get through natural childbirth, this should be a piece of cake." I got one teeny shot of local before the procedure, which turned out to be horrendous and excruciating and quick. I completely lost it in the middle of it and was crying and shaking uncontrollably. I got to have some cathartic full-body sobs in the recovery room before we left.

We went immediately afterward to pick up DD from aftercare at her school, and told her I wasn't feeling well (keeping it vague). By that time I was high on valium and my emotions were not so close to the surface. I kept sort of passing out in the car while DH drove and chatted with DD. We actually ended up having a nice evening... DH cooked and took care of us both and DD and I snuggled up on my bed and she read to me. I was actually really, really glad she was there.

So I wish it was over and I could go for closure now, but the truth is I'm still in limbo until I get those pathology results (tomorrow). The doc did not see any visible chorionic villi in my tissue, but they may show up under microscope. If the report shows no villi from my uterus, that means ectopic, and with betas over 10,000 now, I'm probably no longer a candidate for methotrexate. Instead I would go for emergency laparascopic surgery to find and remove the embryo. Just imploring the universe at this point to let this be the end.

Thank you so much, wonderful women, for supporting me through this difficult time. I have felt the love and it's meant a lot to me.


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## M Anna (May 27, 2011)

God bless you, LitMama. That's a hard, hard day. I hope the results come back such that you don't need surgery. (((((hugs)))))


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## stegenrae (Jun 10, 2006)

Oh (((LitMama))), what an ordeal! I hope it's over for you and you don't have to have the laparascopic procedure (*that* would lay you up for a few days, physically, and wouldn't be easy to keep from your DD). All things considered, it sounds like yesterday went as well as could be expected, and that your daughter loves you dearly.

Please keep us posted on what you find out tomorrow.

...thinking good thoughts for you...


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## DivineMrsM (Dec 19, 2008)

Your story is so much like mine. That makes me sad that you have to deal with anything that I went/am going thru.

I had a lap done last week as my levels shot up all of a sudden and she thought ectopic with a psuedo sac. It wasn't ectopic. I have the d&c tomorrow to take the sac out.

I hope yours isn't ectopic either and you just get to move on from here. Limbo sucks.


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## LitMama (Sep 22, 2009)

Thank you for the kind words and good wishes, *Stegenrae* and *M Anna!*

I got the pathology results back from my D&C, they showed no villi, so my pregnancy is definitely ectopic. I spent the evening in the emergency room last night and got my first shots of methotrexate. I get a second series of shots on Monday (on the 2-dose regimen because my betas are over 11,000). Praying it will work! Just home resting and recovering now. The methotrexate is making me quite ill but I'm happy to be on the healing side of this journey.

*DivineMrsM*, how are you doing? Did you have a D&C? Hope you're holding up okay. Sending lots of healing vibes your way.


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## M Anna (May 27, 2011)

Thinking about you both, DivineMrsM and LitMama.


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