Saturday, January 9, 2010

Empty Gestational Sac After IVF


Question:

Hello, Dr. Ramirez,

Does In Vitro increase the odds of an empty gestation sac? I am 6 weeks pregnant and had an ultrasound with no heart beat detected. I bled just before the ultrasound but there was no bleeding before that.

Two frozen embryos were implanted but only one sac is visible on the ultrasound after the bleeding. The sac is round and empty. What do you think?

Answer:

Hello,
I'm sorry about the news. The answer to your question is no, IVF does not increase the risk of genetic abnormalities in the fetus. An empty gestational sac is due to the lack of development of the fetus. That occurred AFTER implantation, and therefore, after the IVF. It probably occurred due to a genetic defect in the embryo that implanted. It is considered a form of miscarriage, which can occur in up to 40% of pregnancies whether natural or IVF.

Many women who get pregnant naturally are not aware that they are even pregnant before they "lose" the pregnancy. Because we test and ultrasound IVF patients soon after transferring the embryos, they have the opportunity to learn if their pregnancy is proceeding or not proceeding earlier than most. This is not necessarily a bad thing, since actions can be taken to prevent miscarrying in subsequent IVF cycles.

Good luck and keep trying!

Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
http://www.montereybayivf.com/
Monterey, California, U.S.A.

10 comments:

  1. Hi Dr. Ramirez, I had IVF done and then had a positive pregnancy test. One week ago I was 5 weeks 4 days and started bleeding pretty heavy bright red blood. I went and had an ultrasound done and they said I had SCH. At that point there was a gestational sac with yolk sac. Four days later still bleeding had another ultrasound done and was told that the gestational sac still measuring correctly but there was no yolk sac visible. Does that mean miscarriage. It has been now 1 week and still having bleeding not to the point of it gushing but I was told to lay low and have another ultrasound in 4 days. What do you think?

    ReplyDelete
    Replies
    1. Hello,

      I don't know what the acronym "SCH" stands for so can't comment on that part. However, if my math is correct, you are now 6+ weeks pregnant and the ultrasound showed an empty sac (no yolk sac and no fetal pole). If are are truly 6+ weeks pregnant, then those findings would be abnormal. By 6 and 1/2 weeks, you should see a yolk sac, at the very least, and a fetal pole with heart motion. Considering your bleeding and ultrasound findings, those would not be good signs for the pregnancy and could imply that it will end in miscarriage.

      Sorry it's not better news.

      Delete
  2. hi
    my hcg on Monday was 5602 and on Thursday had transvaginal ultrasound and had a 10mm empty sac no yolk nothing have to have bloods done again next week and another scan week after. is this normal

    ReplyDelete
    Replies
    1. The ultrasound may be too early to detect anything more than a gestational sac. This shows that there is a uterine pregnancy but you need to wait another 1-2 weeks and repeat the ultrasound to see if anything develops. Of course, this answer is very dependent on your gestational age (i.e. the number of weeks since your last menstrual period). If you past 6 weeks and have a low bHCG and no fetal pole on ultrasound, that is a bad sign meaning it might not be a normal pregnancy and might end as a miscarriage. If you are not past 6 weeks gestational age, then you just need to wait a bit.

      Delete
  3. Hello. I recently had my first IVF procedure done and transferred my (only) two embryos. At 8 weeks 3 days, I went for my first ultrasound and it showed two empty sacs. I cannot find any information online about why there would be two that are empty. I see that many women might have one that is a blighted ovum and the other viable. Do I just have really bad luck or is something else wrong?

    ReplyDelete
    Replies
    1. Hello. There is no specific statistic or explanation that can be given for why both your sacs would be blighted ovums. Part of the explanation could be attributed to luck but more than likely, the two embryos that were transferred had some inherent abnormality that caused them not to develop properly. The most common reason for a blighted ovum is genetic abnormality. In this case, it is likely that both had some type of genetic problem that they to the lack of development.

      Delete
  4. This comment has been removed by a blog administrator.

    ReplyDelete
  5. I am 33 years old, had a IVF implantation failure. Then we opted for a frozen egg transfer for the 2nd cycle. Never been pregnant before. I had a frozen embryo transfer on jan 27th. Pregnancy +ve on 6th Feb. Increase in beta-hcG confirmed on blood test taken on 10th Feb. On my 6w4d Ultrasound on 24th Feb, my dr said that she couldnt see the fetal pole and asked me to come back after 2 days (today, 26th Feb) , and still the fetal pole is not visible. She said that, she just saw some unclear dots at one edge, which may be good. Although my beta-hcG in blood taken on 24th Feb seems to be normal. They took another blood test today to test if the value is doubled. No spotting/bleeding. But still on prolutex inj and estrifam (2mg x 2).I am 33 years old, had a IVF implantation failure. Then we opted for a frozen egg transfer for the 2nd cycle. Never been pregnant before. I had a frozen embryo transfer on jan 27th. Pregnancy +ve on 6th Feb. Increase in beta-hcG confirmed on blood test taken on 10th Feb. On my 6w4d Ultrasound on 24th Feb, my dr said that she couldnt see the fetal pole and asked me to come back after 2 days (today, 26th Feb) , and still the fetal pole is not visible. She said that, she just saw some unclear dots at one edge, which may be good. Although my beta-hcG in blood taken on 24th Feb seems to be normal. They took another blood test today to test if the value is doubled. No spotting/bleeding. But still on prolutex inj and estrifam (2mg x 2). Any chance of viable pregnancy? Or is it blighted ovum?

    ReplyDelete
    Replies
    1. It's too early in the pregnancy to determine if it is viable or not because a 6+ week ultrasound is very early in the development. Viability is determined at 7-8 weeks gestational age when a fetal heart beat should be readily seen.

      Delete
  6. Went for u/s was told to be 6w1day but ges sac measured at 5w2day.No fetal pole or yolk sac Dr. Said pregnancy doesn't seem viable and for me to come back in a week if sac still empty. He wants to schedule d&c. What's your thoughts?

    ReplyDelete

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