QuestionDr. Ramirez,
I have been dx with unexplained IF. My husband & I are in
our mid 20s and have been TTC for 2 years. We have both
been fully worked up, and everything was normal.
I completed my first month on injections (10u of Lupron,
175u of Menopur both once a day SQ as well as oral
estrodial, metforin, prenatals & vaginal progestrone), but
did not do an IUI, rather timed intercourse. I triggered
on 8/26/08 with 5,000u of hcg SQ, and believe I ovulated
36hrs post injection.
On Friday, 09/05/08 I began lightly bleeding. In my 2
years of charting my cycle I have never had mid-cycle
bleeding, and normally have 30 day cycles. Friday was CD
25, about 9-10 dpo. The fluid was not typical of my normal
menses, but more like old blood with small amounts of fresh
mixed it. My first thought was implantation bleeding,
considering no other medical reason (in my mind) for an
early period with an HCG Trigger injection (this was my 4th
trigger shot since starting IF treatments). Please correct
me if I am wrong.
I testing at home this morning, Monday 09/08/08, with first
mornings urine, negative. I have a beta pending per my RE
from Friday. If this is implantation bleeding and it
started Friday, could the beta drawn on that day be
positive? Or should I request a follow up?
Also, when should I test at home for a fairly accurate
result?
Thank you for your time,
Kelly
AnswerHello Kelly,
Thank you for your question. First, although we do see implantation bleeding late in the cycle. It is not universal, so that you can't definitely say that it was implantation bleeding. Using vaginal progesterone can also cause some cervical bleeding which we see more commonly. My guess is that is the bleeding that you had.
Just for explanation sake, and to answer you question, if it were implantation bleeding, you would have to wait 2-6 days before a blood pregnancy test would show positive. A urine pregnancy test, like the home pregnancy test, will not detect the BHCG until the level were at least 20. That would be a week after implantation. In order for you to get an accurate result, I would not test for 2 weeks after ovulation. That is generally when we do the blood pregnancy test, but the level should be high enough for a home pregnancy test to turn positive as well.
I hope this helps.
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
