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Understanding Early Pregnancy: Dual Egg Sacs & Ultrasound


Question
I am 29, have three children 12, 8, 5.  The first day of my last menstrual period was June 21st, conception around the 5 or 6th of
July- it is the only time we had intercoarse for several months before and for a month after.  I had a positive pregnancy test the third week of July at my Dr.'s office and had an ultrasound on the 19th of August.  It showed two separate egg sacks that were about 4weeks size.   I have had some bleeding off and on but nothing too concerning, my hcg levels were a bit low, but then climbed so my doc wasn't concerned.  Now my repeat ultrasound this last week showed that I have one egg sack about 4-5 weeks along.

My partner and I are so confused and it has caused some distrust and problems between us because this pregnancy was unplanned.  Neither of us can understand what possibly could have happened.  I have had minimal bleeding, my pregnancy symptoms have been consistent and I have been growing just as with my other pregnancies.

My last pregnancy(the 5 year old)started as a twin pregnancy also but somewhere between week 10-16 one of the two absorbed.  I ended up being pregnant 44 weeks before being induced because the baby didn't measure at a full term pregnancy until then.  I did have some aging to my placenta and was monitored very closely at the end.

My doctor can't explain it with any certainty.  Could I have miscarried, not really known that was happening, ovulated and become pregnant again?  Or what could possibly have happened?  I have been searching for an explanation but haven't found anything.    

Any insight you could offer would be greatly appreciated.

Answer
If your last period started on June 21, you did, indeed, ovulate on July 3 or 4 and must have conceived if you had sex on July 3,4,5, or 6. By August 19, you should have been 8 weeks pregnant and, by then, a fetus and a fetal heartbeat should have been seen. If only two 4 week size sacs were seen but no fetus, it does not sound like a viable pregnancy.  Now, a week ago you had another sulogram still only showing a 4-5 week sac but no fetus. That would indicate a missed abortion. I would suggest getting a blood test for pregnancy (Beta HCG) twice, 48 hours apart to assess your HCG value at this time. If it is still low, I'm sorry but it appears that you had a missed abortion. This can occur with no bleeding. The fetus just stops growing for some reason and you only see an empty gestational sac.