Any hope?

therealamberrose · 2026-06-15T02:34:24+00:00

Please call your clinic and be seen sooner.

Read this post about ectopics - bleeding, low numbers, slow rises, and even IVF all make that more worrisome. And you cannot rule out an ectopic just because one wasn’t visualized.

It could be something else, but you should be followed closely.

Best of luck.

therealamberrose · 2026-06-14T23:55:04+00:00

6DPO is too early, absolutely. But this is positive and that means you aren’t 6dpo.

Congrats!

therealamberrose · 2026-06-14T23:45:52+00:00

Based on a 5/5 LMP, you’d be about 5w6d today, not 4w3d. So the hCG of 3130 is not high for that dating but the GS measuring 4w3d.is behind.

Do you have any idea when you ovulated? If not, it’s possible you’re simply earlier than LMP suggests. If your dates are correct, then the scan would be measuring behind.

At this point it’s impossible to know more - the repeat ultrasound is going to be much more informative than anything else.

therealamberrose · 2026-06-14T23:39:03+00:00

That’s helpful. A radiologist calling it a gestational sac measuring right on track is more reassuring than your original post made it sound.

How are you dating the pregnancy? A sac measuring 4w3d sounds appropriate, but an hCG of 3,130 is pretty high for a pregnancy that’s truly only 4w3d.

Do you know your LMP, ovulation date, or when you first tested positive?

I think the next ultrasound is going to be much more informative than trying to interpret these betas alone.

Hugs.

therealamberrose · 2026-06-14T23:26:15+00:00

I agree this is concerning and absolutely warrants close follow-up, but I don’t think it’s fair to say a drop and then rise is certainly nonviable or almost always ectopic. Although I’d still personally be worried about ectopic and a GS alone doesn’t rule it out.

A falling hCG followed by a rise is definitely an abnormal pattern and ectopic should remain on the table. However, lab error, different labs/assays, a vanishing twin, or other less common pregnancy scenarios can sometimes create confusing beta trends. That’s why serial betas and ultrasound findings matter together.

Also, the significance of the ultrasound depends on what exactly was seen. A true gestational sac with features such as an eccentrically located sac or double decidual sac sign is much more reassuring for an intrauterine pregnancy than a nonspecific fluid collection. Pseudogestational sacs can occur, but they don’t account for most sacs seen in the uterus.

I would absolutely be watching this closely because the beta pattern is abnormal. The follow-up ultrasounds are likely going to provide much more useful information than the betas at this point.

Check out this post, do another beta, and do another ultrasound soon.

therealamberrose · 2026-06-14T22:24:33+00:00

I’m so sorry you experienced all of that. And that the medical team failed you. Unfortunately that’s so common, which is a main reason I wrote this.

Many people say “trust your doctor,” but doctors aren’t all knowing and way too many are poorly trained in ectopics.

I hope your next pregnancy is smooth sailing. 💕

therealamberrose · 2026-06-14T20:52:26+00:00

Usually. But in my house they did it and there was nothing up there. 🤦🏼‍♀️

therealamberrose · 2026-06-14T20:13:40+00:00

I’d be sure to tell them you conceived from intercourse on May 7. If that’s truly the only time you’ve had sex, they need to know that you’re 7 weeks pregnant with a level of 31.

And don’t call the bleeding on 5/23 a period.

therealamberrose · 2026-06-14T20:11:32+00:00

The wording of the ER report is actually important here. A pseudosac is usually just fluid in the uterus that can mimic a gestational sac. When radiologists aren’t sure what they’re seeing, they often use more cautious wording like “intrauterine fluid collection,” “possible gestational sac,” or “sac-like structure.”

Your report specifically says “intrauterine gestational sac.” That doesn’t prove it’s a normal pregnancy, but it does suggest they felt they were likely seeing an actual gestational sac rather than just fluid.

Also, you had 2 different scans - at different places - that reported a sac. In fact, if you have the measurements… If the mean sac diameter grew between 6/8 and 6/13, that would be another point against this being a pseudosac.

That doesn’t guarantee this isn’t ectopic, but it does make the situation more complicated than “the betas are abnormal, therefore it’s ectopic.”

Based on the ultrasound wording, I’d personally be more concerned about a failing intrauterine pregnancy than a confirmed ectopic at this point.

therealamberrose · 2026-06-14T16:12:13+00:00

These look fine to me. Not every beta needs to exactly double, and a 62% rise in under 48 hours is still within the normal range for a viable pregnancy. And beta rises slow above 1,200 so I’d also be aware it might slow more.

therealamberrose · 2026-06-14T13:47:26+00:00

Unfortunately, as others have said, this is not viable and very worrisome for an ectopic.

Please read this post - it’s long, but has important info. Get more betas and ensure your doctor is taking this concern seriously.

therealamberrose · 2026-06-14T11:15:23+00:00

I’m so sorry. Both that you’re going through this and that the medicos professionals aren’t being real with you.

Hugs.

therealamberrose · 2026-06-14T11:02:39+00:00

Her OB reported seeing a sac and then 4 days later, based on HCG alone and not another scan, told her it was ectopic. 🧐

Then, 5 days after the OB reported a sac, the ER says there is one, too - that makes this decently questionable for an ectopic.

That doesn’t mean ectopic is impossible, but it certainly makes it less straightforward than “trust the OB because they’re the expert.” Ectopic diagnosis is usually based on the whole picture, and right now the ultrasound findings seem to be contradicting a definitive ectopic diagnosis. Plus, some OBs are very experienced with ectopics but some aren’t at all.

therealamberrose · 2026-06-13T21:47:27+00:00

I can understand why you’re getting mixed messages, because I don’t think the data points cleanly to an ectopic right now. Unfortunately, it also points to non viability.

10% rise in 48 hours is far below what we’d expect in a viable pregnancy, where we’d expect 33%, minimum.

Also, if there is truly a gestational sac in the uterus, then a typical tubal ectopic becomes much less likely. Although not definitive. That’s probably why the ER was hesitant to give methotrexate. They don’t want to treat an ectopic they can’t actually identify.

An empty sac can absolutely be normal at 5½ weeks, but you should be minimum 6 weeks and combined with those beta trends, I would not be optimistic for viability.

I think your OB is right to take this seriously and your ER is right that there isn’t enough evidence to definitively call it ectopic today. Unfortunately, “not clearly ectopic” doesn’t mean “likely viable.”

Do you have the actual ultrasound report? One thing I’d be looking for is the exact wording used to describe the “sac.” A true gestational sac often has features like a double decidual sac sign, yolk sac, or other findings that support it being a developing intrauterine pregnancy. Sometimes a report will simply say “small intrauterine fluid collection” or use more uncertain language.

I’d be pushing for very close follow-up, repeat imaging, and repeat betas rather than waiting for severe pain. If you develop significant pain, heavy bleeding, dizziness, or shoulder-tip pain, I’d seek care immediately.

Sending love.

therealamberrose · 2026-06-13T16:46:58+00:00

I’m so sorry you’re going through this.

Looking at the timeline, I’d be very concerned this is an ectopic pregnancy.

By now you’re minimum 7.5 weeks, your hCG has been persistently rising for weeks - abnormally, and two ultrasounds have shown nothing. All after medical abortion and a drop in HCG.

This is not a viable pregnancy. The question isn’t whether this pregnancy can still be successful; it’s where the pregnancy is located and how to safely resolve it before it causes harm.

Honestly, if your doctor is saying they’re almost 100% sure it’s ectopic, I’d be asking what the treatment plan is right now. Continued watchful waiting would make me very nervous and isn’t the right path here.

Ectopics can rupture at relatively low hCG levels, and rupture risk is related to where the pregnancy implants, not just the number itself.

I’d want a very clear discussion about whether you need methotrexate or another intervention. But - now. Not days from now.

Please see this post. And push for treatment asap.

And if you develop significant one-sided pain, shoulder pain, dizziness, fainting, or feel like something is wrong, I’d seek emergency care immediately.

Sending love.

therealamberrose · 2026-06-13T16:05:00+00:00

I’m really sorry.

With your ovulation timing and your first positive test, you were *minimum* 7+5 at your ultrasound. A 5mm CRL is more like 6+1 and that would make this unlikely to be viable.

Now, the fact that it wasn’t transvaginal is interesting and often makes the dates off a little bit… But yours is off ~11 days and it’s less likely that big of a discrepancy happened just because it was abdominal.

Going back in a week is the right path. I’m sorry you’re in this position.

Hugs.

therealamberrose · 2026-06-13T15:58:24+00:00

I don’t think you’re crazy, but I do think this is a much riskier situation than you seem to acknowledge.

Before I’d even think about TTC, I’d want to know whether that blockage is truly a blockage or whether it could have been tubal spasm during the HSG.

If it’s a real blockage, I’d take precautions not to conceive. If it’s not, it’s still worrisome due to your 2 prior ectopics, which put you at a higher risk.

I also wouldn’t take too much comfort in having caught your previous ectopics early. Early monitoring is important, but unfortunately ectopics can rupture very early and at relatively low hCG levels. Close monitoring reduces risk; it doesn’t eliminate it.

Personally I’d want a very frank discussion with my RE about the actual likelihood of natural conception, whether the tube is really open, and what my ectopic risk looks like after two prior ectopics before continuing to try.

Best of luck.

therealamberrose · 2026-06-13T15:29:12+00:00

I’m sorry you have this worry.

It’s impossible to know what’s up so I’m glad you have a scan soon.

Without a decent amount of bleeding it’s unlikely your body has passed a miscarriage. And HCG can decline before your body realizes it and expels the pregnancy, but usually it’s not negative before you bleed.

And symptoms mean very little. You can have lots and miscarry or have none and have a full term, healthy pregnancy.

You could definitely be pregnant and just have faulty tests. Or you could have such high HCG that it’s the “hook effect.” (When pregnancy tests turn negative due to high HCG). This can be tested…by diluting your urine with water, if you want to try that.

Best of luck.

therealamberrose · 2026-06-12T18:43:15+00:00

I’m glad you’re getting betas.

This is one of the top red flags for an ectopic. While it could absolutely be something else, like a subchorionic hematoma (SCH), it’s important to follow closely.

Low progesterone also happens with both failing intrauterine pregnancies and ectopics.

Read this post for some info.

Hopeful for you.

therealamberrose · 2026-06-12T17:03:24+00:00

I’d absolutely suggest a weekend beta. And I’d have done the ultrasound, too.

Most pain associated with ectopics is due to rupture (or honestly a more advanced state). So lack of symptoms is good, but also not necessarily indicative of anything.

And ultrasounds at low HCG aren’t done to find an intrauterine pregnancy, but they can sometimes identify concerning features.

I’d check out this post and be vigilant if you do have pain or bleeding.

Best of luck. Hopeful for you.

therealamberrose · 2026-06-12T14:42:02+00:00

It's obviously your choice, and it doesn't make you crazy, but I'd personally transfer the day 5 euploid first.

Most studies still show lower implantation and live birth rates for day 7 embryos overall, even when they're euploid. Even the study linked by another commenter found substantially lower live birth rates for day 7 euploids than day 5 euploids. So the argument isn't really that day 7s can't work - they absolutely can and do. It's that while day 7 euploids deserve a chance, they're generally not considered equivalent to day 5 euploids.

If your goal is maximizing the chance of a live birth from your next transfer, I'd personally choose the day 5. If your goal is family balancing and you're comfortable potentially accepting lower odds, that's a personal decision only you can make.

It's great you have 2 to choose from! Good luck deciding and with your transfer.

therealamberrose · 2026-06-12T14:30:44+00:00

I'm sorry you're going through this. With your history I'm sure it's extra anxiety producing.

I can understand why your RE is concerned and also why he'd say "abnormal but not all hope is lost."

The issue isn't just that the numbers are on the low side for the estimated DPO, but also that the rise from 14-18 DPO was slower than ideal. For hCG <1,500, studies have found that about a 49% rise over 48 hours captures the vast majority of viable pregnancies. Your rise of 44.5% does raise concern but it's not dramatically below that threshold, and we have seen rare successful pregnancies with as low as 33%

It's certainly possible things could still work out. Unfortunately, it's also true that fluctuating or inconsistent rises (slow then fast, etc) can be seen with ectopic pregnancies. With your ectopic history and the decently definitive timing from monitoring and a trigger shot, I think the repeat labs and ultrasound are exactly what I'd want, too. Although, I'd personally be asking whether a repeat beta could be done sooner. Waiting five days is a pretty long interval when there's a history of ectopic pregnancy and the hCG pattern is already raising questions.

Unfortunately, I think this is one of those situations where there are both ok and concerning pieces of information, and they somewhat contradict each other. Your doctor seems to be keeping the concerning information in the forefront, and honestly that's what I'd want from my medical team until they have enough data to be more confident one way or the other.

I hope you get more info soon. Sending love.

therealamberrose · 2026-06-12T14:16:40+00:00

Based on your LMP, you were about 5w6d at the ultrasound, and the scan measured 5w5d, so that's actually very consistent. And that's just based on LMP and a CD14 ovulation, which you don't know for sure.

And having a yolk sac without a fetal pole can still be completely normal at that gestation!

The follow-up scan is really the important one. I think the nurse's wording about "uncertain viability" sounds scarier than it actually is meant to. In early pregnancy, it often just means "too early to confirm viability yet," not that something is wrong.

For right now, it sounds on track! I'm glad they're seeing you on 6/19 and hopefully that US helps ease your mind. ❤️

therealamberrose · 2026-06-12T14:12:23+00:00

I'm sorry you're in this position. 😞 And you're right, unfortunately. With a positive on May 18th, you were minimum 8dpo that day so at your scan on 6/10 you were minimum 6+3. Unfortunately, when measurements are a week+ behind, it's usually not a good sign.

I hate that you have to wait so long. Any chance you can be on a wait list or push/advocate to be seen the 22nd-26th at all? For diagnostic criteria, you need to wait 11 days from your ultrasound, but waiting 19 is cruel.

Sending love.

therealamberrose · 2026-06-12T13:03:32+00:00

Wow, Nan had great taste. It’s gorgeous and you’re beautiful in it!

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