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I did an IVF cycle. I got a positive pregnancy test and I…

I did an IVF...

I did an IVF cycle. I got a positive pregnancy test and I stopped progesterone and estrogen supplements shortly afterwards. One day after stopping, I started bleeding heavily, but my pregnancy test was still positive. The heavy bleeding and the cramps lasted only two days, but it's been six days and I am still bleeding, although very little. Meanwhile, I have taken a pregnancy test every morning, and they are all positive. What is going on? Why am I still bleeding if the tests continue to turn out positive?

Doctor's Assistant: Have you been keeping a personal medical record?

I'm not sure what that is. My hcg levels were initially low but they doubled every two days. The last result was not exactly double of the previous one, but it was taken less than 48 hours after the previous one. My doctor is eager to write the pregnancy off, so if I ask him, all he'll say is that I'm about to have a miscarriage, but I don't see how I can still be pregnant two weeks later, without supplements if the pregnancy was going downhill.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I am 42 years old.

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Answered in 26 minutes by:
12/23/2017
Dr. J
Dr. J, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 589
Experience: Gynecologist
Verified

Hi there. Board-certified obgyn here.

I'm so sorry to hear you're going through this. How frustrating after everything you've been through. May I ask when was your last ultrasound? What did it show? What was the date of your embryo transfer? Was it a 3 day or 5 day embryo? And what was your last hcg level?

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Customer reply replied 5 months ago
Hi, Dr. Juran--I haven't had an ultrasound because my doctor would not schedule one (I manage to get one scheduled for December 28th with a regular clinic but I only told them that I had tested positive). I had 10 embryos and two were transferred on day 5, which was November 21st (last month). Of the remaining embryos, only three made it to day 6, and of those three only one tested normal after pgs. That's why my doctor thinks that both of the transferred embryos must have also been abnormal, but how can he know that if they were not tested? It is just as likely that one of them was normal, like the other embryo that has not been transferred yet.My hcg level went from 14 on Dec. 4, to 28 on Dec. 6 to 128 on Dec. 11 . On Dec. 13, it was 187. That's when my doctor e-mailed me to tell me I should have a D&C. I thought that was premature, so I refused to do it. I had my last estrogen patch on on Dec. 13, and I took my last crinone gel on Dec. 14. I started spotting on Saturday evening, Dec. 16, and had a lot of pain On Dec. 17, but I felt much better on Dec. 18. Since Dec. 19, I have been bleeding lightly, every day less. And I have been taking a pregnancy test every morning, and they all turned out positive. This afternoon I took a digital test, and it said "pregnant."By the way, I told the IVF nurse on Wednesday that my pregnancy tests were still turning positive, and all she said was, "keep my updated." I just don't understand how I can still have positive pregnancy tests and the IVF clinic won't give me any explanations. We are hoping that the pregnancy is developing and that the bleeding is withdrawal bleeding caused the interruption of progesterone and estrogen supplements and it will soon stop altogether. Is that unrealistic?Thank you in advance!
Monika

Ah I see.

The urine pregnancy tests you've been taking will be positive, probably for many more weeks even if you did have a D&C because they will turn positive usually with an hcg level > 30. It can take weeks for the hcg to gradually return down to zero and you may continue to test positive on urine pregnancy tests until the hcg level comes all the way down, which can take a few weeks, as I mentioned.

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Customer reply replied 5 months ago
But I did not have a D&C! That's what the doctor wanted me to do, but I did NOT do it.
Customer reply replied 5 months ago
My last hcg test was on Wednesday 13 and it was only 187. How can I still test positive on Dec. 22?
Customer reply replied 5 months ago
are you saying that the bleeding is definitely a sign of miscarriage?

Thank you. Yes, I see where you did not have a D&C.

Based on the information you've provided, it seems that your doctor felt the hcg was not rising appropriately and thus did not feel this was a viable pregnancy. You then started having bleeding/cramping. Is this correct?

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Customer reply replied 5 months ago
The part about my doctor is correct. But I only started the bleeding after I stopped the progesterone and estrogen supplements and I did not pass any tissue.

Thank you.

I'm afraid that in any early pregnancy, when we hear about bleeding and cramping, we worry about miscarriage.

Even in the case of a confirmed, known miscarriage, or in the case that someone did decide to have a D&C, it can takes weeks afterward for the urine pregnancy tests to become negative, because it takes weeks for the hcg levels to come back down to < 30. At an hcg level of 30 is approximately when a urine pregnancy test will be positive. Once you get down to an hcg < 30, the urine pregnancy test will be negative. Again this can take weeks for the hcg to come all the way down.

And of course, on the chance that the pregnancy is continuing normally, they will also be positive.

It's hard to know what's going on with the pregnancy without checking another hcg, so this may be a step worth considering so you can feel more informed about how the pregnancy is doing.

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Customer reply replied 5 months ago
Well, I suppose the ultrasound test I am scheduled for on the 28th is going to provide a definitive answer, but it's just so hard to not know what is going on and I was just wondering if there is any chance at all that the pregnancy might be continuing normally?

It is so hard. These first few weeks of pregnancy are so difficult and stressful especially after going through IVF.

I would say there is a chance that things are progessing normally even if the hcg trend is not behaving as we would have hoped. If you didn't want to wait til the 28th, you could ask your doc to give you an order for another hcg sooner just to gather more info about what's going on.

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Customer reply replied 5 months ago
Thank you very much, Dr. Juran. I appreciate this information. It is a lot more than I've gotten from my IVF nurse and it helps a lot. Best, Monika

You are welcome, Monika. I wish you all the best in your journey. Try to hang in there.

If you are satisfied with the responses provided, I do appreciate your positive rating. Thank you.

Dr. J
Dr. J, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 589
Experience: Gynecologist
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