Fluctuating HCG

[Lys90]

Ok, so the gynocologist called me back and I have to clarify - the two things she found in my uterus may be pseudosacks from an ectopic, or they may be pregnancies - it is too early to tell. She said one had many indicators of a pregnancy like a ring and some blips on EKG, and the other looked more like a clot or a pseudosack but she can’t rule definitively on either yet as it is so early.

[ChaoticBlues]

It sounds like you are finally getting somewhere. That they are starting to build a picture. Cysts can be confusing if that is what they are seeing as it's taking them away from figuring out everything else going on. You are still very early. If it is ectopic its less life threatening this early on. Are they still checking your HCG? I think your HCG has to be at least a certain amount before they can see a fetus. Hope they figure this out for you soon and you get definitive answers. It helps with closure which takes a while.

The waiting for the fetus to grow that kind of happened to me. When I saw the consultant she said she thinks it's a miscarriage, I said I think it's ectopic, she was like well if it is you just have to wait and see but pretty much go home as you will start miscarrying and come back in 2 weeks to be checked over. I did and my hcg had gone up after going down and they couldn't see anything, then they were like it's in an unknown location so ectopic then I should choose surgery or mxt injection. Choose quickly. I had to make the decision on my own no one said the pros or cons. If I knew what I knew now I would have had the surgery. Although the ivf doctor said I made the right decision with mxt so I don't know.

If it is in your tube i do think you should start thinking about what you would choose mxt or op, as i had no idea i was so rushed by the hospital. I hadnt heard womens stories. I've seen stories like mxt injection lowers AMH. I only had it once thankfully. Its a form of chemo, it affected me a lot I felt out of myself, dehydrated. Last like 5 days. Then the severe pain for weeks and weeks. Saying that the op can be full on, I've read women's stories of difficult recovery. One woman had surgery they somehow didn't get the fetus, so she had the mxt aswell. That is awful!

This is a really tough time. The unknown is awful and then if it is ectopic being traumised is really understandable. Its like your body has betrayed you. But also put your life at risk, then losing a baby. It's so many feelings.

It's good you have a supportive partner.

[ChaoticBlues]

So weird I saw your later message after I posted my prior message, so not cysts but pseudosacs but still they're not sure. EKG blip sounds interesting. So early I guess.

[Lys90]

Well I have one cyst on each ovary (normal she said), but not necessarily in the uterus. Well, one of the two lookes more like a blood… Clot? Cyst? I don’t know. The other had allot of signs of pregnancy but yes - too early to confirm. She didn’t really confirm or disconfirm anything. It could be “vanishing twin”, one ectopic plus one uterine, just uterine, just ectopic, two uterine and one ectopic. I’m obviously pregnant somewhere but they still don’t know where and my HCG is still increasing, I’m bleeding, and I have pain in the side and intermittent cramping… Who knows? At least they said there was no blood in my abdomen so for now things are “calm”.

Your experience is really helpful. At this point I think I will choose the surgery if it gets to that. My HCG was up to over 1300 today, so by the time I go back to an ultrasound next week it may be so high mtx success rates are lower and two doses may be required. I would consider mtx at less than 5000 HCG or maybe 3000 I think. I absolutely do not want to mess with my AMH. Have you retested it after mtx? I did mine january last year and again in june due to switching clinics, and it had actually gone up by like 1.5 points. I know there is some margin of error with the tests but I’m convinced it’s my excessive vitamine regime. In particular I read vitamine D deficiency can negatively impact. I was vitamine D deficient (confirmed in blood tests) so been taking that, CoQ10+, L-carnitine, fish oil, and vitamine B since my tests in January. Egg reserve is a worry for me, AMH is on the lower end and I see that many of my embryos don’t make it in IVF. So if mtx can mess with that… I don’t really feel like I have much to give. It is why I do new rounds of IVF/egg collection even though I have two frozen. I’m in this not just for one child but I am hoping to have two or three one day… So I figure it is better to have some in reserve that I can use later than to try to do more IVF when I am a few years older. Tough choices. In the US I have heard it it super common to do three rounds of IVF back to back before doing only frozen transfers (fresh attempts are less common there due to OHSS risk). Then again it is also common to do genetic testing on all embryos… That’s not even legal here.

[CamLe]

Hello Lys

I thought I'd post a reply because I, too, recently experienced really confusing diagnosis. I got diagnosed with an EP three times in the span of four days. As it turns out, the first two times what they saw on my very early scans (I was 5.5 weeks on the first US) was the corpus luteum, which I since read in radiology articles is a structure commonly known to be mistaken for an EP. In my case, they had also identified small structures in my uterus that were too small to identify, so if they can see the sac on yours I'd think that's a great sign.

I guess I mostly wanted to share your confusion and what I learned from mine. They went from day 1 diagnosis of EP that was then changed to 'probable' due to lack of HCG 48 hour trend (I had only one data point), lack of seeing the gestational sac in the structure (later confirmed to be the corpus luteum), and unidentifiable structures in my uterus. On day 2, they diagnosed a ruptured ectopic and after receiving my HCG results changed they diagnosis to probably intra-uterine pregnancy and possibly hemorraging cyst to explain the structure (later confirmed to be the corpus luteum) and the blood they saw in my abdomen (they told me they couldn't even be sure from the images whether it was in my tube of next to it...). It was only on day 3 that they finally saw a new structure they confirmed at EP, which had not been visible on previous scans and they also felt like what they saw in my uterus was now too small for my HCG levels. After surgery they told me both the pregnancy and corpus luteum were in my tube.

Based on what you've said, the fact they see gestational sacs in your uterus sounds like great news, even though they aren't willing to rule out EP yet. I wish you the best and have my fingers crossed for you and Chaotic blues as well. Cam

[ChaoticBlues]

I have heard about the vanishing twin which would explain the hcg slowly increasing as one twins hcg rises and the decrease. If that were the case and one was in your fallopian tube then they would never give mxt it would have to be surgery to remove the tube for sure so that it doesnt affect the baby in the uterus. If it turned out to be this that would be something. 1300 hcg is a proper increase. There's definitely a fetus still developing.

Definitely good there's no blood in your abdomen. It is a waiting game for sure. That's hard. How bad is the cramping? Have they said you can take paracetamol?

I remember when I started miscarriage bleeding I thought ok this isn't physically bad, 2 days later I woke up in severe pain, I could barely get out of bed, I went downstairs, laid up right on the sofa in pain for 4 hours, fell asleep. I was like WTF was that....so bad, wasn't sharp it's like a dull ache cramping from my left side and down my left leg. From that day til now, I've slept on the sofa because I was so traumatised lying flat on the bed and barely getting up.

That's why I mentioned what I heard about mxt and i only heard this after I had it. I was given barely any information prior. Just not to try again for 3 months and side effects that weren't the ones I had. Nothing about what I experienced.

No I've not retested my amh. Mxt you are told not to have folic acid until your hcg is 0 as it works against it. I would say if you are in that position where you get to choose really research both. As I said I would have gone for the surgery if I knew what I knew now.

Sounds like you are family planning which is great. Its good to have some insurance with freezing your embryos. So important to not let this deter you.

Thanks Cam...ectopic pregnancy is such a hard thing to go through but some how we do.

[Ainc]

Hello, I am wondering how did this end up. I might be going through a similar thing, low beta and fluctuations