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Indication of MISCARRIAGE, ECTOPIC PREGNANCY on late implantation of EMBRYO.

Resolved Question:

My age is 28y
Ivf
I had 2 Blastocyst embryo one was good quality and the other one was not very good ( the rating is according to the embryologist)

On Friday October the 17th, they transfer 2 embryo back, and both were Blastocyst (D5T)
I was asked to preform HCG blood test on the 28th and after the result the Dr asked me to have other test on the October 30 then Dr said more blood work is needed on NOV 4 and NOV 6.
There was dark brown spotting but not bleeding from Oct 25 for 5 days
Then I had light bleeding not my normal period bleeding from October 30 for 3 days the bleeding was coming throw with the brown spots ( Dr said this can be normal)

The blood result
I did my first HCG blood test on the OCT 28 ( 12DPT) result was 22.55
I did my second HCG blood test on OCT 30 ( 14DPT) result was 79.76
I did my third HCG blood test on NOV 4 (18DPT) result was 83.36

my doctor asked me to continue on my medication (aspirin,folic acid and 3 times a day cyclogest progesterone (pessaries)

Kindly explain to me can this be a late implantation of the embryos, early indication of miscarriage, ectopic pregnancy or there is a chance of normal pregnancy.

I am very confused of the results.

Category: OBGYN

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Category: Infertility Specialist
 23 Doctors Online

Hello,
Thanks for posting your query at DoctorSpring.com
Let me be frank with you.
The B HCG values are too low to belong to a normal pregnancy.
They are too low for even an ectopic pregnancy, and to differentiate an ectopic pregnancy from an impending miscarriage, the vital test is a pelvic transvaginal ultrasound scan.
If I had to pick an option , in the absence of a scan yet, I would go with an impending miscarriage, though it is heartbreaking news for you.
I would urge you to have a scanning at 5 weeks post transfer to know what is really the case.
All the best
Please feel free to discuss further.
Regards.


Patient replied :

I was told this could be late implantation , can this be the case and is there any chance I continue the pregnancy and have a baby ,


Hello,
Well, in medicine and science, there are always odds and percentages.
There is always a chance that the pregnancy might continue normally, however in my opinion they are very slim.
Chances of a miscarriage are way higher, that is how I would put it.
Take care.
Regards.


Patient replied :

Dear dr could it be late implantation , and how late can the implantation happen
kindly I'll do the BLOOD test on nov 6, what level of HCG would be good , kindly just tell me a number that would be good to see on nov 6



See, a Day 5 blastocyst would implant within a couple of days.
At the most, it could be late by another 3 - 4 days.
Even considering that window, I would not consider late implantation as a possibility.
On November 6, you would be 20 DPT, I would say atleast above 1000 is a reasonable figure.
I repeat, a scan will provide more information.
Take care.


Patient replied :

Now it is 20DPT, NOV 6th my HCG 113
Any advice


Hello,
I advise an ultrasound scan as soon as possible.
Please get back to me with the scan reports.
Regards.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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