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What Causes Dark Brown Spotting, Pain In Groin Area And Morning Sickness?
Question: I am 6 weeks 2 days pregnant. I had a vaginal ultrasound 2 days ago. Since i was exactly six weeks we couldnt hear the heartbeat but did see thr flutter. 2 days later i am having dark brown spottimg. It doesnt appear to have bright red blood but may be a small amount of dark red blood. Should i be concerned?
When it says to worry if you have cramps, what kind of cramps? I feel pangs down in my female area but not sure if is cause for concern.
This morning i also had some strong morning sickness. Could the pregnancy turn bad that quickly?
Last thing to note, we are using a 27 y/o donor egg and not my 43 y/o eggs
When it says to worry if you have cramps, what kind of cramps? I feel pangs down in my female area but not sure if is cause for concern.
This morning i also had some strong morning sickness. Could the pregnancy turn bad that quickly?
Last thing to note, we are using a 27 y/o donor egg and not my 43 y/o eggs
Brief Answer:
seems likely from progesterone deficiency or luteal phase defect
Detailed Answer:
Hello,
Any form of bleeding during an established pregnancy should be considered a threatened abortion unless proven otherwise by an ultrasound. If there was a normal ultrasound 2 days back and there was no evidence of any sub chorionic hematoma then it is likely that the dark brown discharge is probably due to progesterone deficiency or luteal phase defect. You would have to be placed on TAB MICRONIZED PROGESTERONE 200mg once at night daily till 14 weeks to support from pregnancy. If you have already been on progesterone as you should be in case of an IVF, then you must practice bed rest for few days till the bleeding stops completely. This should wear off in few days once the progesterone levels stabilize.
There is always a constant mild pain experienced in the groin region in the early weeks due to stretchin of ligaments due to growing uterus and they must not be confused with cramps or uterine contractions. these are normal .
Thirdly morning sickness and nausea occurs due to increased hcg levels in the blood, which is secreted by the pregnancy itself due to implantation over uterus and growth of placenta and can cause nausea and even emesis during the early weeks and may last through out 1st trimester , considering your age group.
You may discuss with your physician for an antiemetic like TAB DOXINATE 1 tab thrice a day to allay any nausea or vomiting during pregnancy and its pregnancy safe.
I hope i have answered your query in detail,
wishing you good health,
regards
Dr.Samiir Kumar
seems likely from progesterone deficiency or luteal phase defect
Detailed Answer:
Hello,
Any form of bleeding during an established pregnancy should be considered a threatened abortion unless proven otherwise by an ultrasound. If there was a normal ultrasound 2 days back and there was no evidence of any sub chorionic hematoma then it is likely that the dark brown discharge is probably due to progesterone deficiency or luteal phase defect. You would have to be placed on TAB MICRONIZED PROGESTERONE 200mg once at night daily till 14 weeks to support from pregnancy. If you have already been on progesterone as you should be in case of an IVF, then you must practice bed rest for few days till the bleeding stops completely. This should wear off in few days once the progesterone levels stabilize.
There is always a constant mild pain experienced in the groin region in the early weeks due to stretchin of ligaments due to growing uterus and they must not be confused with cramps or uterine contractions. these are normal .
Thirdly morning sickness and nausea occurs due to increased hcg levels in the blood, which is secreted by the pregnancy itself due to implantation over uterus and growth of placenta and can cause nausea and even emesis during the early weeks and may last through out 1st trimester , considering your age group.
You may discuss with your physician for an antiemetic like TAB DOXINATE 1 tab thrice a day to allay any nausea or vomiting during pregnancy and its pregnancy safe.
I hope i have answered your query in detail,
wishing you good health,
regards
Dr.Samiir Kumar
Above answer was peer-reviewed by :
Dr. Prasad
I am taking a progeaterone in oil at night. Should i add a progesterone tablet? What is luteal phase deficiency? Everyone did look good af the ultrasound .
Brief Answer:
No need to add
Detailed Answer:
Hello,
I think if you are already on progesterone then there is no further need to add any more. You just need to have bed rest for few days till bleeding stops completely.
A luteal phase defect is defined as decreased progesterone production during pregnancy by the corpus luteum which is remnant of the graffian follicle. In your case it should not be a concern as it’s an IVF and there would not be any.
So in your case it has to be provided from external sources through progesterone tablets to secure pregnancy firmly to the uterus which you are already on.
Repeat USG is advised after a week to look for the heart beat confirmatory to ascertain viability of fetus.
Regards,
Dr.Samiir Kumar
No need to add
Detailed Answer:
Hello,
I think if you are already on progesterone then there is no further need to add any more. You just need to have bed rest for few days till bleeding stops completely.
A luteal phase defect is defined as decreased progesterone production during pregnancy by the corpus luteum which is remnant of the graffian follicle. In your case it should not be a concern as it’s an IVF and there would not be any.
So in your case it has to be provided from external sources through progesterone tablets to secure pregnancy firmly to the uterus which you are already on.
Repeat USG is advised after a week to look for the heart beat confirmatory to ascertain viability of fetus.
Regards,
Dr.Samiir Kumar
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
A couple follow up questions. I am scheduled for a progesterone blood test tomorrow. My fertility doctor doesn't believe i should be comcerned, although they have never checked my level. She says that the 1 ml dose of progesterone in oil ahould be keeping my level high enough. It seems odd since they never confirm my level.
Toy questions:
1 is there a downside to adding to my progesterone dosage until i get confirmation? Can it harm the fetus or have an adverse effect?
2. You recommended bed rest until the levels stabilize (assume that means until the spotting stops?). Does bedrest really help or is it more to make myself feel better? I have heard that if you are goimg to miscarry, rest doesnt matter. Is that only relevant if there is a chromosome issue and in this case the issue is likely me and not the fetus?
Toy questions:
1 is there a downside to adding to my progesterone dosage until i get confirmation? Can it harm the fetus or have an adverse effect?
2. You recommended bed rest until the levels stabilize (assume that means until the spotting stops?). Does bedrest really help or is it more to make myself feel better? I have heard that if you are goimg to miscarry, rest doesnt matter. Is that only relevant if there is a chromosome issue and in this case the issue is likely me and not the fetus?
Brief Answer:
you may get serum progesterone levels done...
Detailed Answer:
hello,
thanks for the follow up...
Firstly, progesterone in oil has been given to support the pregnancy , which you are already on since the embryo transfer. This would help in implantation and growing of placenta.It is possible that the bleed/spotting experienced could be just a sinus getting ruptured during placental invasion causing mild bleed and then stopping on its own.
The reason i suggested progesterone levels and ultrasound was to rule out any deficiency even if it may not have been there , but it is always better to rule out when the pregnancy in question is a precious pregnancy.
So, progesterone can in no way harm your fetus.
Secondly, you are right that bed rest per se doesnt stop any abortion if it has to occur but there is a normal pregnancy, where bed rest can allow decreased uterine irritability and hence lesser incidence of bleeding. It is evidenced through various studies that bed rest plays a role in stabilizing the pregnancy in a genetically normal fetus. But yes, as you said, if there is a genetic abnormality then the rest is immaterial.
I hope i have answered your query,
regards,
Dr.Sameer Kumar
you may get serum progesterone levels done...
Detailed Answer:
hello,
thanks for the follow up...
Firstly, progesterone in oil has been given to support the pregnancy , which you are already on since the embryo transfer. This would help in implantation and growing of placenta.It is possible that the bleed/spotting experienced could be just a sinus getting ruptured during placental invasion causing mild bleed and then stopping on its own.
The reason i suggested progesterone levels and ultrasound was to rule out any deficiency even if it may not have been there , but it is always better to rule out when the pregnancy in question is a precious pregnancy.
So, progesterone can in no way harm your fetus.
Secondly, you are right that bed rest per se doesnt stop any abortion if it has to occur but there is a normal pregnancy, where bed rest can allow decreased uterine irritability and hence lesser incidence of bleeding. It is evidenced through various studies that bed rest plays a role in stabilizing the pregnancy in a genetically normal fetus. But yes, as you said, if there is a genetic abnormality then the rest is immaterial.
I hope i have answered your query,
regards,
Dr.Sameer Kumar
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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