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5 Week ultrasound - NO heartbeat No fetal pole. HELP!
I am 6 weeks and 1 day today. Here is what has happened so far:

4 weeks (10/20) HCG = 524
4 wks 3dys (10/23) HCG = 1,993
4 wks 6 dys (10/26) HCG = 7,024

THEN

Ultrasound at exactly 5 weeks (10/27) = Showed sac but no fetal pole no heartbeat...

They are having me come in again this monday for another ultrasound (I'll be 6weeks 3 days then).

My question-

IS ALL THIS NORMAL?

WHEN CAN FETAL POLE BE SEEN?

WHEN CAN HEART BEAT BE SEEN?

ARE HCG'S NORMAL?


PLEASE HELP! ANYONE WITH INFO OR ADVICE!!

Thanks so much!!!

Kat
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58 Answers
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Avatar universal
Hi...I cannot anser all of your questions because pregnancy vaires for everyone.  I've heard that it is not unusal for a heartbeat to not be detetected at 5 weeks.  I didn't hear a heartbeat until i was 10 weeks.  
So...i know it's easier said than done, but try not to worry too much.  good luck with everything.
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I don't think you should worry.  That was really early and your numbers look great!!
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158812 tn?1189759426
Your levels look very promising....not seeing anything at 5 weeks to my knowledge is normal too.  I had a 5 wk 3day u/s and saw nothing.  I then had a 6w 5d u/s, and saw everything including a heart beat.  I absolutely wouldn't get upset about this right now.
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I think the average is normally 7-10 weeks.  I have known a couple people to have it down at 5 and the didn't see it.  I think everything will be ok.
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134578 tn?1483549754
Try not to freak out.  Your doctor should have been able to tell you whether things are normal or not.  All the numbers look fine, and it's pretty unusual to see a heartbeat before six weeks.
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I had the exact same thing happen to me.  At 5 weeks 3 days it only showed a sac, no hb.... I went in 3 days later for another ultrasound at 6 weeks and there was a hb fluttering.  My daughter is now going to be 2 in december.  

Usually you don't see the hb until week 6 on average, according to my gyno.  Some you see sooner, but average is week 6.  Good Luck and let us know.
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Thanks guys! I go in for another ultrasound today at 11AM. I am currently 6 weeks and 3 days. I will let everyone know what happens. I'm thinking that everything will be ok because i have been feeling nausious the past two days (all day long) which is good right?

Thanks again and i'll let yall know what we see today!

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Ultrasound @ 6weeks and 3 days (today) revealed fetal pole and heartbeat!


All is well!
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YEAHHHHH!!!! I knew it would work out.  Congrads and I hope you have a healthy 9 months.  Good Luck!
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Hi. New here. I lost 2 in the last yr but, just found out I'm pregnant again. I found out right before I got preg w/ this one that I am AP antibody positive for lupus. I have a new dr and he just did and ultrasound and shows I'm 5 wks 3 days and he told me before I went all we would see was the gest sac and that's all we did see so, I know how it feels... scares you to death. I'm so nervous w/ this one i'm going crazy.Dr started me on the low dose asprin right away and after this sono this wk(Hopefully I will see that lil heat beating away)8/21 I have to go to the high risk ob/gyn to get me started on the blood thinner. Thank God I changed drs otherwise, I would never have known why I was lost the first two and would have lost this one,praying all goes well.
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so Kim.  it's been some time, i hope all turned out well for you.  my sister has lupus, she had 2 miscarriages.  both termed blighted ovum.  no yolk sac or fetal pole were in the gestational sac at even 7 weeks.  i just got pregnant.  i'm 6 weeks 3ish days.  yesterday i went to the doctor's and same thing for me- no yolk sac and no embryo yet.  i go to the hospital tomorrow for the stronger ultra sound machine to see if anything can be seen.  if not, they're saying it's not a viable pregnancy.  guess my question is- since my sister has lupus, i feel like i have something in common with you.   did everything turn out to be OK for you?  
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Hi - I'm new at this.  I did ivf about 9 months ago - got pregnant and lost at 7 weeks.  I am now pregnant again through a frozen embryo transfer.  I went to my dr. (i recently moved so he is new to me) and I measured 5 weeks 2 days - my hcg was 1479, we saw a sac but that was all.  At the end of the conversation my dr. said " don't worry we aren't going to throw the towel in on this pregnancy yet."  I have no idea what he meant by that.  Is it normal just to see a sac at this point?  I don't know whether to be worried or not.  Any advice??
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Hi-I have been so nervous this past week because of spotting and then at my ultra sound no fetal pole detected just the sac. I thought I was 6 weeks 3 days because my last period was 7/14th, but they said they think I'm actually 5 weeks 3 days because of ultra sound results and also my hormone levels. I decided to search the internet for some information and came to this sight. All of your thoughts and comments are making me feel alot better. But I am still a little nervous because of the slight spotting. I've had 2 healthy pregnancy, but you know...you still think the worst.
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Hi , My name is keerty from india.  I am 8 weeks pregnant 10 days back when i did a ultrasound scan baby was 1cm long & had heartbeat. but today as of sep 7. 2007 when i went a scan the baby is there but not heartbeat. my dr ask me to wait & see for 1 more week for the heartbeat. dr once the heartbest is lost is there any chances for coming back. Is this a miscarriage ?? I am very much worried dr. pls help. also I had a miscarriage on may 23, 2007. IS ALL THIS NORMAL? Can i see the heartbeat again ??/
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I had 1st ultrasound today where they said I was measuring 5 weeks, 2 days. Saw gestational and yolk sacs, but no heartbeat -- said to come back in 1 week.......I'm so nervous.
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290648 tn?1211595446
5 weeks 6 days, hi ladies.   i have an 11 year old son,  and had 2 miscarriages in 2003 and 2004.  both times, no fetal lpole, just a yolk sac.  first one dr. did a d&e at 7 1/2 weeks,  next one he wanted to wait to see if it would come out on its own, it didn't, and  i hemorrhaged at 8 weeks... severely, and very afraid of that happening again.

went for first ultra sound today.  first day of last period was 8/21  so i should be 6 weeks today.  

at us today, just showing yolk sac again, no fetal pole yet.  And the ultrasound tech. said the same thing, 'maybe you just aren't as far as you thought'  .   the measurements she took (on the yolk sac i think) showed 5 weeks 6 days,  so i guess we are right on with the timing,  i just need to see a fetal pole.  :(    

its hard to not think its going to happen again.  and each time this happens I cherish my 11 year old more and more, and realize how lucky i am to have him.

i had blood drawn this morning, and they are supposed to call me tomorrow morning, so i'm going to ask for blood to be drawn again to compare.  

looking forward to getting to know all of you.  thanks for listening, stephie4
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4 days ago i found out i was pregnant, the next day i had an ultrasound and the dr. told me that i only have the sac but no heartbeat and fetus seen in me. She measured the sac and said that i was supposed to be 7 wks and 3 days pregnant. i went to my OB a while ago and said that maybe i was blighted or it is just to early to see. they are telling me to have an ultrasound again after 2 wks.

im so scared and cant wait to find out the result. but 7 wks, should be now visible and should hear the heartbeat by now. pray for me

Jemz_philippines
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don't worry.  at this point in time if your bladder wasn't full enough it very hard to see and hear anything. i've had the same scare before. just make sure the next time you go you drink lots of water to fill your bladder all the way. they may do an internal ultrasound if they r really concerned. they can see every thing a lot better this way. i can tell you to relax i have been through this plenty of times i have been pregnant 9 times and have had 6 live births the others i miscarried at 6 1/2 weeks. you have nothing to worry about.
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Have a question.. What did ur gyn say?
Your levels seem to be rising.  
hCG levels should be increasing by at least 60 % every 2-3 days, but ideally doubling every 48-72 hours.

The earliest change that could be seen through a vaginal ultrasound at this time would be the “decidual reaction”, which is the thickening of the endometrium. The endometrium lining thickens as the blastocyst burrows into it. This cannot always be seen by ultrasound—sometimes it may take a special eye or very good equipment to see this “reaction” in the endometrium lining.

*A key point to remember when using ultrasounds is that a transvaginal ultrasound can detect development in the uterus about a week earlier than a transabdominal ultrasound.

Week 5 Gestational Age (Fetal age 3 weeks)
Development
The gestational sac is often the first thing that most transvaginal ultrasounds can pick up at about 5 weeks. This is seen before a recognizable embryo can be seen. Within this week, at about week 5 ½ to the beginning of the 6th week, a yolk sac can be seen inside the gestational sac. The yolk sac will be the earliest source of nutrients for the developing fetus.

Hormones
hCG levels can have quite a bit of variance at this point. Anything from 18 - 7,340 mIU/ml are considered normal at 5 weeks. Once the levels have reached at least 2000, some type of development is expected to be seen in the uterus using high resolution vaginal ultrasound. If using a transabdominal ultrasound, some type of development should be seen when the hCG level has reached 3600 mIU/ml. Although development may be seen earlier, these levels provide a guide of when something is expected to be seen.
Week 6 Gestational Age (Fetal age 4 weeks)
5 ½ to 6 ½ weeks is usually a very good time to detect either a fetal pole or even a fetal heart beat by vaginal ultrasound. The fetal pole is the first visible sign of a developing embryo. This pole structure actually has some curve to it with the embryo’s head at one end and what looks like a tail at the other end. The fetal pole now allows for crown to rump measurements (CRL) to be taken, so that pregnancy dating can be a bit more accurate. The fetal pole may be seen at a crown-rump length (CRL) of 2-4mm, and the heartbeat may be seen as a regular flutter when the CRL has reached 5mm.

If a vaginal ultrasound is done and no fetal pole or cardiac activity is seen, another ultrasound scan should be done in 3-7 days. Due to the fact that pregnancy dating can be wrong, it would be much too early at this point to make a clear diagnosis on the outcome of the pregnancy.

Week 7 Gestational Age (Fetal Age 5 weeks)
Generally from 6 ½ -7 weeks is the time when a heartbeat can be detected and viability can be assessed. A normal heartbeat at 6-7 weeks would be 90-110 beats per minute. The presence of an embryonic heartbeat is an assuring sign of the health of the pregnancy. Once a heartbeat is detected, the chance of the pregnancy continuing ranges from 70-90% dependent on what type of ultrasound is used. If the embryo is less than 5mm CRL, it is possible for it to be healthy without showing a heartbeat, though a follow up scan in 5-7 days should show cardiac activity.

                                                                goodluck

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Hi,
New to the group...Had Ultrasound yesterday when I thought I was 9wks, LMP 2-21-08, but the U/S showed a sack with (what I think is something in it) to be about 5 wks. Could not confirm fetal pole and no heartbeat.
The only saving grace is that I have a late period every other month, and I know that March was a late month. There is one day 3-18-08 that I know things happened without protection, so If I ovulated 12 days late I could be 5wks 3 days.
Has anyone had a close experience???
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