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Thread: gestational sac "bunched up"?

  1. #1
    Join Date
    Jul 2011
    Posts
    6

    Default gestational sac "bunched up"?

    I am spontaneously pregnant after having twins 4 years ago through IVF. Because of my history, I have been monitored closely and all has been well until today. My first 3 hcg levels doubled appropriately, and I was seen at 6 weeks due to spotting. The ultrasound "looked great" and the baby's heart was beating. They determined the spotting was due to progesterone suppositories they placed me on as a precaution, which are irritating to the cervix.

    Before the spotting, I had been scheduled for an ultrasound, that happened to be 2 days after the great ultrasound. I decided to go ahead with it as I was still having spotting and wanted to make sure the baby was still hanging in there. The CRL was normal and heart rate was 135. But the doctor said the gestational sac is "a little bunched up" which she said means the gestational sac is measuring about a week behind the baby. She told me that this can end in miscarriage but she has seen it go onto healthy pregnancies as well, and that at this point the pregnancy "could go either way". I am supposed to return for an ultrasound in two weeks. She refused to give me any statistics and I am driving myself crazy. How I am supposed to get through the next two weeks?

    Have you seen this? Do you have any data about the chance of the pregnancy going on to be healthy?

    I would appreciate any insight you are willing to share. Thank you, in advance, for your time.

    Sincerely,
    Katie

  2. #2
    Join Date
    Sep 2008
    Posts
    151

    Default

    Dear Katie,
    Congratulations on your pregnancy. I find this often to be the case; someone having a spontaneous conception after previously needing IVF. I truly believe that for some people it is as their body needs to "learn" all of the steps necessary to successfully support a pregnancy that paves the way for future attempts. So pleased for you.

    Regarding the ultrasound findings, I have never heard of this "bunched up" description in any research study nor in any textbook. I do not know what your doctor may have been referring to. I can reassure you that several studies have determined that a regular fetal heart rate that is greater than or equal to 120 BPM is very reassuring. So unless your doctor has something more specific which is causing their concern; I would remain cautiously optimistic. Keep following all of your prenatal instructions and rest assured knowing that you've already achieved several important milestones; conceiving, implantation, early development, etc.

    Please check back and let us know how you are in a couple weeks.

    Best thoughts,
    ~Robert

    Robert Greene, MD, FACOG
    California IVF Fertility Center

  3. #3
    Join Date
    Jul 2011
    Posts
    6

    Default

    Dr. Greene,

    Thank you for your response. Sadly, I lost the baby one week later at 8 weeks. I am devastated, to say the least, especially after seeing such a strong heart beat. I am trying to move forward and I just want to do whatever I can to prevent miscarriage in the future.

    I have read portions of your blog regarding nutrition. This is of special interest to me as doctors have gone back and forth on diagnosing me with PCOS. I have had the appearance of polycystic ovaries on ultrasound, although none of the other symptoms of the syndrome. I do, however, ovulate and have regular cycles on Metformin. I also find it curious that I became spontaneously pregnant after losing 30 pounds. I am now currently 120 pounds and 5'4".

    My question, is in regards to your post involving the importance of vitamin D3. I have been tested for this and been very low in the past (I think my numbers where 14 when they should have been between 50-60). I have been taking a supplement of 1000 IU prior to getting pregnant. While pregnant I was taking a prenatal that had 400 IU and I have stayed on it since the miscarriage. While trying to get pregnant again, should I be getting more D3? Do you have any other suggestions?

    Warm regards,
    Katie

  4. #4
    Join Date
    Sep 2008
    Posts
    151

    Default

    Dear Katie,
    I am so very sorry to learn of your loss. Having experienced an early miscarriage with my own wife as we went through treatment; I do know how disappointing this can feel.

    I am not able to give you specific advice on what may or may not reduce your chance of this happening again. I would need to know your full history as well as your partner to begin to even formulate an opinion. There are many suggestions of steps which could be helpful--like the use of vitamin D3--but without knowing if they would apply to your situation it would be too easy to mislead you.

    I encourage you to continue reading and asking questions. This can be a difficult journey but a good outcome is well worth the effort.

    Best thoughts,
    ~Robert

    Robert Greene, MD, FACOG

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