My LMP was 1/18/99. On day 22 of my cycle my progesterone level was tested
and found to be 0.8. I was told therefore that I probably had not ovulated.
On 2/22/99 I found I was pregnant. The doctor said I therefore probably
ovulated after day 22 of my cycle. I believe I conceived on 2/13/99. I
had an ultrasound on 3/8 which found a gestational sac in the uterus
which they say measured 3 mm and put me at about 3 weeks pregnant from
conception (which is consistent with the late ovulation, but not with LMP
date). I had another ultrasound 1 week later on 3/15 and the sac had grown
to 8 mm, but nothing inside the sac could be detected, no yolk sac, no
fetal pole. My HCG level on 3/12 was 2209 and on 3/16 was 3754. I am
scheduled for another ultrasound on 3/22, and for a d/c on 3/23 should
nothing be seen inside the sac on 3/22. I am very scared as this could be
my 4th miscarriage. My question is whether something should definetly be
seen inside the sac at the next ultrasound, which would put me at about 5
weeks pregnant from conception? If after my ultrasound on 3/22, they still
can't see any yolk sac, fetal pole, etc, but my HCG levels are continuing
to rise (but not double) should I postpone having a d/c any longer? Thanks
for your insight. This is very informative cite.
Pregnancy was apparently confirmed on 2/22/99. This is 9 days after your suggested dated of conception, 2/13. Even a very sensitive blood pregnancy test is unlikely to show a positive result this early.
If we work from the date of 2/22 and assume that is 14 days after conception, 3/22 will be 8 weeks into a pregnancy.
If we work from the date of 3/22 as conception, 3/22 will be 7 weeks and 2 days.
Thus, by each date, there should be clear signs of fetal development and fetal life at the 3/22 ultrasound.
hCG levels that are slowly rising at this time in pregnancy are not reassuring; in combination with an ultrasound that does not identify fetal development, the hCG levels are confirming that this is not a health pregnancy.
The decision to have an operative procedure must be made by a patient and her treating physician.
Keywords: hCG, ultrasound, early pregnancy
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