Empty Gestational Sac: Understanding Ultrasound Findings & Symptoms

Question
I am approximatly 6-8 weeks pregenant. My first ultrasound at or around 5-6 weeks a gastational was seen but was empty, same story at about6-7 weeks. I went in for an ultasound today and should be around 7to 8 weeks,as little as 6 weeks. My LMP is not accurate as my cycle is not normal. On the US today, my obgyn didnt see a gestational sac just a cycst on my ovary and fluid in my uterus. I still have all the symptoms of bieng pregant. No bleeding or spotting, very minimal occasional cramp here and there and no pain. My doc said if it was a tubal pregnancy, I would probably have some bleeding and pain. He finally did a Quantitive HCG blood test today. I am so puzzled and confused. Can a gestational sac disappear with out any bleeding? Would I feel pain? Could I have miscarried without any bleeding? I am very puzzled and any explanation you could offer would be greatly appreciated! Thank you?

Answer
Dear Jerri,

Sometimes if the pregnancy is not progressing normally, as it seems yours was not, the gestational sac can collapse. It sounds like your gestational sac never had any contents within it, since you said they did not note an embryo or even a yolk sac at the 5-6 week OR 6-7 week checks. I would suspect this might be what has happened. If the gestational sac collapsed, it obviously would not be easily visualized on ultrasound at this point, but the pregnancy would not be viable any longer. And you would not necessarily have had any of the cramping/pain or bleeding associated with a typical miscarriage yet. The quantitative hCG will likely come back rather low and confirm a lost pregnancy. Your doctor may then give you the option of miscarrying naturally or having a D&C.

I hope this has helped you and answered your question. I wish you well.

Brenda