# 5-5.5 weeks, 13000+ HCG, No fetal pole seen, what to think???



## Moonridden (Mar 12, 2012)

Hello -

I had surgery 11 May to remove an ectopic and my left tube. I discovered I was pregnant again on 3 July. Ive seen a couple of nurses, and have HCG quants done, to attempt to rule out another ectopic. I don't know how pregnant I am, exactly, since I had a really long cycle after my surgery and I wasn't charting. Im only guessing how far along I am based on when my pregnancy tests started being positive. I was having some mild cramping today - nothing that felt serious, but I wanted to rule out an ectopic - so I called the OB nurse and she sent me to the ER. They did an ultrasound and drew more blood for HCG quants. (Monday, 9 July, my HCG was at 1,017; Wednesday 11 July it was 2,598; today is was 13,700 something, I believe. I know it was over 13,000.)

Once it came back, the doctor came in and abruptly told me it was a molar pregnancy and I'd need to have a d&c tonight. My HCG was high but they found "nothing but a blob" on the ultrasound. He told me to go up to the OB clinic and they'd do a second ultrasound to confirm before they "did anything to me." I went to OB, where they had several doctors there, including someone who apparently specialized in this kind of thing. During the first u/s in the OB clinic, they were finding nothing but some cysts and what they said was consistent with the "snowstorm" pattern and they were telling me that, no matter what else they find, this pregnancy was definitely not going to result in a baby. Then sudden, one of them goes, "wait a sec! What is that?!" and they zoomed in and tried to get measurements, before deciding to send me to have an u/s with the 3D u/s machine. A third doctor came in and they looked for a while, and decided that there did, in fact, what appeared to be a gestation sac in there, so they decided not to do the D&C, but wait a week to see if there was a fetal pole next Monday. They were not super-encouraging, though, because they really thought that I should have, at the very least, a visible fetal pole with that high of HCG in my system. I have heard that, even with high HCG, it's not abnormal to see much of anything if I am, in fact, only 5-5.5 weeksish.

Another odd thing: my fundal height is measuring around 10-12 weeks. They had no explanation for that, other than multiples (which also explains the high HCG), but they assured me that they definitely didn't see anything other than the one sac.

I go back tomorrow to have my HCG drawn again, and a week from today, I go back for another ultrasound.

What do you make of this? Has anyone had a similar experience? What was the outcome? Should I assume that this pregnancy is not viable, or is it not unheard of to not see anything other than a sac right now, regardless of my HCG?

Thank you!


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## wissa19 (Jul 7, 2011)

I don't really have similar experience, but I thought I would put my numbers out there for you. At 5 weeks 2 days my HCG was 13,699, there was a gest sac and yolk (no fetal pole)...there was also some kind of much smaller cyst. The cyst was gone by the next ultrasound at 7 weeks and I'm now 27 weeks. If you are unsure of your dates it's possible it's still too early to see anything other than a sac.

I had fertility treatments and they were concerned about multiples/ectopic because of the HCG levels, but there is just one in the right place.

Unfortunately, I think you are just in a wait and see scenario. I hope when you go in next week they will see a fetal pole.


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## Yarnista (May 4, 2008)

Try not to worry yourself too much. I went through a similar thing at your point in pregnancy, my midwife did an ultrasound and didn't see anything but the sac. Then called me at home to tell me my HCG level was high for not seeing anything and she didn't want to give me false hope. Then a few days later I went to the hospital for an ultrasound and they saw everything. Do not let them do a D &C until you have waited for the little one to develop more because I read many stories online of similar situations and everything turned out great. When I went through all this I read that in the U.K. they do not do ultrasounds until 9 weeks to save all this worry. I hope this helps you, try to stay positive, I know it's so hard.


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## Moonridden (Mar 12, 2012)

Welp, I'm no less confused today than I was yesterday, but I have a bit more information, I guess. Or a small amount of clarification, anyhow. I was so stressed and fried last night that I asked few questions and a lot of stuff just didn't really sink in.

They told me yesterday that they wanted me to come back today and get my HCG redone, just to make sure that the 13,700 wasn't a lab error. I went in today, around 9AM, around 21 hours after yesterday's. The woman I saw yesterday - one of the four doctors - called me this afternoon and let me know that I'd gone up to 16,300. She said that that was a good sign, that the HCG was still going up (although it sounds like it's slowed down drastically ...). I asked her for some clarification about the cysts, since they had gone from saying that I was showing a "snowstorm pattern" while they were looking on the smaller in-office u/s, to asking about fibroids while examining me with the big, 3D ultrasound.

She told me that the small u/s machine didn't show "the greatest picture ever" and they were only able to see sections of my uterus at once. They weren't sure what they were seeing, but they did see the sac on the small u/s once they were visualizing the right area, and they wanted to get a better look, hence moving me to the 3D u/s. It was apparent that my uterus was enlarged, and they were not able to tell for sure, but in the 3D u/s, they believed it looked like I might have had a fibroid. But they "very definitely" saw a gestational sac, and even though my HCG was high, age-wise, it was still possible that it was just too early to see anything more. They didn't want to do anything drastic yet. I asked if they knew what "age" the gestational sac appeared to be, and she said they didn't have an age, but it looked like the sac was about 1 CM by 1 CM, which she said could be normal for my timing.

I also told her that I'd measured ahead with both of my previous normal pregnancies, by about 4 weeks. She 'hmm'ed' a lot, but then said that that was something to factor in, too, and it's possible that is just something I did.

Hopefully we'll find out more next week. With the cysts less likely, I'm tempted to feel a little hopeful.

Thoughts are welcome, of course. X-posted.


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## Lauren82 (Feb 26, 2007)

At 5-5.5 weeks, all you are going to see is a gestational sac. Your hCG looks great. With this pregnancy, I had very high HCG and didn't see an embryo until almost 8 weeks! We just kept seeing a sac and then finally a yolk but the baby was hiding. They kept telling me to expect the worst. Well, the worst is currently a 32 weeks baby girl in my belly. Try to stay positive.


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## wissa19 (Jul 7, 2011)

I'm not sure why they thought your HCG levels are such an issue. It's high, but it's not unheard of. Like I said mine where high and everything was fine and they couldn't see anything but the sac & yolk. Also, HCG tends to slow down once the number gets so high...the doubling time gets longer & longer.

You're just in a waiting game right now and that is very frustrating. Most OB's do not even do ultra-sounds until 8 to 12 weeks (as already mentioned). They do them later to avoid the kind of thing you're dealing with right now.

Did they check your progesterone levels too?


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## Vegan Princess (Jun 20, 2007)

Yes, HCG numbers stop doubling every 48 hours once they get over 1,000. I am hoping all turns out well! It sounds like things are probably doing what they should and they are stressing you out over nothing! I hope you see a lovely heartbeat at your next u/s!

Cindy


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## Moonridden (Mar 12, 2012)

Thank you all for your replies!

Okay. Well, I went in today for the follow-up ultrasound and another HCG quant.

Everything looks good. Last week, they only saw a small, empty gestational sac. Today, they saw a much larger gestational sac, a yolk sac, and one - as far as they could tell, only one, anyhow - fetal pole. Which, I'm around 6 weeks, maybe 6w3d, so that's about what they would expect to see, they said, for a normal pregnancy progression. However, it really, really bothers them that my HCG is as high as it is, because, according to textbook, you should be able to see a heartbeat when HCG levels are that high. So they aren't ready to say it's a normal pregnancy yet. It's the discrepancy between the high HCG and my dates/what they see on the ultrasound that bothers them.

Idk, I feel pretty good about it. I mean, at six weeks, this was pretty much what I was expecting to see, and even if I do have high HCG, that doesn't make a fetus grow faster, right?

I just spoke to one of them again, because my labs weren't back by the time the u/s was done, so he called me to tell me what they were. They're at 29,670. Which is actually really normal for the 6th week. He said that looked good to him. But now I'm a little concerned, because it's doubling significantly more slowly than it was. He said that was fine, the level is perfect, and it doesn't keep doubling once you get that high, but that seems like a really drastic slow down, to me! (It was 16,300 last Tuesday and 13,700 last Monday.) He said he only would have been concerned if it was in the 100-thousands, or if it wasn't rising at all. So, yay?

As usual, any thoughts are welcome, as are any anecdotes, if anyone has any experience with any if this. Thanks for listening!


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## yummymummy2hannah (Aug 23, 2006)

Hey,

I just wanted to chime in and say I had a very similar experience as you last month. I went in to date my pregnancy with an ultrasound. We weren't sure if I was 6 weeks or 9 weeks. I was 6. My HCG was 20,065 but no fetal pole in ultrasound. They weren't sure all was ok or not. They said it could have been a blightened ovum. A week later they checked HCG to see if rising. It went from 20,065 at 6 weeks to 69,000 at 7 weeks. I went back in 2 weeks later at 8 weeks and there was our baby bear (looked like a baby bear!) with a great heat beat and perfectly at size on the 2nd ultrasound. So, don't worry too much. Keep calm, relaxed, only positive thinking and if you feel yourself slipping into the fears make yourself stop. I promise thats the only way to keep your sanity.  Good luck mama.


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## Moonridden (Mar 12, 2012)

I went back in for yet another ultrasound today, and his time, they found the heartbeat!  They measured me at 6w6d. They're having me come back in for one more a week from today, but they're optimistic now. =). I have officially been put in the clinic's system as viably pregnant, I have m first OB appointment on Thursday, and I have a printed picture of a little sea monkey. Stuff is looking much, much brighter!


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## at_the_hip (Jan 12, 2008)

I just wanted to chime in and tell you that I had extremely high hCG levels (peaked at over a million) and they sent me directly to a perinatologist. Basically it was either multiples or molar. But instead I now have a beautiful 9 year old girl...i was followed the whole pregnancy and everything was perfectly fine. While looking online you see a lot of doom and gloom around high hCG but clearly there are good outcomes!! Congrats on your good ultrasound and don't worry, very likely everything will be just great!


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## LLQ1011 (Mar 28, 2012)

Some women have high HCG. YAY BABY! Your baby just was getting down to business better than most.


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## Moonridden (Mar 12, 2012)

I updated everywhere else that I had posted this, but apparently I forgot to update here. I lost the baby after all. My OB wanted me to come in again for one last look to determine everything was okay - we all expected it to be, after seeing the hb - so I went back on Monday 6 August, and the heart was no longer beating ... in fact, all we saw was a collapsing sac. I didn't make any choices at that point. But went back in two days later to confirm. It really is gone. I have not started to miscarry yet, but I want it to be over. I have Misoprostol - I want to avoid D&C if possible, so as to not run the risk of scarring my remaining tube - but I have been waiting to take it until my husband gets back. Probably will take it tomorrow.


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## wissa19 (Jul 7, 2011)

Moonridden - I'm so sorry.


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## Adaline'sMama (Apr 16, 2010)




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## blueyezz4 (Sep 23, 2006)

*Moonridden* - I just found this post this morning actually and I'm so sorry to read the newest news tonight. I'm so sorry you are having to go through this... just doesn't seem far!!







I hope that the pills work for you. I've used those in the past. How did your OB tell you to take them?


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## darkblue0729 (Apr 16, 2008)

Moonridden, I am so sorry mama. I will be sending lots of healing vibes your way.


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