Help understanding test results

[lilly00000]

I have read many posts on these forums,  but there are so many stories and I would really like some comments on my situation, as I haven’t found  answers that seem to match my test results

My LMP period started around 8/12.  I am 41 and this is my first pregnancy.  I have had two doctor appts, and the results from those are below.

First u/s and blood test on 9/24.  The u/s showed a sac and yolk but no fetal pole. My HCG levels from that day came back at 28,100.

My second u/s was on 10/6.  The u/s showed a sac, yolk and “a group of cells which is the baby” (they did not use the term “fetal pole” and I’m not sure if it is the same thing or not).   But now there was no hb detected.   A midwife (my dr was not in that day) told me there was a “100% chance” my HCG levels would come back lower.    Instead though, my HCG levels from that day came back at 48,100

At both appointments they termed the baby “non viable”.   My doctor called today wanting to schedule a d&C for tomorrow (10/8). I asked him if we could do another u/s next  Thursday and the D&C next Friday if no hb is detected then, which he said was okay but it sounded like that was just a concession to me – there was no hope of a viable pregnancy.

Maybe I have false hope, but I have very high and rising (though not doubling) HCG levels, and some development (the baby cells showing up on the u/s) in between the two appointments – a situation I haven’t seen anyone post here.  The doctor says I should have seen a hb at HCG 6,000, and the levels are only rising because of the placenta.
Does anyone have any comments for me?   I’m worried if I put off a D&C for too long, maybe I will not recover as well from it (to try again) or have some complications.  On the other hand, my HCG levels rose, are at a high level, and something showed up between the two ultrasounds.  

Any help interpreting this would be appreciated.  

[adgal]

Having had 5 miscarriages myself, I understand how difficult a time this is for you.  I am so sorry you are going through this.  I do have to say that it does not seem like a viable pregnancy.  With HCG levels that high, you should see a heartbeat on the u/s.  It is very possible that your body has not recognized this yet and that is why you are not having m/c symptoms.  Please understand, I am not saying this to be a defeatist, just to share my own experience.  

All that being said, there is no panic to make a decision.  There is nothing wrong with requesting a 2nd opinion.  I did, and although the outcome was the same, it did give me peace of mind and took away that "I wonder" feeling.  I needed to know for certain. Holding off on having a D&C does not decrease your chances of ttc again quickly. Your pregnancy was in the early stages and most Dr.s recommend one full cycle.  So do what you feel is best.  Get another u/s to know for sure if you need to.  There is no danger to you in doing that.  I truly wish you well, and to let you know there is still lots of hope...after 5 losses I am now successfully pregnant (24 weeks) with a healthy boy.  I will be 41 when he is born.  It can and does happen.  Sadly, so many of us here have experienced m/c and most of us have gone on to have healthy pregnancies.  Take care and I wish you well.

[lilly00000]

:)  All the best to you too!!  

[lcgnyc]

I know what you mean.  We went for our first U/S yesterday and at one point the tech said "I'm sorry...."  My heart sank.  My husband and I laughed afterwards because what she went on to say was "...if I'm pressing hard."  You become conditioned to expect the worst.  Although Ziggy Zygote is measuring at 5w 3d instead of 7w, heartbeat is 120 and doctor isn't concerned.

Good luck!

[lilly00000]

Laura - thank you for the comment.  It helps a LOT to think about starting over and having everything work out the way it is supposed to from the start.  

I can't even picture someone giving me good news, because these are the only two obstetrics appts I've been to in my life - and so far it has been a really discouraging experience.   Both ultrasounds have ended with a grunt from the u/s person, "I will get a doctor to talk to you about this" followed by a sinking feeling in my stomach.   I feel totally defeated. I'm scared to start the process over and have something like this happen again.

The fact that your second experience was much better really helps to think about - thanks again

[lcgnyc]

Hi Lilly.

I can't answer your specific questions, but my experience might help.  First of all, I am sorry you  are going though this uncertainty and anxiety.  I understand and I know how difficult it is.  I miscarried over the summer.  They deteced the fetal pole and a slight heartbeat flickr at 6 weeks (so slight it didn't register a beats per minute rate).  At 7 weeks they detected a 90 bpm heart rate.  (HCG increased a bit b/w weeks 6 and 7, but it wasn't increasing very much, then plateaued, then dropped.  That said, the rate at which HCG increases once a heartbeat is detected is not that relevant for some reason.)  A few days later I went for another sonogram and the heartbeat had weakened. I had a D&C a few days later.  I opted for a D&C because the practice where I was being seen does a lot of D&Cs.  I also prefered the kind of closure that a D&C would give me.

I certainly have read more than enough testimonials fom women whose pregnancies seemed to be not viable and suddenly bounced back, so if having another ultrasound is the right thing for you, then that is what you should do.

(I am pregnant again and went for my first u/s yesterday.  HCG has been increasing nicely and 120 heartbeat was detected, but although I know I am at 7 weeks, I measured at 5 weeks 3 days, so I'm hoping my next U/S shows a growth spurt.)

Good luck, Lilly.  
Laura