This one is for those of you with degrees from Google U., Message Board U., Blog U., personal experience, or actual medical degrees in miscarriage.
Background facts facts:
Dec. 22: LMP
Jan. 7: LH surge (Day 16- normal for me)
Jan. 8-9: Ovulation (dates for this exercise will assume Jan. 9, to be conservative)
Jan. 20: Positive HPT (11 dpo)
Jan. 28-Feb 1: Moderate bleeding (19-23dpo)
Jan. 29: Ultrasound shows nothing except “maybe some thickening of the lining”
Jan. 29: Beta- 282 at 20dpo (Reference: Median- 837; Range- 29-10,000)
Feb. 2: Beta- 464 at 24dpo (Reference: Median- 3,328; Range- 144-28,000)
Jan-29-Feb 2: “doubling” time: 113 hours (Reference: Median- 39.58; Range- 12.46-311.62)
Since Feb 2: No bleeding, no cramping, some dizziness (normal pregnancy symptom for me)
Your assignment
Part 1: Present a hypothesis as to what’s going on here. Ectopic? Blighted ovum? Doomed embryo located in uterus? Other? Please show your work/explain rationale behind your hypothesis. Please pay extra attention to the fact that there was blood and now there’s not, but the HCG is still going up, if way too slowly.
Part 2: What should I be aware of going into Thursday afternoon’s ultrasound? I figure three things can happen. 1) He can see an ectopic; 2) He can’t see anything and “presumes” ectopic; or 3) He can see something in my uterus. Am I leaving out any other possibilities? What questions should I ask based on any of the above scenarios? What should I know about treatment options? (Wait for it to resolve on its own, D&C, methotrexate, anything else?)
I’m most scared of the uncertainty around option 2. I’m also terrified of being prescribed methotrexate since I’ve read the horror stories of people lying on the bathroom floor cramping, bleeding, and vomiting. I especially hate this idea since my doctor doesn’t work on Fridays and, while I can reach a colleague on Friday, I think I’d be stuck with the local emergency room (notoriously terrible) if there is a problem over the weekend.
Responses are due no later than Thursday, 3:00 p.m. EST. Partial answers permitted. Thank you for participating.
Updated to add: Thanks for all the responses so far. Keep ‘em coming! Also, to clarify: I *know* there’s nothing viable going on in there, so no need to hope for good news in the form of a quadrupling beta and a heartbeat or anything. I realize that even if I see those things, I am almost definitely just dragging out an inevitable miscarriage of a chromosomally abnormal fetbryo, like Kathy McC’s comment. Good news this week is a declining beta and, failing that, something definitively located in the uterus.
