
Had IVF ICSI. E2 And Progesterone Levels Are Okay But Low BHCG. No Ectopic Pregnancy. Chances Of Getting Pregnant?

Thanks for your query.
I have read your query & I understand your concerns.
Following is my reply:
1) Beta hCG values should double every 48 hours which has not happened in your case. Though there is late rise in the levels, it is not doubling. Hence it is possible that you have had a biochemical pregnancy ( detected in blood test only but not on ultrasound).
2) You IVF centre has adviced you to stop medicines as they are also thinking as I told you. Hence probably pregnancy is not viable.
3) I understand its devastating news. But you have to slowly accept it.
4) Alternatively, you can continue the medicines for another 2 days and check beta hCG again to check doubling value. There is no harm in continuing medicines if you wish to.
5) Fibroids might have been missed by your doctor in earlier scans and diagnosed now. Not to worry much about it.
6) There is no risk for keeping the pregnancy and continuing medicines. You can ask for more time from your clinic.
I hope I answered your query. I will be available for any followup queries you have.
Regards,
Dr.Mahesh Koregol
IVF & Infertility Specialist.


Your answers are very clear.
If I will decide to keep the pregnancy and continue to live with it as long as I feel okay, do you think I should continue going for blood tests to monitor my hcg level and go to another doctor to do a scan again?
What symptoms should I look for or be aware of to make sure that I am not running my life at risk? (I might be developing ectopic pregnancy without knowing it...that's a possibility right?) I just want to know so at least I would know when I should go for immediate help. The moment that I ask for more time from the IVF Clinic, I would think that I am bearing all the risks or consequences of all my decisions.
Is there something that you can advise that I should do regarding caring of myself that can help in keeping my pregnancy?
I have extra embryos (Day 6) frozen. Will these still be okay for implantation? No genetic testing was done for these embryos (blasts) because since the first two (day 5) were genetically tested (PGD) and they are okay, we hoped and believed that the other blasts are okay. Do you think it makes sense? Or should we do another PGD for the the extras?
When is the best time to try again?
Thank you.


Did an ultrasound at Day 22, no sac found. Another Bhcg test today, Day 23, result is 461. Doctor advised that it may be a tubal pregnancy and an official scan will be done on Day 25.
According to Wikipedia, "Mortality of a tubal pregnancy at the isthmus or within the uterus (interstitial pregnancy) is higher as there is increased vascularity that may result more likely in sudden major XXXXXXX hemorrhage". If it is a suspected tubal pregnancy, why do we need to wait for two days before something is done to me? Do we really need to wait for pain to occur before we say that it is ectopic?
What is the normal procedure after knowing that a patient is having an ectopic pregnancy?
Is two days not XXXXXXX enough? Is it okay to wait?
Thank you
Your doctor is right. It could be a tubal pregnancy.
1) Possibility is that it could be a delayed slow rise of beta hCG value which is also possibility.
2) Ectopic pregnancy has to be diagnosed by ultrasound or by performing laparoscopy . Ultrasound is not always diagnostic and difficult to see ectopic sac. Hence your doctor is not sure. Laparoscopy is invasive surgery hence dotor is watching you.
3) When diagnosis is not sure, your doctor is waiting to make final decision which is fine.
4) If you get pain abdomen or bleeding per vagina, please rush to hospital. Till then is ok to wait.
Wish you safe health.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist

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