Saturday, March 28, 2015

High hCG and No Baby Seen? FORGET THE hCG! It's All About the Size of the Gestational Sac!

If you are being diagnosed with a blighted ovum just based on your hCG levels and no baby being seen, your doctor is wrong.

Let me repeat...

Your doctor is wrong!

If your doctor has not been telling you the size of your gestational sac, you need to ask.

Going to repeat again...

Blighted Ovum scare?  Ask the size of your gestational sac at each appointment.

If this is a blighted ovum scare, you don't need ultrasounds every two to three days.  This is self-defeating.  It'll leave you worried.  Gestational sacs need time to grow.  They don't grow much in two to three days.   If your pregnancy is indeed viable, your baby needs time to grow and be seen.  Give it a week. 

You can wait longer but, really, the waiting is torture, a week is fine.  Please, keep in mind, I had to go almost a month before finding a baby in my gestational sac and the sac measured 28.5mm.  At only 21.5 mm, it still looked empty.

I know you are worried but if there are no serious complications (i.e. threat of ectopic, infection, etc...) make sure your ultrasounds are scheduled one week apart. 

Also, so important, once that gestational sac is seen, hCG levels do NOT need to be taken.  They can rise, plateau or drop and this can still be a viable pregnancy.  I have talked to women whose hCG levels were over 100,000 before they found their babies.  I've talked to women whose hCG numbers seemed to plateau around 30,000 to 40,000 and then went on to find their babies.

So what should the size of the gestational sac be before a blighted ovum is suggested?
I love the UK's new guidelines.  I oft repeat them because these guidelines would do away with the majority of misdiagnosed miscarriages.

The gestational sac should measure at least 25mm before a blighted ovum diagnosis is even suggested. 

Want to know more about these guidelines?  I blogged on this last year:

Misdiagnosed Miscarriage? The UK Has Changed their Guidelines. Your Doctor Needs to Take Note

If you are in a pregnancy forum here online, share this page!  Yes, some women will miscarry but you may prevent somebody from ending their pregnancy while there still might be a viable pregnancy. 

The take away from this blog post.  If you have seen the gestational sac, stop focusing on the hCG levels.  Focus on the growth of the gestational sac

- and -

just to throw another wrench into the works...

And, Even More on the Unreliability of Ultrasound Measurements During the First Trimester

Your ultrasound tech may get a different measurement than another ultrasound tech.  For absolute certainty, if there are no complications, you may want to wait one week after the gestational sac reaches 25mm to verify the empty sac.

Yes, a blighted ovum diagnosis is one of the most miserable diagnoses you will ever receive.  The waiting is torture but a number of women have waited it out and found their babies.

42 comments:

  1. I am 5w4d and I went to the ER yesterday with heavy bleeding. My hcg level was 20000. The doctor told me it was a possible blighted ovum. I am going back in 1 week for another u/s. This is my 2nd pregnancy and I am so nervous. I hate the waiting game!

    ReplyDelete
  2. I am 5w4d and I went to the ER yesterday with heavy bleeding. My hcg level was 20000. The doctor told me it was a possible blighted ovum. I am going back in 1 week for another u/s. This is my 2nd pregnancy and I am so nervous. I hate the waiting game!

    ReplyDelete
    Replies
    1. Much too early to diagnose a blighted ovum. This may or may not end in miscarriage. Stay monitored but you should see the sac growing from week to week for there to be hope. (((hugs)))

      Delete
  3. Hi - I am hoping that I am in the same position as all you ladies.
    My last period was January 16, 2016, it lasted for only 1.5 days. I was having pregnancy symptoms so I took a home test 10 days before my next period was due and it came back positive. I had blood work done Feb. 25 and my levels were at 169. This is my second pregnancy and I started showing very early. March 17 I had an ultrasound (8+ weeks) but it came back saying they could not detect a pregnancy. I am being sent tomorrow for blood work. I am still having pregnancy symptoms, some nausea, vivid dreams, an expanding belly...my doctor thinks I have miscarried.... Could she be mistaken?
    Thank you, I appreciate any comments OE feedback

    ReplyDelete
    Replies
    1. I am so sorry you are going through this scare. Let us know what your hCG levels show. They really should see the sac and if your levels indicate that you are pregnant, this may be ectopic. (((hugs)))

      Delete
    2. Thank you for replying so quickly, I will let you know what I find out.

      Delete
    3. Hi Kay Suzanne - got my results back and my hcg levels are at 13, 099...which would mean I am only 5-6 weeks pregnant rather then the 9 weeks the doctor thought. What do you think?

      Delete
    4. I am being sent for additional bloodwork on Thursday to see if levels are increasing or decreasing

      Delete
  4. Hi, I went in for a ultra sound on Feb 29th and was told i was 5w4d gave me a picture if the sac with a little bean in it.. I had slip and fell yesturday and although only my back is hurting no sporting no cramping I decided to go to the e.r and have everything check out being in the safe side because I've had complications in the past. At first they did a reg ulta sound then went vag. They kept asking me are you sure your 8 weeks?? Finally the e.r doc came in and ask me the same question wanting to know why I thought I was 8ws. When I explain I had a picture he said that my sac measured 6weeks and They couldn't find a heart beat but my level were 20,000. That either I was earlyer then I think or I'm having a belighted ovum. I'm following up with my o.b. I've had a belighted ovum so I'm very aware what that means. But when I had on I bleed and cramped on and off. This pregnacy I haven't had any problem. Please give me some insight.

    ReplyDelete
  5. Hi, I went in for a ultra sound on Feb 29th and was told i was 5w4d gave me a picture if the sac with a little bean in it.. I had slip and fell yesturday and although only my back is hurting no sporting no cramping I decided to go to the e.r and have everything check out being in the safe side because I've had complications in the past. At first they did a reg ulta sound then went vag. They kept asking me are you sure your 8 weeks?? Finally the e.r doc came in and ask me the same question wanting to know why I thought I was 8ws. When I explain I had a picture he said that my sac measured 6weeks and They couldn't find a heart beat but my level were 20,000. That either I was earlyer then I think or I'm having a belighted ovum. I'm following up with my o.b. I've had a belighted ovum so I'm very aware what that means. But when I had on I bleed and cramped on and off. This pregnacy I haven't had any problem. Please give me some insight.

    ReplyDelete
  6. I am so sorry you have been going through this scare. Time is the only test of a blighted ovum. I do hope you've received your answer by now. (((hugs)))

    ReplyDelete
  7. Hello everyone.
    So I went to the Dr today for another ultrasound and was told I'm measuring 6 weeks and 2 days and it looks like I have a blighted ovum because they only see the gestational sac. I'm also measuring 2 weeks behind my LMP.
    They scheduled me for another ultrasound next Thursday and I also did more blood work.
    Last week I went on Wednesday the 6th and was told I was 5 weeks and 6 days.
    I also did blood work that following Friday.
    On Wednesday my HCG levels were 19,699 and Friday it was 24,902. They said that since my levels were not doubling that I probably did not have a viable pregnancy.
    They also did not test progesterone because they said that really did not matter.
    Has anyone experienced anything similar and had a successful pregnancy?
    I'm 31 years old and this is my 1st pregnancy.
    Thank you for the feedback.

    ReplyDelete
  8. Need help! So I'm 100% certain of ovulation date as I triggered and temped. Last week at what should be 6w6 we went, had a vaginal ultrasound and while hubby and I swear we saw something, dr said all there was was a gestational sac measuring 7w1 or 2.12 cm and a yolk sac, no baby. Just went today and I'm 8w0 and they found a baby but only measuring .53cm max which he said is like 6w2 with no heartbeat and a gestational sac of 7w3 or 2.32 cm. the presence of a baby gives me hope, but the slow growth makes me think the dr is right and I should have a dnc... What do you think? He's stopping my progesterone and baby aspirin which scares me if this is misdiagnosed miscarriage...

    ReplyDelete
  9. my daughter has had 2 u/s she was told at the first- twins each in a separate sac....no pole no heart beat...one gestational sac measuring a. 5 weeks b. 6 weeks...hcg ...5683...this week (2 weeks from first one) told 2 sacs..no change...both sacs at 5 weeks...hcg 55270.....told blighted ovum..expect to miscarry over the weekend? no signs? no spotting? no pain? no fever? she should be about 6 weeks..both u/s were vag ones

    ReplyDelete
  10. Hello. I'm going through the exact same thing. My last period was 3/11/16. So I went in last week for an ultrasound and they said I had a blighted ovum. They drew hcg levels first one resulted at 71,000 two days later it resulted at 79,000. They said that confirmed it was a blighted ovum. I've had no signs of miscarriage and I feel extremely pregnant. I decided to wait a few weeks to have another ultrasound. I was wondering how it turned out for you?

    ReplyDelete
  11. Is it rue that blighted ovum can only happened once?

    ReplyDelete
    Replies
    1. Not true at all but if you are having D&Cs before nine weeks, you can't be sure they are truly blighted ova.

      Delete
  12. Hello Ms. kaye, I am more than 8 weeks pregnant based on my LMP April 1,2016. I visited my OB on June 1, i had the UTS with a gestational sac of 1.22cm but no yolk sac and heartbeat,my hcg is 18,681 mIU/ml. I had an ongoing medication with cyclogest and crinone 8% BID to increase my progesterone coz i had spotting for 2 weeks with a brownish color,but after 2 wks medication my spotting is gone and my progesterone increased to >40ng/ml.My First UTS on May 10 was no gs seen,only 3 fibroids are seen. On May 15, my OB found gs measuring 0.53cm via transvaginal uts, after 3 days May 18 another trans Vaginal uts had been made with 0.61cm. Its difficult for them to find out gs through abdominal uts, but when i came back after 2 weeks June 1,2016..My ob can able to see clearly the GS via abdominal uts,but not yolk sac and heartbeat yet.I have an appointment after a week for another uts.I am so much worried because 2 years ago I suffered from a blighted ovum and it made me scared a lot. My OB told me maybe I miscalculated, I guess I just ovulated late and having an early pregnancy,and not exactly 2 months pregnant that I thought. My hcg keeps on doubling every 3 days. When I read the stories here in your site,I feel hopeful for a viable pregnancy, no signs of miscarriages, a little bit nauseous but morning sickness is gone. Im still keeping a good faith, and hoping for the best,in Jesus name.

    ReplyDelete
  13. Hi,

    Had first ultrasound at what should be 7 weeks yesterday. GS measured 6w5d. Sac looked normal but no fetal pole or yolk sac. Got told to take blood test and another ultrasound in a week.

    Hcg came back 75000 which seems strong and doctor told me not to stress out yet.

    I've had no bleeding and light cramping here and there.

    Anyone experience anything like this and have hopefully a positive outcome.

    Trying not to stress.

    ReplyDelete
    Replies
    1. Hi going through ough exact same thing. What was th e outcome of your pregnancy?

      Delete
    2. Hi going through ough exact same thing. What was th e outcome of your pregnancy?

      Delete
  14. Hello and sorry for my english.
    In few words: i am pregnant in 7w 3d. (hope i still am) LMP 25.12.2016
    31 days HCG 1500
    34 days HcG 4900
    6w ultrasound: emty gestational sac- dr diagn. blighted ovum.
    6w4d Ultrasound again: emty gestational sac- again diag. blighted ovum and prop urgent D&C
    6 w3d HCG: 38400
    2 days after HCG: 47400, dr. said it didnt double, not even 60% procent, again prop. urgent D&C.
    since 6w brown spotting.
    i received treatement with utrogestane and duphastone, folic acid and vitamins.
    7w1d: ultrasound with another dr: little embrio, not beeing sure about fetal cord.
    i have to wait another few days to repeat US.
    Is there any hope for me?

    ReplyDelete
  15. Hello and sorry for my english.
    In few words: i am pregnant in 7w 3d. (hope i still am) LMP 25.12.2016
    31 days HCG 1500
    34 days HcG 4900
    6w ultrasound: emty gestational sac- dr diagn. blighted ovum.
    6w4d Ultrasound again: emty gestational sac- again diag. blighted ovum and prop urgent D&C
    6 w3d HCG: 38400
    2 days after HCG: 47400, dr. said it didnt double, not even 60% procent, again prop. urgent D&C.
    since 6w brown spotting.
    i received treatement with utrogestane and duphastone, folic acid and vitamins.
    7w1d: ultrasound with another dr: little embrio, not beeing sure about fetal cord.
    i have to wait another few days to repeat US.
    Is there any hope for me?

    ReplyDelete
  16. At 7 weeks 4days g.sac measures 25 mm with no fetal pole and hb doc said it is blighted ovum

    ReplyDelete
  17. Hi there,

    I had a miscarriage last August so was over the moon to find out in March that i was pregnant again. I should be 8 weeks and 1 day pregnant today.

    However, I went for an ultrasound on Thursday (should have been 7 weeks, 6 days then) but only an empty gestational sac was found, no baby, fetal pole or heart beat. I was told then that they should see something that far along so it was most likely a failed pregnancy.

    Went to my doc the next day who told me that the sac measurement put me at 5 1/2 weeks pregnant, which is almost impossible as i know when my last period was. She had my hcg checked and my levels came back at 38,000, which is normal for 6-8 weeks pregnant. But at that level they should have seen something in the sac. She said it was all very strange, and because of the small size of the sac (20mm-from memory), the date of my last period and the high level of hcg she told me its most likely a molar pregnancy. Its an extremely rare condition, but the numbers dont add up and its the only explanation.

    She also said my hcg levels wouldnt be that high with a blighted ovum or normal miscarriage. I never thought Id be sitting here today hoping that it is 'just a miscarriage':(

    I have had more blood tests done today and go back monday to find out the results. If my hcg levels havent doubled, she said she would need to refer me to King Edward hospital to have a D&C and testing done to check that its not malignant (as a molar pregnancy is a tumor)!

    On top of that I also wont be able to try for children again for another 6 months to a year which is absolutely devastating as time is not on our side.

    I had a laparoscopy at the end of last year to have endometriosis on my appendix removed...could this have something to do with it? Ive read stories about scar tissue and a tilted uterus affecting ultrasound results?...

    Has anyone been through anything like this that can give me a little bit if hope or advice? Has anyone experienced an empty sac at their 8 week ultrasound
    And gone on to have a healthy pregnancy?

    I suffer from an anxiety disorder as it is and this is almost unbearable. Absolutely devastated :(

    ReplyDelete
    Replies
    1. My gestational sac looked empty at 8 weeks. If the gestational sac is growing from week to week and not yet measuring more than 25mm, it is too early to diagnose. (((Hugs)))

      Delete
  18. This site is helpful but the size of the sac makes me nervous. My LMP was March 13 but my periods are 31-36 days. Husband and I took ovulation test on our honeymoon, I got a positive March 31. I got a positive early pregnancy test April 10. Went in for our first ultrasound April 25th and only saw a gestational sac. My HCG was 8K. HCG two days later was 13K. Second ultrasound was May 10 and were told the baby was only measuring 6w but they did see a fetal pole and yolk sac. We were told to get a D&C as it was 100% miscarriage. I just couldn't wrap my head around doing that since we had seen growth.

    Got a second opinion yesterday (May 15) and a heartbeat was visibly detected but could not be heard yet. Sac again measuring around 6w (one tech said 6w5d, one said 6w0d). HCG 65K, progesterone 21.5. Baby was .33cm. Dr said he is not optomistic but we should wait it out another week.

    This is challenging because the baby should be 8 weeks but is measuring 6 weeks and has continued to measure 6 weeks for a week. BUT we are seeing growth and we now see a heartbeat. Sigh. Anyone had something similar to this?

    ReplyDelete
  19. Hi everyone! So I went in for my first us appt of Wednesday 12/13. I was supposed to be 8w1d. Tried to do abdominal but tech said she couldn’t find the baby, only the sac. She then did a TV ultrasound and she said she found the gestational sac, yolk sac but no fetal pole. I was so shocked. I was not expecting that! The doctor came in and explained that I may have miscarried. I have no symptoms of miscarriage, no pain, no bleeding etc. she informed me I could get prescribed a pill to onset miscarriage, or schedule a dnc. I suggested that possibly inovukated later than the 14th day as my surge didn’t come through until the 16th day and could’ve ovulated two days after than which would only make me seven weeks. She said my sac measured 2.8cm which was about 8 weeks and we should see a baby there. I asked if we could wait. She said yes, asked me to take hug blood tests that day and Friday. My numbers were 113k on Wednesday and only 130k today. Should I be worried it didn’t double? I have a second ultrasound scheduled for next week. Please help! I’ve seen so many great outcomes here and hope that I am one of them!

    ReplyDelete
    Replies
    1. Your numbers look fine. The best thing that can be done, if there are no complications, is to wait a week for a follow-up ultrasound to verify. A week gives everything more time to grow and be seen if the pregnancy is viable. Really your numbers could rise, plateau, or drop at this point and be normal. (((hugs)))

      Delete
  20. Hi, I'm about 6w4d. I went into the ER last night for cramping and morning sickness. I've missed five days of work due to not being able to get out of bed. They did a scan and showed a 6 week empty gestational sac. Sent me home with zofran and told me to follow up with my obgyn. Now this morning I call and let them know I was seen last night at the ER and was recommended to follow up today. The receptionist blew me off. Now about ten minutes later I went into the restroom and found fresh blood on the tissue. I call the doctor back and they ask me to come in. Now my hcg was leveled at 37,565. Now seeing all of this and feeling my uterus he says it's enlarged and with no sign of developing embryo he pushed for a d&c immediately scheduling me tomorrow @ 1pm. He said he'll again do a transvaginal ultrasound to check for signs of development and if nothing is seen we are to proceed forward. Now reading these posts gives me hope. I'm scared and I don't want to kill any chance of this baby or babies. What do i do.

    ReplyDelete
    Replies
    1. I am so sorry you are going through this. Many things can cause bleeding during good pregnancies including sex, bowel movements, and internal exams. You are really early. The most important thing to do, if there are no complications, is watch the sac from week to week. If it is growing and not yet over 25mm, it is too early to diagnose a miscarriage. (((hugs)))

      Delete
    2. I'm very pleased to let you all know...they performed another transvaginal ultrasound and they found our baby. Showing a steady heartbeat of 128 beats per min. I'm so overjoyed and exhausted with emotion from the news. This has all been a roller-coaster for me and I'm just glad it has a postive outcome!

      Delete
    3. Oh yay! I am so happy for you! Thank you for the update. Have you shared your story on The Misdiagnosed Miscarriage. I will help so many women. If you'd like, I can share your two posts or you can type up your story. Again, congratulations!

      Delete
  21. Good day
    Yesterday I went started bleeding and called the Dr immediately and she said I should come in. The bleeding started as Brown when I wiped and became red with clots. My Gynae checked me and said everything is fine, the sac was there and the heartbeat also which was 99bpm she said m 6w1day and I thought (according to my app) that I am 7w1day. I raised this and she said I should not worry about it its just one week difference. She also prescribed Utrogestan 200mm x2 for me to swallow twice for 3days then 1 daily from the forth day. When she did the scan she said she saw plenty of blood but the medication will help it come out, otherwise everything is fine and the fetus is okay. She took urine just to test if maybe I have an infection and also took blood to see what blood type I am. I just can't stop thinking of the bleeding that I am experiencing as it is as if I am on my period, I am going after 2weeks to see if everything is still okay. Is all of these normal or I should be worried more?

    ReplyDelete
    Replies
    1. I am so sorry you are going through all of this. Hard to say what is happening. There are other reasons women bleed during a pregnancy so it is hard to say what is happening. Please, stay closely monitored. (((Hugs)))

      Delete
  22. Hi,

    My LMP was 18 March and my ovulation date is 5 April. My cycle typically around 31-36 days. I went for doctor check up on 30 April and doctor saw a sac ( virginal scan) and confirm I am pregnant about 5 weeks. I was happy like a bird as this is my first pregnancy.

    My next cehck up on 12 May, doctor did varginal scan but we can’t see anything , except the sac is growing bigger , there is no fetal, no york, no baby, is an empty sac! I was shock as I do not have any cramps or bleeding, I don’t understand how this can happen. Doctor told me not a good news, she said we should see something at 7 weeks, she schedule me for HCG test and come back again 2 days later for another cehck up.

    Two days later doctor did another scan and same outcome, can’t see anything even HCG level has up from 7700 to 50,000 but She told me I should make a decision to pass out, I just couldn’t believe it. I asked if that’s possible my date is wrong, is that positively my uterus is titled that’s why we can’t see the baby? She said not possible, she even show me another person early pregnancy scanning to proof it should see a fetus and York Sac at 7 weeks. I said I still have another HCG test taken this morning, should we wait for it, she is not positive but since already went to lab then ok. I told her I need to discuss with family before any decision, she said we can wait for another week.

    My third HCG result was out in afternoon and it increased from 50000 to 57000, it seems a goodnnews for me to keep the hope. We decided to get second opinion and will see the new doctor in next Monday. I has been doing online searching to find similar conditions like me, I saw some positive condition and feel better, I really hope next week check up can see the baby. Nervous and worry but still keeping hope.

    ReplyDelete
  23. Hi Spring. Sounds like this is still too early to know. I do hope you have gotten better news. (((hugs)))

    ReplyDelete
  24. this is very informative and very hopeful! how does finding a fetal pole and a fetal heartbeat play into all of this? (is that what is meant by "find the baby"?)

    My HCG is on track. My sack had a yolk but no pole, but the tech said the sac was really small so probable needed some time. (I think my first son was also behind the sac size curve in the begining as they pushed my due date back 2 weeks from LMP.)

    I was told that with my HCG levels a fetal pole SHOULD be seen (around 9,000 and going up each day), but this blog makes me think otherwise and gives me hope :) Thank you for any additional information.

    ReplyDelete
  25. Hi. I went to er because my apoiappoint was too far out and was just feeling off. My last period was on 5\31 and according to that I should be around 9weeks 4 days. They checked my hormone levels and they are 9600 but sac measures 6week 3 days. I haven't had cramping or bleeding but doctor thinks I may be trying trying to miscarry. He also said there may be twins. They have to do a Sono Thursday this week and I'm scared. Has anyone else heard or seen anything like this?

    ReplyDelete
  26. I tested positive on December 10th of 2018 which should make me 9 weeks. I went to the Er as my insurance won’t let me get in to an ob until at least 2/1. I had an ultrasound & it does not look good. They found a 22.5mm gestational sac but no fetal pole, saying it measured at 7 weeks 1 day. They told me that It’s a blighted ovum and that I should come back in 3 days to test my hcg and see if there’s hope, it’s currently a little above 40,000. He said there is a slight chance baby is just behind and too small to see, but that he was pretty confident it would end up as a non viable pregnancy. I am so scared!! Is there really hope at this point or am I crazy to not just accept it? I have endometriosis and have had two surgeries in there, no mention of a tilted uterus or anything. I just don’t know what to think because by 7 weeks there should be at least a fetal pole visible, right?

    ReplyDelete
  27. I have being on blog Sites for a while now and today I felt like I should share my story because I was a victim too. I had HIV for 6 years and i never thought I would ever get a cure I had and this made it impossible for me to get married to the man I was supposed to get married to even after 2 years of relationship he broke up with me when he finds out I was HIV positive. So I got to know about Dr. Itua on Blog Site who treated someone and the person shared a story of how she got a cured and let her contact details, I contacted Dr. Itua and he actually confirmed it and I decided to give a try too and use his herbal medicine that was how my burden ended completely. My son will be 2 soon and I am grateful to God and thankful to his medicine too.Dr Itua Can As Well Cure The Following Disease…Alzheimer’s disease,Bechet’s disease,Crohn’s disease
    ,Cushing’s disease,Heart failure,Multiple Sclerosis,Hypertension,Colo_Rectal Cancer,Lyme Disease,Blood Cancer,Brain Cancer,Breast Cancer,Lung Cancer,Kidney Cancer, HIV, Herpes,Hepatitis B, Liver Inflammatory,Diabetes,Fibroid, Get Your Ex Back, If you have (A just reach him on drituaherbalcenter@gmail.com Or Whatsapp Number.+2348149277967)He can also advise you on how to handle some marital's issues. He's a good man.

    ReplyDelete
  28. I am supposed to be 6 weeks and 4 days. The sack is 2.5 cm, my HCG is 55,000, and there is definitely something in the sack but doctor seems very concerned that there hasn’t been a heartbeat. My HCG has been doubling every 2 days and sack is getting bigger. Should I be preparing myself for a nonviable pregnancy?

    ReplyDelete