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Thread: Early pregancy with size concerns

  1. #1
    Join Date
    Sep 2011
    Posts
    3

    Default Early pregancy with size concerns

    Hello,

    I have PCOS and have been trying to get pregnant for a year and half. I was taking metformin and progesterone, i have an irregular cycle, but ranging over 30 days, usually about 32. I was supposed to start on clomid this cycle, but we got a positive pregnancy test. I went on Monday to test Beta HCG at 5w2d, and it was 439.3, which I was told is low. I went today at 5w4d for u/s and the endometrium was 13mm and the gestational sac only 2.5mm. I was told it's not a good sign, but it's not conclusive. They said I shouldn't take meds for fixing the pregnancy, as they can't tell if it's viable yet. I'm supposed to repeat Beta next monday and u/s on tuesday, so at 6w2d and 6w3d respectively.

    I need some advice, as I am freeking out and thinking only the worse. My symptoms are constant, nausea, fatigue, headaches (even migraines), sore breasts, cramps. I had light spotting in the past 3 mornings, but at he u/s they didn't see anything on the probe.

    Thank you and hope to hear back soon!

  2. #2
    Join Date
    Sep 2008
    Posts
    151

    Default

    Dear SalseraLoca,
    Congratulations on your pregnancy! You have already accomplished the most important diagnostic test. So regardless of how this cycle turns out you're in a much better position knowing that you can conceive. Don't overlook the importance of this fact. That said, I would not give up on this pregnancy. Since this was an "unmonitored cycle" it is uncertain when you actually ovulated and when implantation took place. Although you are dating your pregnancy rather precisely based upon your last menstrual period; women with PCOS that begin ovulating on metformin do not do so as predictably as you might think. So although I do not know your complete medical history nor do I have any idea on the experience or the quality of the ultrasound unit; I would remain cautiously optimistic. The reality is that there is not anything that can be done to improve your chances except for maintaining positive thoughts, making healthy choices in your diet and lifestyle. So try to keep your stress level low and let us know how things work out. We're all hoping for the best.

    Best thoughts,
    ~Robert

    Robert Greene, MD, FACOG

  3. #3
    Join Date
    Sep 2011
    Posts
    3

    Default

    Dear Dr. Greene,

    Thank you so much for your prompt response. I'm am much calmer now, and i will hold out for the results next week to see how it goes. The spotting stopped, so i'm hoping that's a good sign. I will post some news after next week's beta and u/s.

    Best regards,
    SalseraLoca

  4. #4
    Join Date
    Sep 2011
    Posts
    3

    Default

    Dear Dr. Greene,

    I'm writing again with a heavy heart. I've repeated the beta measurments yesterday, at 6w2d and another U/S today at 6w3d. Beta was only 1026, which I realize is small. From my own calculations, if it were rising by at leat 60%, it should have been at least 1600 by now. At the U/S the doc was only able to see a gestational sac of 0,3cm and with imprecise contour.

    The spotting continues, on and off, but a few drops every day. I'm afraid the inevitable is close. He didn't say anything definite. He told me it doesn't look good and to repeat betas another week from now, so next Monday and to come back for a 3rd u/s next Tuesday.

    I'm thinking of getting a second opinion, mostly on if it's worth to take a progesterone, such as duphaston or utrogestan to help out, or if I just should leave it alone and let nature take its course. I didn't take any meds so far.

    But I'm sad also because the doc said I should wait 6 months if I misscarry before trying to get pregnant again and starting back on Metformin and possibly Clomid.

    Can you please advise either way?

    Thank you so much,
    Alex

  5. #5
    Join Date
    Sep 2008
    Posts
    151

    Default

    Dear Alex,
    I am so sorry that this pregnancy has not been working out as you had expected. Unfortunately, I do not know nearly enough about your history nor that of your partner to begin offering specific advice. I can remind you that however this pregnancy works out; you can at least be encouraged by the fact that you conceived. That alone improves your prognosis of achieving a healthy pregnancy. Sorry that I can't provide you with more specific guidance.

    Best thoughts,
    ~Robert

    Robert Greene, MD, FACOG

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