7 weeks no sac on ultrasound, afraid of miscarriage

[kassiek1228]

Hey everyone...so I know there are a few threads out there relating to this sort of thing but my case is a little different so I wanted to put everything out there to see if anyone had any input.

Well, I am definitely pregnant, taken about 10 tests, all positive, bloodwork positive, etc. Only symptoms I have gotten were tender/sore breasts, acne worse than normal, frequent urination, hungry a little more often and fatigue. No morning sickness or anything like that.

Well I went for my first ultrasound (vaginal) at 7 weeks. Prior to having it done I had to do a urine sample, which emptied my bladder a little. When I did the U/S, the doctor (and I) didn't see anything. No heartbeat/no sac. The doctor was very concerned and said this wasn't normal and was almost positive it was going to be a miscarriage. She did a blood sample to test the hormone levels and such and said she will call me tomorrow to let me know if they increase. If not, she wants me to come in Monday to get it taken care of.

I haven't had any signs of a M/C, no bleeding, no large amounts of liquids or pain.

I took a pregnancy test today just to see what it would say and it says I am still pregnant and the pregnancy line actually showed up darker than the control line.
This was going to be my first pregnancy and I was very excited and all I have been doing is crying on and off waiting to find out the results.

Any input would be helpful.

 

[jtr2803]

Is it possible that you aren't as far as you thought? I booked an early scan today and advised they don't like doing then at 7 or under because just a few days can make a huge difference?

 

[kassiek1228]

She wanted to accept that as an option, but we were pretty sure. My last dated period was October 14th

 

[Olivia2]

Did they check your tubes to make sure the pregnancy wasn't tubal? Are you saying they couldn't see anything in the uterus? Was your scan transvaginal or abdominal?
Hope you get some answers soon and bub is quiet happy hiding away in your uterus.

 

[kassiek1228]

They just did the transvaginal and yeah it showed nothing inside, completely empty. I hope so too...I hate playing the waiting game .

 

[WantsALittle1]

Do I understand correctly that your test line has JUST become darker than the control line? If so, then you could be very early indeed. A gestational sac cannot be seen until around 3 weeks after conception (5 weeks LMP for someone who ovulates around CD 14), and my test lines overtook the control line at 14 DPO, a full week before any sac would have shown on ultrasound. So if you ovulated later than you thought, it could simply be too early for anything to show.

A few more questions to help narrow it down--

When was your first positive home pregnancy test?
When do you think you ovulated?
Do you mind sharing the dates and levels for the hCG blood tests you had done?

FWIW, my home pregnancy tests weren't getting darker with my son around 12 DPO, so I went in to see my OB. He did an ultrasound even though I told him that I was only 12 DPO. When the ultrasound showed no gestational sac, he said that it didn't look good, was definitely a chemical pregnancy and told me to go home, take a hot bath, and drink some wine. I knew I was pregnant, so I didn't. When I called him the next day and asked for a beta, he said, "Why? You're not pregnant. I'm sorry, you miscarried." My first beta came back at 32. He said a single beta didn't mean anything. However, when the second beta came back 4x higher than the first, he ate his words. My "chemical pregnancy" was born 34 weeks later

 

[Spudtastic]

Do you know when you ovulated? With this pregnancy I did not ovulate until day 26 so when I went in for my 7 week ultrasound we only saw a 4 to 5 week sac with nothing at all in it. There was no baby and no fetal pole. Nearly three weeks later I went for another ultrasound and there was a baby with a hb measuring 8+1. That put me at 5+4 for the scan that showed a 4 to 5 week sac. I'm currently 34 weeks pregnant.

I would encourage you to wait and see another couple of weeks.
There is always a possibility of a miscarriage and I am sorry if this happenss to you but I think giving things a chance is important.

 

[kassiek1228]

my HCG was at 384 at on the 18th of November. If I remember correctly, I was ovulating around November 2nd ish time area. My first positive test was November 11th and it was a very faint line. Took tons more, all more prominent, but not too crazy dark (idk if that actually matters). I haven't gotten my results back yet from yesterday but as soon as I do I will definitely post them.

 

[WantsALittle1]

If it was 384 on Nov 18th then I would expect a sac to be visible by now. My understanding is that a sac should be visible for hCG between 1000-2000 mIU/mL according to the APA website, and with the time that has elapsed since the first beta, the level should be above that range by now. There could, however, be something structural in the uterus that's preventing the ultrasound from showing it.

The easiest way to look at what your hCG is doing while waiting for that second beta is via HPT progressions. I.e if you compare the test from today to the test from yesterday--is it darker or lighter? (It has to be the same brand, taken with the same concentration of urine--FMU or SMU are the best).

I know it's so hard to wait for these answers to come back, and it is a great sign that there has been no cramping and bleeding. Doctors don't know everything, and sometimes we simply defy their expectations. Wishing you the very best hon, please keep us updated

 

[Smirn]

My bloods came back 16500 and they couldn't se anything the 6 days later there was a baby and heart beat x

 

[WantsALittle1]

Smirn, they didn't even see a sac?

 

[Smirn]

They saw just a black hole

 

[WantsALittle1]

A black hole is what the appearance of the gestational sac would be--it shows up as an anechoic structure in the uterus

If anyone is interested in the numbers, according to this website, a gestational sac is expected from an hCG of ~2000 onward. They wouldn't expect to see a yolk sac until hCG reached 5000-17000+ and they wouldn't expect a fetal pole until 25,000-47,000+

https://www.babymed.com/blogs/dramos/which-serum-hcg-level-should-you-see-pregnancy-ultrasound

 

[Smirn]

Well the only saw the back hole (sac) and I was 16500!!! Even the doctor to me it wasn't good

 

[Scout]

Regarding previous posts about hcg, I also think it depends on how far along you are, bc hcg can vary so widely. Mine at 4w6d was 18,762, but my OB didn't do an ultrasound bc he said he wouldn't expect to see much as I was too early regardless of what my hcg was. He waited until I was 6 weeks and everyhting was there and measuring right on track.

Good luck, hun. Do you know if you have a tilted uterus? I"ve read that can make it hard to locate a pregnancy until later on. Hope everything turns out okay for you.

 

[WantsALittle1]

Smirn, wish your doctor had been more reassuring rather than causing you worry. I hate it when they do that! Seeing just the gestational sac is totally normal for that stage. For some, hCG has to be well over 17000 before a yolk sac or FP is visible.

My OB had me all worried this pregnancy, told me that baby's heartrate was too low at my 6+4 ultrasound and freaked me out. I spent 10 minutes on the internet when I got home and found out that it was a totally normal heartbeat for the gestational age I was at.

 

[kassiek1228]

So my doctor called me and she said that my HCG did increase from the first time to 16000 I believe. That was good news to me but she still seemed concerned. She said that is normal for what would be a 6 week pregnancy and that even at that stage she still would have been able to see something. I went back today to get more blood drawn so she can compare and I find out Monday if it increased some more.

 

[WantsALittle1]

kassiek, that's a great second beta! I put your numbers and dates into a doubling time calculator (https://perinatology.com/calculators/betahCG.htm) and it got 71.36 hours.

Past a level of 6000, doubling time can be 96 hours or greater (look here: https://www.countdowntopregnancy.com/tools/beta_doubling_calculator.php), so the 71.36 hours could be totally normal, if not great! The only issue with that number is that it's averaging over a much longer time period (weeks instead of days) so there could be some longer doubling times mixed in with some faster ones, leading to that average of 71.36 hours. But still, it's not over 96 hours, so the odds are the levels are increasing just fine.

There are so many reasons why they may not have seen the sac--a uterine structure, tilted uterus as Scout mentioned. Looking forward to your next betas, and I'm hoping they will see something on your next ultrasound!

ETA: Kassiek, when you say they saw no sac, do you mean gestational sac or yolk sac? I only ask because I've been operating on the understand that they saw no gestational sac.

 

[Monkei]

Was it an abdominal or transvaginal ultrasound at my 6 week scan there was nothing just a yolk sack two weeks later a baby with normal hb so don't give up hope xx

 

[laila 44]

Hmmmm. That is quite odd. Sorry you are going through this but st this point I think I'd be most concerned about an ectopic pregnancy. Did your dr check your tubes thoroughly? Often with ectopics there can also be what appears as a "pseudo" sac in uterus. By the time hcg hits over 2000-5000 a sac can be seen on ultrasound. Hope u get answers soon xx