Just a Reminder: IVF Pregnancies Can Be Misdiagnosed as Miscarriages Too!

Every so often, I like to do a search of the web for new misdiagnosed miscarriage stories.  What a difference a bit of time makes.  Fifteen years ago, there were no misdiagnosed miscarriage stories online.  Now?  Do a search and you'll turn up pages of stories.  Plus, you'll find many on The Misdiagnosed Miscarriage site.  

I cannot even begin to count the number of IVF pregnancies misdiagnosed as miscarriages.  Often doctors are quicker to diagnose an IVF pregnancy because they are sure of the dating.  What many are still not taking into account is that the tilt of the uterus can change dating.  Add into that human error and caution should always be taken when receiving this diagnosis.  Yes, there are many women who miscarry after IVF but there have also been quite a few who have been misdiagnosed.

Take a look at one of the web's newest stories:

How My Daughter Became A Rainbow Baby To Herself

Want to read more about misdiagnosed miscarriage diagnoses after IVF?  I wrote this page several years ago:

Misdiagnosed Miscarriage After IVF

If you are being diagnosed as having a miscarriage after IVF but other signs look good (e.g. gestational sac growing even if it looks a bit behind) and there are no complications, ask for another ultrasound a week out.  As with other pregnancies, if the gestational sac is growing and not yet more than 25mm, it may be too early to diagnose.  

(((hugs))) to anybody going through this scare.

Diagnosed With A Miscarriage? A New Study Shows You Really Should Consider a Second Opinion

For years, we have been trying to get the word out that you should always be 100% certain before having your pregnancy ended after a miscarriage misdiagnosed.  Hundreds of misdiagnosed miscarriage stories on the The Misdiagnosed Miscarriage site as well as many more found during a quick Google search certainly make that point.

A study conducted by a Mayo researcher finds that 88% of patients seeking a second opinion end up with either a new opinion or a revised opinion. 

 The Value of Second Opinions Demonstrated In Study

Of course, those high numbers may be because we only seek a second opinion when we are not totally comfortable with the first opinion.  I think often there is something in us that realizes something does not quite feel right.

What does this mean for you and your diagnosed miscarriage?  If you are being pushed to end your pregnancy due to an impending miscarriage, ask yourself these questions:

• Is there an immediate need to end the pregnancy (e.g. infection, ectopic, etc...)?
• If you are being diagnosed with a blighted ovum, is the gestational sac more than 25mm?
• If the sac is not yet more than 25mm, is it growing and is there a reason you can't wait a week to verify it is not still growing?
• Are you comfortable with this doctor and this doctor's diagnosis?

If the answer to these questions is no, you may want to either discuss the wait-and-see approach or find a new doctor.  If you do decide to wait, please, stay closely monitored.  While many women go on to find those heartbeats, many women do not.  If there are any signs of complications, please be seen immediately.

Want To Know With 100% Certainty That This is a Blighted Ovum?

If you have been told you have a blighted ovum but are worried because you've heard or read about all the women being misdiagnosed with a blighted ovum, there is a way you can be certain before letting the doctor end your pregnancy*.

 If you are not yet nine weeks along and your gestational sac is growing but not yet over 25mm, there is still hope.

A few things to remember:

• One ultrasound is NOT enough to diagnose a blighted ovum
• Your ultrasounds need to be at least one week apart to really see if there is growth
• Measuring one to two weeks behind is common in many viable pregnancies (it's the equipment, not you!). 
• Generally, the gestational sac will measure more than 25mm by about nine weeks.  Diagnosing a blighted ovum earlier than nine weeks is just too early.
• If there is a yolk sac this is NOT a blighted ovum.  Doesn't mean your pregnancy can't end in miscarriage but, generally, one week after the yolk sac is viewed, the baby will be seen if the pregnancy is viable.

I get quite a few women messaging me or posting just to ask if they might be misdiagnosed.  Because I am not always able to respond promptly, I can give you my answer before you even post:

If you are not yet nine weeks along and your gestational sac is growing but not yet over 25mm, there is still hope.

*if you do not feel your doctor is doing enough or you feel pressured to end your pregnancy, seeking a second opinion might be a good idea.

Dropping hCG Levels Do NOT Always Mean a Failed Pregnancy

Over the years, I have seen a few reasons doctors are more apt to misdiagnose a miscarriage.    A growing, empty-looking gestational sac is probably the most common reason behind a misdiagnosed miscarriage.  Measuring a week or two behind during the ultrasound causes many to be misdiagnosed as well.   Women with high hCG levels and no baby is seen is another.  These are all topics I have covered here on my blog.

Another fairly common reason a viable pregnancy is misdiagnosed as a miscarriage is because the hCG levels either plateau or drop. 

Before I begin, let's just state the obvious.  Yes, dropping hCG levels can be a sign of impending miscarriage but not always.   Let's look at some examples of misdiagnosed miscarriages because of dropping or plateauing hCG levels.

The first group of women are usually very early in the pregnancy and their levels are still under 1,000.  Mary's story (click on the links to read these stories) is a perfect example.  Not only had she had IVF so doctors were certain of dating, her levels started off low and had very slow doubling times.   Mary went through several weeks of being told her pregnancy was non-viable before finding the heartbeat.  She went on to have a beautiful baby boy.

In this same group of women, we have InGodsTime story.  The first hCG draw showed a level of 25.8.  Three days later it had dropped to 24.  The doctors told her to expect to start bleeding soon.  They were wrong and she has a baby girl now to prove it :) 

Why did these women have hCG levels that started off slow or even dropped?  Over the years, we've seen on the site that dehydration seems to play a role.  You need to stay hydrated but don't overdo the water either.  Illness may also be a reason.  Whatever the reason, we've had numerous stories of levels plateauing or dropping very early on and women went on to find their babies.

A caution though, slow-rising, declining or 'bouncing around' levels may indicate an ectopic pregnancy.  For this reason, you need to stay closely monitored until a gestational sac is viewed.

The second group of women have levels that slow down after they reach 1,000.   Let me just state first of all, this is normal.  I have talked about typical levels on my The First Trimester and Non-Doubling hCG Levels page.  Before they reach 1,200, they can double in two to three days and be in normal range.  Between 1,200 and 6,000, they can double in three to four days and be normal.  After 6,000 they typically slow down and we've seen a number of women whose hCG levels plateaued between about 30,000 and 50,000 and did not go any higher.  This is normal.

Cherbear's story is a fairly typical one.  Her hCG levels went up to the 70,000s, slowed and started dropping.  Her doctor diagnosed a miscarriage.  BelieveNPrayer has a similar story.  Her levels went up to the 40,000s and started declining.  Both women were misdiagnosed with a miscarriage.

The Misdiagnosed Miscarriage site has many more stories like these.  What you need to take away from this blog post is that declining hCG levels do not necessarily mean a miscarriage.  In fact, after the gestational sac is viewed, many doctors no longer take hCG levels because they can go up, stay the same or go down and be normal.  The most important thing is to make sure they find the gestational sac and, after that point, watch the size of the gestational sac.  Doesn't even matter if it measures a week or two behind.  What you want to see is the sac growing from week to week.  If your sac gets to be more than 25mm and no baby is seen then you likely have your answer.

Just Because You Saw Your Other Babies at Seven Weeks Does Not Mean That Will Happen Every Time!

Over the years, I've been contacted by a number of women who are scared they have a blighted ovum because at seven or eight weeks their gestational sacs look empty.  They assure me they have seen their babies by this time in the past and, for that reason, they have no hope.  Yet, a number of those women ended up finding their babies with a strong heartbeats. 

Today's misdiagnosed blighted ovum story was shared with us by Fathi (her post can be found here:  misdiagnosed blighted ovum at 8+weeks ).  Fathi shares that at just over eight weeks, her doctor did not see her baby and was pretty sure it was a blighted ovum.  Rather than wait one week for a follow-up ultrasound, Fathi waited two and, yes, she found her baby. 

Fathi was surprised for two reasons.  First, she had seen her other babies well before eight weeks and second, she doesn't have a tilted uterus.

I've learned over the years that a tilted uterus does not always stay in the same position.  It can change from pregnancy.  Just because you did not have a tilted uterus before does not mean you don't have one now.  And, we know that with a tilted uterus, babies are often seen a bit later.  For this reason, as I've blogged many times e.g. Medical Researchers Are Warning that Viable Pregnancies ARE Being Misdiagnosed as Miscarriages, a blighted ovum should not be diagnosed before the gestational sac is more than 25mm.

And, yes, this is for women who have been told they do not have a tilted uterus as well.  As you can see from Fathi's story, even women with a non-tilted uterus sometimes have to wait to see their babies.

Don't expect to see your babies at the same time during each pregnancy.  Instead, focus on the size of the sac.  If it is growing and not yet over 25mm, you still have hope.  Usually this happens at about nine weeks or so.  

Thanks for reading!

Medical Researchers Are Warning that Viable Pregnancies ARE Being Misdiagnosed as Miscarriages

For more than ten years, we've been raising the alarm.  Too many women with viable pregnancies are being misdiagnosed as having miscarriages.  Many women have refused to end their pregnancies until they were 100% certain they were indeed going to miscarry and, as a result, many babies have been saved.

For years, doctors denied this was happening...despite the fact that we had already collected hundreds of stories at The Misdiagnosed Miscarriage.  All of that is changing.

This week, we have two new news articles on the problem of misdiagnosed miscarriages: 

Study: Viable pregnancies may be getting misdiagnosed as miscarriages

 

and

 

Early miscarriage guidelines should be improved, researchers say

 

and, of course, the study they are referencing:

 

Defining Safe Criteria to Diagnose Miscarriage:  Prospective Observational Multicentre Study

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If you are being diagnosed with a blighted ovum, here is our takeaway message:

 

- Is the gestational sac greater than 25mm? 

   

   If the sac is greater than 25mm, this may indeed be a blighted ovum.  My own gestational sac measurement 28.5mm before my daughter was found and I had had to turn down the D&C twice.  If this is your first ultrasound and there are no complications, one more ultrasound a week out might be a good idea to verify.

 

- If the gestational sac is not yet greater than 25mm, is it growing?

    

To know if the gestational sac is growing, you should space your ultrasounds out by a week to  verify growth.  As I've blogged, measurements can vary between techs but a week gives enough time to see some definitive growth.

 

- Are you more than nine weeks? 

    

We've just talked to too many women who were about nine weeks, myself included, before finding their babies.  I'm a firm believer that if a sac is growing a blighted ovum should NEVER be diagnosed before nine weeks.

 

- Is your doctor monitoring your hCG levels?

  

If so, stop!!!  Once the gestational sac is viewed, there really is no reason to monitor your levels.  Levels can go up and be normal.  Levels can plateau and be normal.  Levels can even drop and be normal.  Levels are good for confirming pregnancy and confirming this is not an ectopic pregnancy.  I can't tell you how many women I've talked with who were scared needlessly because their doctors kept monitoring their levels after the sac was viewed.

 

-  Have you seen a yolk sac?

   

If so, this is NOT a blighted ovum.  A baby is needed for a yolk sac to form.  That doesn't mean this can't end in miscarriage but it does mean this is not a blighted ovum.

And, during this time, stay monitored.  If there are any complications be seen right away.  In the meantime, space those ultrasounds out by a week each.  If you feel your doctor is pressuring you to end your pregnancy too soon, please find another doctor.  Although it is slow going, more and more doctors are accepting that they have been diagnosing miscarriages too soon. 

If you are going through this scare, ((((hugs)))) from somebody who has been there.

 

 

This Week a Misdiagnosed Miscarriage Baby Survived Misoprostol and Another One Survived a D&C -

Despite the fact that doctors tried to end two wanted pregnancies this week, two babies survived. 

I'm used to hearing about misdiagnosed miscarriages.  I hear a new story just about weekly and sometimes several in a week.  Can you imagine how many women never find The Misdiagnosed Miscarriage site and are misdiagnosed as well.  Misdiagnosed miscarriages are a big problem.  They can end a wanted baby's life. 

Even sadder, imagine how many women are incompetently diagnosed by these doctors and have their pregnancies ended?  It happens and it happens too often.

Today, I read two posts by two different women.  One woman was given Misoprostol to end her pregnancy. Her doctor scared her into a medicated miscarriage.

Note here:  if you are not 10 weeks or more and there are no obvious complications, many doctors are fine with you waiting out a miscarriage misdiagnosis. 

Anyhow, despite taking the medication, a week later, a baby with a strong heartbeat was found (for more on Anie's story:  told Miscarriage, Took Misoprostol. HB Found!!!

While continuing to read posts, another woman reported that her doctor diagnosed an ectopic, performed laporoscopic surgery, did not find evidence of an ectopic pregnancy so performed a D&C.  Imagine this mom's surprise when an ultrasound a few days later found a gestational sac complete with yolk sac (perfectly normal this early in a pregnancy  (for more on Beksmel's story:  Confused - Pregnant or not after laparoscopy and D&C for ectopic

There are no guarantees on these babies.  We've seen some babies survive these procedures and are just fine while others go on to miscarry later. 

I am just a firm believer that if there is no immediate need for a D&C before ten weeks, a woman should stay closely monitored and take a watch and wait approach.  If she feels pushed into ending her pregnancy before she is ready, she should seek out a second opinion.  Yes, some women will miscarry naturally during that time but others may end up finding their babies. 

Please, pray for these two women and their babies.  My hope is that they go on to have uneventful pregnancies.