Pregnancy of unknown location

Mum100-blog-IVF-pregnancy-unknown-location-ectopicBehind one of these doors is a pregnancy. It is not a viable pregnancy, our doctors insist. Something is still growing inside me, however. We’re in a land beyond strange.

The diagnosis of miscarriage is now a pregnancy of unknown location. They suspect ectopic again, due to low but fluctuating beta-HCG levels, which have tripled since they diagnosed miscarriage. They say the pregnancy is most likely in one of my fallopian tubes or ovaries. However, they cannot find it on the scan. I guess this is good news – the pregnancy must be small, so there’s less immediate risk of rupture. There is some internal bleeding in my abdomen, which the consultant says may be coming from a tube. This isn’t as drastic as it sounds, however, the medics have assured us.

I’m not sure what I’m feeling – sad? angry? detached? – I don’t know. This latest turn is so unexpected, but we’ve both come a long way since our embryo transfer in understanding we aren’t in control of this. We accepted the loss at 6 weeks 5 days, when we were told it was definitely a miscarriage. Two days later, we said our goodbye in Southwold. I went to Fertility Fest and felt so much love from people, as well as all the amazing support online.

Then, last week, the beta-HCG rose from 282 to 647 – still unviable numbers, no change there. The next day, I had very painful cramps. I laid down in bed with a hot water bottle. I was certain the miscarriage was happening and I felt some relief. Friends online gave helpful suggestions. There wasn’t much increase in bleeding, however. I had some shoulder tip pain, which we were told can indicate ectopic pregnancy. We went to hospital, where I was examined and tested. The beta was up again, 840 this time, but the doctor could not detect a mass.

I have to admit something here. I know it is utterly foolish. I felt a flicker of hope in hospital, when the beta rose again. What if the doctors have got this all wrong? What if there is a viable pregnancy? I know, I know – the verdict is clear from all the doctors – but logic has nothing to do with my desire for a child. It is a primal surge of love I feel, when there is any sign of life at all. I can’t help but feel hopeful, happy.

Cue the Professor

Mum100blog_IVF_monkey_mind_baby_brainMy monkey mind, Professor Wilson, took over last night. He wrote out a summary of key results we’ve had so far. It makes him feel useful, plus it stops him throwing banana skins at me.

  • 10th May: double embryo transfer of 2 day-5 blastocysts – good quality, we are told
  • 20th May (10dp5dt): docs say IVF1 is a negative result – beta-HCG 10
  • 23rd May (13dp5dt): positive pregnancy test but unviable, they say – beta-HCG 37
  • 31st May (21dp5dt): suspected ectopic, referred to the Early Pregnancy Assessment Unit – beta-HCG 321
  • 2nd June (23dp5dt): diagnosis of incomplete miscarriage – scan shows small gestational sac in the uterus at 6 weeks, no yolk sac or foetal pole. I am told to stop Progynova and Cyclogest.
  • 7th June (28dp5dt): beta-HCG drops to 282 – diagnosis of miscarriage
  • 14th June (35dp5dt): beta-HCG is 647
  • 15th June (36dp5dt): beta-HCG is 840
  • 17th June (38dp5dt): gestational sac has gone from uterus. Diagnosis changed to pregnancy of unknown location. Doctors recommend methotrexate injection to dissolve pregnancy. Beta-HCG drops to 804.
  • I have been bleeding for 33 of the last 40 days – mainly dark blood, sometimes fresh.

What now?

On Friday we were given two options for “management” – that term sounds so clinical to me, but this is the language of science after all – objective, unemotional. This is where detachment is useful, I suppose, so doctors can make their decisions each day, without getting emotionally involved.

  • Methotrexate injection

I feel so much aversion to this. Methotrexate is a chemotherapy drug, used with ectopic cases to dissolve the pregnancy. They wanted me to have this injection on Friday when they changed the diagnosis, but I just couldn’t face it. I know it’s irrational but I don’t want to harm the life inside me. They say it’s the safest option but methotrexate also rules out trying for a baby for at least three months – because of the toxicity of the drug to developing pregnancies. And this paper says methotrexate can affect the number of eggs retrieved in IVF cycles, for up to six months.

My blood hormone level dropped again on Friday. Surely there is a possibility this will resolve naturally?

  • Surgery

The doctor said surgery presents greater risks than the injection to future fertility. There could be damage to, or loss of, a fallopian tube or ovary. They cannot find the pregnancy with the scan at the moment, so they may not find it with surgery either.

Mum100-blog-IVF-treatment-control-surrender-letting-go-peacePlease body, remember what you need to do

I have another blood test at 9am – we need to leave for the hospital but I’m dawdling. Dad 100 is telling me to hurry up and get in the car 🙂

I know the outcome is not up to me. I can only trust that this is exactly where we’re meant to be.

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11 thoughts on “Pregnancy of unknown location

  1. Poor you, you are really being put through the mill. Some really tough decisions to make while in such a difficult place emotionally. Wishing you the best for your physical & emotional health as you navigate this path. Sending love xx

    Liked by 1 person

    1. Thank you my lovely. We will get the blood results at about midday. We went to the fertility clinic this morning, after having blood test at Early Pregnancy Unit, to ask for some advice from a fertility doctor. However, we were told there are no appointments until October. So we’re trying to inform ourselves about fertility implications other ways. Thank you so much for your support. Means a lot x

      Liked by 1 person

      1. Good luck with the blood tests. Hopefully you will start to get a clearer picture of what’s happening / needs to be done in the immediate future. Sorry to hear you won’t be able to see a dr until October, that is such a long wait! 😦 fingers crossed you can get some answers before then. Best wishes xx

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      2. Thank you lovely. We’re going to ask our GP to refer us to another hospital, who have said they can see us much sooner. I think our current hospital are very overstretched. X

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  2. What a time you are having – you are so exceptionally strong – I can’t believe that you are having to go through all this and each moment there seems to be a flicker of hope in your heart but then the logic, intellectual side whispers to you. In like you I keep just hoping- I know what you mean about the injection and the surgery – it’s such a tough choice to make – hope results have shed some light for you today cx

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    1. I’m feeling really positive today. Just feel a lot of gratitude for everything in my life. It’s easy to lose sight of how good things are. Bloods went up again yesterday to 1147. They rescanned today but still couldn’t see anything – but the great news is they’re now backing away from methotrexate for the time being. They’re going to monitor closely for now. We’re seeing an ectopic expert on Thursday for a second opinion. I just have a really strong feeling today that we can handle whatever happens. X x x x x x x

      Liked by 1 person

    1. Thank you Nara. Strangely, it’s okay – intense, but okay. I have a sense that we’re getting close to resolution now – I’m hoping for a natural conclusion, so we can try again soon. If anything, all of this has made me even clearer about knowing I am meant to be a mum 🙂 thank you so much for you continued support, it means a lot x

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