Small gestational sac - long story

Many of you know my story, but for those who don’t, here’s part of it. I know how discouraging it can be going through fertility treatments and all of the disappointments along the way, so hopefully this is a small message of hope for anyone struggling through something that seems impossible.

I’m 37 and my husband and I have been ttc for 2.5 years and we’ve been seeing a fertility dr for 1.5 years. I started my first retrieval cycle in March 2020 after a 2-month delay, starting in January, due to a stubborn cyst. My dr suspected endometriosis, so after my egg retrieval we did the Receptiva biopsy and it came back positive for endometriosis. The following month I did a hysteroscopy/saline sonogram and my dr removed 3 polyps. Shortly after my hysteroscopy I started Lupron Depot for 2 months to suppress my endometriosis, then birth control for several weeks to get rid of another small cyst. Finally, in August 2020, I transferred my strongest embryo, a female blast graded 5BA.

In my childish impatience, I tested at home 5 days after my transfer. The line was so faint that I didn’t see it at first, so I threw the test away and chalked it up as a loss. After I pulled it out of the trash over an hour later (shameless, I know) I saw the tiniest faint line. Over the next couple of days my tests got slightly darker, but nothing compared to most of the tests I see from other women. I had my first beta at 9dpt and it came back as 50, which is the minimum requirement for my clinic. Two days later it only went up to 89, so it wasn’t doubling. My RE scheduled my first ultrasound at 5w4d and at that time all we could see was a small gestational sac without a yolk sac or fetal pole. She said it was concerning and told me all we could do was hope for growth over the next few days. That afternoon I started bleeding and I was sure it was a miscarriage. My dr put me on bedrest and took me off my low dose aspirin, but didn’t offer much hope. The bleeding stopped, but my anxiety was through the roof.

A week later I had another ultrasound and we actually saw a heartbeat, but my dr noted that my gestational sac was measuring a few days behind the baby’s age. My dr told me I had about an 80% of miscarriage, unfortunately, but since my baby was PGS tested she said it gave her more hope than if it was not tested. She said all I could do was drink lots of water and continue to take bedrest very seriously (not so easy with an active 3yo at home) . I also had a blood clot that was almost 3x bigger than my gestational sac and threatening my baby.

A week later the gestational sac was measuring more than a week behind the baby, so my dr again warned me of miscarriage. My blood clot also grew. Everything I read online pointed towards inevitable demise of the baby, so in my mind she was already lost and I cried and grieved for this baby that was so wanted and loved. Another week went by and the gestational sac was still a week behind the baby, so again I was warned of miscarriage, but my dr said at least the sac hasn’t completely stopped growing. Also, my blood clot seemed to be shrinking and solidifying. Yet another week went by when I was a little over 9 weeks and I had my last ultrasound with my RE. My gestational sac was still small, but it was time to graduate onto my OB, so my RE wished me luck and told me to continue my bedrest and water intake. My blood clot was still there, but most of it had moved into my pelvic cavity away from my uterus. A few days later I had my first appointment with my OB and my baby looked like she had no room to move. My OB told me she doesn’t measure the gestational sac, but that if my baby had a fluid level issue it ultimately meant the baby wouldn’t survive until birth. I felt like I was living an absolute nightmare. My OB told me to try to live life as normal by getting off bedrest and only drinking as much fluid as I could handle, but not to make myself miserable by forcing too much water.

It felt nice to be off bedrest and I was able to keep myself more distracted by cleaning, doing laundry, playing with my son, cooking, etc, but I still had a horrible nagging feeling that my precious baby’s heart would stop beating any day. Finally, I had another appointment with my OB a little over a week after my previous appointment and I finally had good news. My baby girl was wiggling around like a wild woman, her heartbeat was strong, and her fluid levels actually looked normal. My OB still didn’t measure the sac, but she said I didn’t need to worry about it because it looked great. I couldn’t believe it. For the first time I felt hopeful and excited that I was actually going to have a baby! I still have a long road ahead of me because I’m high risk for preeclampsia (I had a severe form of Preeclampsia, called HELLP syndrome, with my son and required an emergency c-section because his vitals started going downhill and my body parts all started to shut down), but at least for now I can enjoy being pregnant and try to focus on the blessing I am carrying inside of me. This little miracle has angels around her and I truly believe that in April I will be welcoming her into my family 🙏

7w4d (picture below)

8w4d

10 weeks- my first ultrasound with my OB.

11w3d