6 wk us no yolk sac and egg quality question

[kristine625]

I have a couple of questions for you guys...   I am 39 years old.  I had two miscarriages last year (8 wks and 4 wks).   We have always gotten pregnant after one or two tries.  We started seeing a specialist who conducted every test in the book, including the dye test, and found nothing that points to reasons for the miscarriages.  So we are trying progesterone suppositories, baby aspirin, pre-natal vitamins, two additional mg of folic acid a day and 50 mg of thyroid meds a day.  Now, we are pregnant again.

I went in for an ultrasound on Tuesday (exactly six weeks pregnant) due to some brown spotting.  They said this spotting is quite common with the progesterone.  The spotting started at 9:30 a.m. and quickly subsided and stopped at 5:00 p.m.

The scary thing is they saw the gestational sac but no yolk sac or fetal pole.  He said the yolk sac starts developing at 5 1/2 weeks so he is concerned the pregnancy isn't progressing as it should.  I have scheduled another ultrasound on Monday (six weeks and six days) to decide on viability.

How concernd do you think I should be that we didn't at least see the yolk sac at six weeks???

My other questions is, I understand that my age plays a huge factor is getting quality eggs.  How can we increase quality of eggs??  We didn't do the HCG shots- would that increase the quality of the eggs?

Any opinions would be greatly appreciated.  Thanks guys.

[rubyinparadise]

I'm so sorry for what you are going through. The decision to miscarry naturally or have a D&C is a really tough one. I miscarried naturally at 10 weeks and it was very painful, and took several days. I do not regret it, because I was so incredibly emotionally sensitive at the time that I couldn't have handled dealing with a hospital ER, strangers doing the procedure, possibly not being kind or sensitive about it, etc.

I just felt a strong need to stay at home and go through it privately with my husband.

Do your doctors say that there is any risk associated with miscarrying naturally in this situation?

If I had known it was painful and took so long, I may have opted for a D&C instead. It is one of those  decisions where there is not really any "great" option. I am really sorry-- it isn't something I would wish on anybody.

[JJP1111]

Hello all,
My wife and I have been trying for another baby for the past 3yrs.(since our first and only successfully living child) to no avail. My wife is 36yrs. old now, and we realize age is a factor more now than when our healthy child was conceived 4 1/2 yrs. ago. But right now, we would want nothing more than to be blessed with a healthy baby. A year and a half after our child was born, we tried again, and we had a miscarriage within 6wks., then we tried a second time and she became pregnant but after 5 1/2 mos. into the pregnancy, doctors told us that this pregnancy had major abnormalities associated with it. Doctors strongly suggested we terminate fetus/"evacuate" what was inside(which was our baby)--needles to say, we agreed to the procedure and this episode in our lives was extremely traumatic. It took a long while to heal and recuperate physically, socially, and mentally. After a year, we started to try again with no success, until just recently this past June we found that my wife was about 5wks. pregnant. and initially we wanted to jump for joy, but we restrained ourselves just in case of probable complications. The problem we had though is that my wife was experiencing dramatic, severe pain this time(similar to what she had experienced during the third pregnancy). So we went to the doctor and they ran the ultrasound and to all of our surprise, they found an 8 wk. sac but with no fetus(or any indication of a baby)--completey empty--not even any blood flow. So we feel clueless and helpless now. So now the doctors strongly suggests we evacuate the remaining contents inside my wife once again and we're wondering should do this? What are the risks? Is there something wrong with my wife's eggs or my sperm? Should we get tested? Should my wife evacuate the contents or just suffer through this agonizing pain and allow the body to naturally deposit the contents? PLEASE SOMEONE WITH SOME KNOWLEDGE ON THIS OUT THERE GIVE US SOME INFO AND HELPFUL ADVICE. We'd so appreciate it! We're at our wits end. We don't have any family history of this. The doctors have very minimal information to provide us...what should we do?

[usuk]

sorry about your loss. since you are having a D&C, i would do the tissue test. it's not any extra step or procedure and you may rule out some of the "what if's" which will only help you be more optimistic for the next time you TTC. good luck.

[kristine625]

Thanks Amanda,  how are you feeling??

I guess I'm wondering if people test the tissue from a d&c for peace of mind and closure, of if it would tell the doctor anything for the next preg.   My husband and I both had our chromosomes tested and nothing is wrong there.   If it came back abnormal, obviously it's too late to do anything for that pregnancy.   And my understanding is it doesn't necessarily mean the next pregnancy will be abnormal too, since it is such a random thing.

I will definitely ask next week if there is anything that can be done to prevent certain chromosomal issues.  I have heard of going to a genetic counselor but I have no clue what is involved in that.  And again, if we both test o.k. with chromosomes, then that kinda tells me there is nothing we can do....

[adgal]

I had D&C's with two of my miscarriages.  I did have the tissue tested, although nothing came back abnormal.  I guess for me, I just need to know.  That's just who I am.  It's why I personally want amnio...not because it would change anything, but I just need to know.  Other then that, no real answer for you, and in all honesty, for me no answer's were provided.  I wonder if they can do anything to prevent certain chromosonal issues?  I would be curious as to whether or not that is the case.  I am sorry you got the results you did, and I will keep you in my thoughts.  Amanda

[kristine625]

Hello girls.  I went for my second vaginal ultrasound this morning, the doctor once again saw an empty gestational sac.  I saw a different doctor (there are two in this office) because mine was unavail until Wed and I didn't want to wait that long.

It was nice to get a set of fresh eyes on the situation, but he suspects a blighted ovum.  He wants me to come back next week for one last us to confirm and then do a D&C to test the tissue.

I wonder what is the point of testing the tissue if it isn't going to tell us anything for next time.  I understand it may show us it was a chromosomal abnormality, which as we know is nothing we can prevent.  With my age, 39, it is quite likely this was the case.

Would you guys test the tissue?  And why?  Just curious.  Thanks again for all of your input.  It has been really great.

[kristine625]

My thanks again to you all for responding.  I appreciate you taking the time.  I will keep you posted.

[adgal]

You know, one of the things my OB likes to say is that there are absolutely no absolutes in pregnancy.  She doesn't even believe most of the stats.  Everyone is different, every situation is different, and I can tell you that having been on this forum a long time now, I have heard some incredible things happen.  Personally, I just don't read stats anymore.  I agree with some of the things the others have said...no matter what you see on that ultrasound next time around, do not do anything until YOU feel confident.  There is nothing wrong with waiting things out, seeing what happens and not being pressured into making a decision.  I am keeping my fingers crossed for you. Please update us as you know more.  

[oceanv]

Actually (in my case) my Doctor also thought that my dates could be off but since I opk'd and only had sex once that month I really was pretty sure to within 24 hrs.  Even late implantation wouldn't have made that much difference for me.

My theory is that either the ultrasound tech was brutal, or there's a lot of talk about tilted uteruses playing havoc with ultrasounds (which is what I had thought might be my problem but then I don't understand how you can see the sac, a cyst and a fibroid but just the embryo is missing because the uterus is tilted) or there were actually two gestational sacs, only the one was seen (empty) while the other one was hiding in the tilted uterus - does that sound crazy? and the brown spotting was the result of the empty sac. plus if the cervix is closed..not even sure if that theory is medically possible...I've spent a bit of time trying to figure this out and its unexplainable.

I really hope that your embryo shows up on the next scan.
Joanne

[YvetteY]

Hello....

Well assuming you know exactly when you ovulated and you LMP...you  should be seeing the yolk sac and fetal pole at 6 weeks.   Perhaps your dates are off?  I'm sure they wil have you come in again for another u/s.  Hopefully it will be developing at this point.   Otherwise this pregnancy may not be developing properly.   And I'd basically be concerned if I were in your shoes.   You can certainly hope that you will see what you need to see on your next ultrasound because there is hope that it could be there next time, so I wouldn't quite throw in the towel at this point.    

Basically you cannot do anything to improve your egg quality or quantity for that matter.   That's the big problem for most women, I'd say over 38 trying to get pregnant.   The quality just diminished over the years and rapidly starting in your 30s.  I don't care what anyone else tell you that is just the fact of the matter.  Of course this isn't true of all your eggs, because there may be a good one in there.   It's a matter of getting that good egg which in turn becomes a healthy embryo.   You've had your eggs with you since birth .so basically you're trying to get pregnant with 40 year old eggs.  

Hcg shot doesn't do anything to improve quality...all it does is helps to make sure you ovulated.   You obviously ovulated without it.    

I am known as the doom and gloom girl because I tell it like it is....it's just harder....however it can happen and it happens to many......you just have to keep trying....you are only 39 and you have plenty of good quality eggs left...it's just a matter of getting to the right one!  So hang in there!!!   And keep in mind in the back of your head that you are going to have to battle mother nature for this baby!!!    But in all honesty you've got a few good years left!  So don't give up!!!   I know this is hard and disappointing, but just keep your guard up during this process.   Good luck to you and take care.  

[7preg3b]

at 6 weeks with my last pregnancy it showed only the sac nothing else..  the following one showed everthing.  It is my opinion it just may be too early..  Its a waiting game.  and boy do I hate it.  

[kristine625]

Thanks again for all the comments. It is all helpful and please keep it coming if anyone has anything to add.

My ultrasound was transvaginal.  My LMP was March 3.  My LH surge was March 14.  We had intercourse only the 14th and 15th.

But I suppose there is a chance my body could have taken a little longer to fertilize the egg, thus making me not quite as far along as first thought (as amanda mentioned).

Thanks again to everyone and I look forward to hearing more comments.

[oceanv]

Hiya,

Hi had brown spotting, discharge. Went for an abdominal u/s (what type was yours?) they found the gestational sac and nothing was seen in it - this was 6w3d. I had a follow up u/s 10 days later and they found the baby (this was also an abdominal u/s).  Everyone on I think this list and my misdiagnosed miscarriage list said that it was way too early to see the baby at 6wks with an abdominal u/s. Turns out my Doctor thought that they had done a vaginal u/s (don't get me started on my Dr) so when she said that they are almost never wrong that's what she basing it on - she advised me they suspected a blighted ovum and that I should expect to miscarry within two weeks.  I live in Canada so they're pretty hands off (or mine seem to be) so nothing drastic was suggested to speed the miscarriage along. After doing some reading I would have tried to wait as long as possible before doing a d/c anyway (although mentally that is easier said than done i think.) Also, I don't know about you but my symptoms of pregnancy didn't change - didn't decrease so it was all a little confusing, we decided that we didn't really believe them and we'd see what the u/s said, although I don't know if that was false hope or what but what are you going to do anyway while you're waiting??.

All during this I would poas, and it would show as being pregnant.  My OB has decided to completely ignore the fact that I had the first u/s because we all agree that it was a gong show.  I don't want to give you false hope but I definitely would take my cues from my body I think.  BTW I am also 39.

I hope you get the result you desire at your second u/s but even if you don't unless you see something like the sac deteriorating or more signs of m/c I personally would not rush into a d/c but everyone has to make their own decision on that and all the waiting can make a person nuts.

[usuk]

Similar situation here. 3 MCs in a 11 months. Nothing showing up on tests which is good but also mental torture. My doc said it is really just about luck at dropping a good egg, you can boost your chances of fertilizing a good egg if you release more than one egg a month. Which Clomid might do. Injectables I think are better at producing multiple follicles and I may 'go there' next. Good luck and hang in there.

[kristine625]

Thanks for your input Amanda.  I greatly appreciate it.  Don't ya' just love the "wait and see" part?? Ugh.  I wish you the very best.  Your words really helped me a lot.  And do keep me posted on your situation as well.  Good Luck!

[adgal]

My gosh, our story is almost the same.  I feel like I am reading something I could have written.  I am in a similar situation right now in that I am waiting to find out if my pregnancy is viable. Also having brown spotting.  The difference is I am too early for an ultrasound, so it's HCG levels we are concerned about.  I can tell you what my OB told me yesterday, as it applies to your situation as well.  Even when we believe we know ovulation and conception dates, it is very easy to be off our dates.  We may ovulate later, have a longer implantation, or just "slow starters".  In the early stages of pregnancy, thinks can happen quickly, and just a day or two can make the difference.  Although it is true you should see a sac now, if you are not as far along as you believe, that could make the difference.  You are in that horrible waiting time, and I know how you feel.  Right now a week seems like months away.  Hang in there.  I have heard so many stories here where nothing was seen when they thought it should be, and a few days or a week later, everything changed.

As for egg quality, that is a tough one.  If I lose this pregnancy, it will be 5 in a row for me.  I too have had every test imaginable, including genetic testing between my husband and I.  The only advice my OB could really give me was to live as healthy a lifestyle as possible.  Also, to remember that we may not be getting the best quality eggs every month, but if we are still conceiving rather easily, that is a good sign.  Chances are if we keep trying we will get that healthy viable pregnancy we want so badly.  I don't believe HCG shots will increase quality, although I don't know that for sure.  I tried chlomid in an attempt to do that, as I have heard that can work. Talk to your OB about it.  

I wish you well, and welcome.  Please keep us posted.  Amanda