5weeks~no fetal pole? should i be concerned?

[Hoping4sumBBdust]

Hi, I am posting here before I post in my TTC forum. We have been trying to get pregnant for quite some time, and have primary infertility. April 2nd was LMP, and I took Clomid 100mg days 5-9 On CD 30, I had a negative HPT with ovulation being day CD 17 CD 31, I went into the ER for extreme pelvic pain, was informed I was pregnant. I also had a ruptured ovarian cyst that an u/s revealed.

Also during that u/s the ER doc said he couldnt find a pregnancy anywhere, so I was sent to radioolgy. Radiology said the same thing, and I was told to have a follow up, because they didnt see a pregnancy in my uterus or an ectopic. So today I had my followup. The ER doc made me feel like I should have NO hope whatsoever, so I kind of dont.

Today, at exactly 5 weeks since LMP, my HCG is just over 1,000...... not sure what the numbers were in the ER. The doctor came in and she said congrats, and gave me a big hug *nicest doc ever* When doing the u/s she found the gestational sac, but no fetal pole I dont know if I should be worried. Is it just too early to tell? I have to go back on Wednesday, but feel optimistic, very, very, very caustiosly optimistic.

All I keep coming up with when I google it is a blighted ovum, and dont know if I could deal with another pregnancy loss at this point.

So, to all you pregnant mamas out there, can someone please help me understand when a fetal pole should be present? We want this to be true so badly, but are so fearful. All I want is to see that lil bean on the moniter, and hear a heartbeat. Any words of wisdom?

[lilylove]

I'm sorry, I don't really know the answer to your question. But I couldn't read your post and not offer a hug. : I hope tomorrow's u/s is good news!

[Finch]

I got this (bolding mine) :

Week 5 - Gestational Age (Fetal age 3 weeks)

Development
The gestational sac is often the first thing that most transvaginal ultrasounds can detect 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. <snip>

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.

http://www.americanpregnancy.org/pre...evelopment.htm

Just try and think positive for right now, there is a VERY good chance it was simply too early yet.

[sunflwrmoonbeam]

I'm about 5 weeks right now too. Keep in mind the embryo is only the size of a grain of rice. I've heard that it's normal to not see the embryo at this point, but that it'll show up later.

[paniscus]

I agree with what Finch found - I am FAR from an expert and I only have my personal experiences to share.

I had a blighted ovum and the ob determined it stopped growing some time in the 5-6 weeks time frame because of how the fetal pole looked (I don't honestly remember the specifics - I was too in shock at the time). I feel like he said there wasn't one but I don't honestly remember.

So based on that, which matches what Finch found, I would say it is just too early to tell. It sounds like the dr. found exactly what she would expect to find at exactly 5 weeks.

I will be thinking of you tomorrow.

[Stayseeliz]

I was sent to the ER with DS to rule out an ectopic pg at 5w. They did an u/s and didn't find anything to suggest a pregnancy but a thickening of the lining of my uterus. They said to prepare for a m/c and I could start trying again right away. I was devastated!

They were totally wrong. It was just too early to see much at 5w. DS is a happy, healthy almost 6yo today. I wouldn't worry too much just yet!!

With this pg I had my first u/s at 6w4d and could barely see anything but a tiny beating heart. Don't despair! it's really early!!

[MySunflowerBoys]

I just had something similar happen. I am 5 wks 6 days. I went for a dating sono a week ago, because my LMP was March 19, but I didn't get a +OPK until April 11. According to o date, I was 4 wks at the sono, but 6 wks according to the LMP. All they found was a gest. sac. My beta's were 1613, the dr considered that low, since she said I should be 6 wks. She had me coome back yesterday for another beta test & this morning they called & said it was 5793 so that is a good sign that things are progressing well. I go in for another sono on May 14. I think they will adjust my dating & give me a due date of Jan 2 if all still looks good.

Hope all goes well with your tiny one and you get some reassurance soon. The waiting is the hardest thing!!!!

[Hoping4sumBBdust]

Thanks to all of you for all your responses.... knowing that I am not the only one going through this makes me feel so much better. I would really write more, but can barely stay awake, plus I have a doc appt. bright and early. I will let you all know how my #'s look, as well as the u/s Again, thanks

[pampered_mom]

Originally Posted by MySunflowerBoys

I just had something similar happen. I am 5 wks 6 days. I went for a dating sono a week ago, because my LMP was March 19, but I didn't get a +OPK until April 11. According to o date, I was 4 wks at the sono, but 6 wks according to the LMP.

I wish they wouldn't be soooooo attached to the LMP dating. It's so arbitrary!

[paniscus]

Any news Hoping4sumBBdust???

:

[Hoping4sumBBdust]

Well, I had my appointment today, and my numbers went from 1,094 to 2,634 in since Monday, so thats a good thing. I have another appt on Wednesday, the 16th. This time I had another doctor - thats how the military is, and they told me i should follow up with my RE.

She did say today, because I had used Clomid to get preggers, and I never really have "normal" cycles, maybe I am only 4 weeks, 2 days, instead of 5 weeks & 2 days. But my LMP was April 2nd, and I O'd day 16..... so I am still 22dpo today.

There was still the gestational sac, but no fetal pole. Hopefully by next week, there will be a yolk sac. Thanks ladies for all your words of encouragement. This is a stressful time.

I really feel like they pushed the 1st ultrasound, and all they're doing is worrying me. By my calculations, I should be 5w, 2d EDD Jan 6th. No one else I know has had 3 u/s in less than a week? Grrrrr, the frustration. Please say prayers for a sticky bean, I have had 2 m/c's in the past, and worry greatly. Thanks again ladies

[paniscus]

When I had the blighted ovum my numbers didn't change at all - not up or down. So I would say that is a *very* good sign.

Btw, I am dealing with a military birth also. I am so at tricare right now. I spent all morning yesterday getting the pregnancy test for the referral (you don't need an appt you just walk in - oh, wait, no you needed an appt for that but it looks like we can get you in in just 3 hours) Then the rest of the morning dealing with tricare (well, yes, cnm are technically covered but the mtf won't authorize it).

Oh, and I am due 1/6 also.

[Belleweather]

I'm jumping in from the december community... with a EDD of either 12/31 or 1/1, I never know where I belong...

But I had an ultrasound at 5 weeks as well that showed a gestational sac and a yolk sac that measured small, with no fetal pole. I also had the rudest, most unhelpful ultrasound tech ever in the whole wide world, who was so negative that DH and I walked out of the hospital crying, and SURE that we were going to lose this baby. We tried for 18 months with help to concieve DS, and this was a suprize miracle baby and we were devestated.

My midwife calmed us down and refered me to a chart that said at 5 weeks, 0% of ultrasounds showed a fetal pole, and at 6 weeks only 86% did. She felt that given that our dates were pretty much just a best guess, that this was not the end of the world. We did a couple of beta hCG tests, which were doubling appropriately and showed good levels, so I was told to consider myself pregnant until proven otherwise. We're going to do another U/S around 8 weeks, but so far so good... continuing symptoms, good beta numbers, no bleeding.

I'm really starting to feel like early ultrasounds for 'dating' purposes do more harm than good... when I was freaking out, a friend linked me to a babycenter page where the original poster was freaking out about the same thing that happened to both of us and there were 14 PAGES of "Me too!" replies. Most of them came out okay, which I found really reassuring.

Hang in there. I think we'll both be okay.

(The chart is here: http://www.childbirth.org/articles/EUE.html Sorry, I don't know how to make the URL pretty)