Making sense of early IVF pregnancy scans

IVF patients are very excited when their beta HCG is positive - they are finally pregnant, and can now start dreaming of holding their longed-for baby in their hands in a few months. 

However, the truth is that not every pregnancy results in a baby - and this is as true of IVF pregnancies as bedroom pregnancies. About 15% of all pregnancies will miscarry, and IVF does not reduce the risk of a miscarriage.

This is why we do ultrasound scans - to confirm your pregnancy is healthy.  Here is a simple flowchart to help you make sense of how the doctor interprets your pregnancy scan results.

Please note that all early pregnancy scans need to be vaginal ultrasound scans - abdominal scans don't provide enough details to make the right diagnosis. Vaginal scans are safe and will not hurt your pregnancy.

If the scan is done very early, the doctor will not see a pregnancy ( gestational) sac on the scan, because it's either too small, or it's not in the uterus ( if you have an ectopic pregnancy). Scans should only be done after  your HCG level is more than 1000 mIU/ml - doing it before this is pointless, because it's too early to see the sac.

If the doctor can see a pregnancy sac in the uterus, but cannot see an embryo/fetus inside the pregnancy on the scan, this is no reason to panic. Sometimes this is because the sonographer may not be skilled, or the machine may not provide enough  resolution. You should then repeat the scan after a few days - preferably at a more advanced scan center.

If the size of the gestational sac is more than 18 mm, and the doctor can't see a fetal pole, this is bad news and suggests you have an intrauterine fetal death. This is called an anembryonic pregnancy ( missed abortion). Read more at http://www.drmalpani.com/early_pregnancy_scans_atlas.htm

The commonest reason for a miscarriage is a genetic abnormality in the fetus, and this is Nature's defense mechanism, to prevent the birth of an abnormal baby. While these defects are often random, they are commoner in older women. This is because the eggs of older women have more genetically abnormalities, because they have "aged" and have genetic defects, which cannot be screened for.

Do NOT do a D&C for this. This can cause Asherman syndrome ( intrauterine adhesions). Read more at www.drmalpani.com/knowledge-center/articles/asherman. Ask them to terminate it medically with mifegest and misoprostol

Even if you do miscarry, don't get disheartened. The fact you have conceived in the past ( even though you did miscarry) means your chances of having a healthy baby in the future are excellent.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !