QuestionHi Dr. Ramirez,
I am 43 and became pregnant through IVF. At my 7w4d transvaginal US,
there was no heartbeat. My HCG levels have been increasing. What are
the chances that this is still a viable pregnancy? I have a tilted uterus,
does this make it more difficult to detect the heartbeat?
Thank you, Lisa
AnswerHello Lisa from the U.S.,
Congratulations!! You've beaten the odds in getting pregnant, but are facing the other problem that occurs with the age factor. That is, there is a higher incidence of genetically abnormal embryos which lead to a higher miscarriage rate/fetal demises. Usually by 6+ weeks, a heart beat should be present in a viable pregnancy. The fact that you are 7+ weeks and no heart beat means that this is not a viable pregnancy, and unlikely to continue. The bHCG levels have to bearing. However, this statement assumes that your dates are exactly known because with IVF, we know when the embryos are transferred so we know the dates exactly. In a natural pregnancy, there could be the chance that the dates are not correct adn the pregnancy could be earlier than calculated. Sometimes with IVF we do see late implantations, so I would probably repeat the ultrasound in a week to confirm the results. A tilted uterus should have no impact on a transvaginal ultrasound scan.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
