5wk 6d no Fetal Pole or HB any help!

I went into ER last night because I was experiencing some cramping and light spotting. ( Never experienced it before so I was a bit worried) Tech did both U/S transV and Abdomen saw the yolk sac but no fetal pole and my HCG was 21,000.( Doc feels like at that HCG Level should see more) Was told that pregnancy may not be viable to come back to ER on Saturday to have a recheck of blood to see if HCG is increasing. Has anyone had this happen at this point and still had a healthy baby? I am trying not to google too much and be encouraged but feeling kind of down because I really want this pregnancy!

I think this early there is enough variation that it could be okay. When I was 5w3d in my first pregnancy, there was no fetal pole yet, just a yolk sac, and it was fine. That said with my current ivf pregnancy we were able to see a fetal pole and heartbeat at 5w6d. I have also had ultrasounds in pregnancies at just exactly 5 wks (due to cramping and to make sure it wasn't ectopic), where we saw just an empty gestational sac--that ended up being DS2 (and they weren't concerned because that's generally all you see at 5 wks 0d.) Unless you did IVF or something and know EXACTLY how far you should be, a couple of days makes a huge huge difference this early, it's good to see a yolk sac so you know it's not a blighted ovum. (For it to be a blighted ovum, there would be no yolk sac even.)
Even with opk's you could have possibly ovulated a tiny bit later than you think.
You are better off having an ultrasound again in a few days to a week to reassess viability over bloodwork, once your numbers are that high, while they should still increase, it's not going to be the normal exact doubling times. And just a few days can make a big difference between what you will see on ultrasound.

Also with my second pregnancy, my hcg numbers got really high, really fast, but that doesn't mean I was farther along then I was...(that was an IUI pregnancy so we were fairly certain of my dating although not as exact as IVF), there is just such a huge range of normal, I wouldn't panic over the numbers being high with no fetal pole just yet and I would also caution you to not take whatever your repeat numbers are too seriously either way (unless they are dropping.)

Good luck, fingers crossed for you!

Hi Pink- I am pretty sure I ovulated on Jan 1 I use Ovusense along with CBD Sticks to confirm O. They said I was measuring 5w6d and according to LMP i would be 5w5d. I just looked up what that would be and its 5w4d so I guess it is kinda early I am going to wait until Feb 12 for my 1st appt with my NP to have another scan but will be returning the ER on Saturday just to check my HCG levels to see if they are increasing. Fingers Crossed this is a sticky bean!

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Originally Posted by 2blue1pink

I think this early there is enough variation that it could be okay. When I was 5w3d in my first pregnancy, there was no fetal pole yet, just a yolk sac, and it was fine. That said with my current ivf pregnancy we were able to see a fetal pole and heartbeat at 5w6d. I have also had ultrasounds in pregnancies at just exactly 5 wks (due to cramping and to make sure it wasn't ectopic), where we saw just an empty gestational sac--that ended up being DS2 (and they weren't concerned because that's generally all you see at 5 wks 0d.) Unless you did IVF or something and know EXACTLY how far you should be, a couple of days makes a huge huge difference this early, it's good to see a yolk sac so you know it's not a blighted ovum. (For it to be a blighted ovum, there would be no yolk sac even.)
Even with opk's you could have possibly ovulated a tiny bit later than you think.
You are better off having an ultrasound again in a few days to a week to reassess viability over bloodwork, once your numbers are that high, while they should still increase, it's not going to be the normal exact doubling times. And just a few days can make a big difference between what you will see on ultrasound.

Also with my second pregnancy, my hcg numbers got really high, really fast, but that doesn't mean I was farther along then I was...(that was an IUI pregnancy so we were fairly certain of my dating although not as exact as IVF), there is just such a huge range of normal, I wouldn't panic over the numbers being high with no fetal pole just yet and I would also caution you to not take whatever your repeat numbers are too seriously either way (unless they are dropping.)

Good luck, fingers crossed for you!

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:agree: THIS! Great answer, agree with every word.

Doctors do us no favors with this kind of talk because there are a lot of pregnancies in this situation that work out just fine.

try not to panic till you have reason to. :heart:

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Originally Posted by Alliwantisblue

Hi Pink- I am pretty sure I ovulated on Jan 1 I use Ovusense along with CBD Sticks to confirm O. They said I was measuring 5w6d and according to LMP i would be 5w5d. I just looked up what that would be and its 5w4d so I guess it is kinda early I am going to wait until Feb 12 for my 1st appt with my NP to have another scan but will be returning the ER on Saturday just to check my HCG levels to see if they are increasing. Fingers Crossed this is a sticky bean!

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I'm a sonographer. At 5w4d I wouldn't really expect to see a fetal pole. Bonus if it's there, but normal if it's not.

Measuring a gestational sac is not very accurate. (One of the doctors I work with won't consider gestatational sac "dating" at all.) It is seriously teeny tiny, less than a millimeter off can change the "dating" by days or even a week. We only do it for a general idea of how far along the pregnancy should be when there isn't a fetal pole yet to measure, so if we have a gestational sac measuring like 8 or 9 weeks, and no fetal pole, then our doctors would be concerned. For dating purposes, measuring the actual fetal pole/embryo is much more accurate, so it measuring 2 days ahead doesn't mean you were actually 5w6d by any means. A gestational sac with a yolk sac that's 5w4d is exactly where it should be. Good luck, fingers crossed for you!
I'm sorry you have to wait a couple more weeks for another ultrasound, but I do know doctors like to be cautious and schedule them later than sooner so they have a better idea of what to tell you (ie. not seeing a heartbeat at 8 weeks is very concerning unless dating is way off, not seeing a heartbeat at 6 weeks gets iffy...)

Very similar happened to me. They weren’t seeing anything and it worried them. When my HCG came back really high (I forget the exact number), they were super concerned it was an ectopic pregnancy. Went back a couple of days later. Turned out my HCG was so high because I was having twins! One ended up not developing much further beyond the sac but the other one was a healthy full term baby. :)


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Went back to recheck levels and hcg only rose a little over a 1000 doctor immediately wanted to have me scheduled for D/C. I think I may wait not sure just trying to be strong so hubby doesn’t break too! I’m more than sure I’ll sneak and cry when no ones awake tonight 💔

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Originally Posted by Alliwantisblue

Went back to recheck levels and hcg only rose a little over a 1000 doctor immediately wanted to have me scheduled for D/C. I think I may wait not sure just trying to be strong so hubby doesn’t break too! I’m more than sure I’ll sneak and cry when no ones awake tonight ��

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I don't want to give you false hope but I don't trust hcg numbers when the levels get that high. It does balance out at some point and everyone is different. It didn't drop. I personally would definitely make sure to get another ultrasound in about a week prior to doing a d&c, if you chose to go that route. I have seen some pretty crappy ER doctors, honestly I'm not impressed that they were trying to schedule you for a d&c with a rising hcg. (And honestly, they should always give you an option to miscarry naturally. If a pregnancy is truly not viable there still isn't any harm in waiting for a "natural" miscarriage at this point. Obviously it's not okay to wait 10 weeks or something, but there's no reason to schedule a d&c right off the bat, here, even if it is an inevitable miscarriage.)

I am still keeping my fingers crossed for you. Sorry you are going through this. Are you having any more cramping or spotting?

Hcg slows right down after it reaches around the 6000 mark so as 2blue1pink says I would definately be asking for another scan in a week or so from the last, possibly longer if you're not bleeding. Good luck and everything crossed all is well [emoji1696]

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Thank you I am not having anymore spotting a few cramps here and there but nothing devastating. I am going to see if I can get another U/S on the 1st and then if nothing is seen wait until my appt on the 12th to decide what steps I’ll take.