No positive pregnancy test

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1

Hi

I just want to share my situation in the hope somebody else can provide any advice on any similar experience.

So I’ve not had a period since mid April. I started doing pregnancy tests when my period hadn’t arrived. I’ve taken approximately 10 tests and all negative.

Anyway I knew something wasn’t right so paid for a private scan 1 week ago. It was here they found an ectopic and advised I attend A&E because of the pain. I was admitted that night with the prospect of surgery the next day.

However the next day I was told my HCG levels are < 5 so cannot be pregnant and they thought it was a cyst. They agreed to send me for a further scan that day. I was in the room such a long time where I had two radiographers come in to clarify what they could see.

The scan confirmed an ectopic pregnancy however there are some other structures they cannot identify. There was a lot of free fluid so I this did not help. They are still unsure and advised they would send me home as expectant management and I would need to attend for a repeat scan later this week. I was very angry that they couldn’t tell me properly what was happening.

I’m not on my second course of antibiotics for a ? water infection but only had leukocytes in my urine.

They couldn’t understand how my HCG tests were negative and cannot be certain whether the ectopic is adjacent to my ovary or inside my ovary.

I’m so worried about the repeat scan.

Has this happened to anybody else? How successful is expectant management? Do you normally feel like it is self resolving? Ie. does the pain improve? 2 weeks of waiting I think is a long time.

If they still can’t identify what is happening this week what will they do? I can’t carry on like this in pain and off sick from work.

Thank you in advance for any advice.

2

Dear daydreamer,

I am so sorry to to hear of your ectopic pregnancy and loss.

Ectopic pregnancy can be notoriously difficult to diagnose because it often presents with symptoms that can be suggestive of other, more usual, conditions such as gastroenteritis, miscarriage or even appendicitis. Doctors rely on women to give them clear histories about their symptoms and so the more you can tell a doctor about what has changed, what feels different and what is worrying you, the more likely they are to be able to diagnose you.

Unfortunately I am not medically trained so cannot give you specific advice on your symptoms.

To diagnose ectopic pregnancy, doctors usually use a combination of scans and blood tests, if scans are inconclusive, doctors would carry out a series of blood tests to check hCG levels to see if the numbers are rising as expected. However, in isolation, hCG tests only provide a part of the picture - declining levels indicate that a pregnancy has ended and will be miscarried. It can also possibly indicate an ectopic pregnancy that is “self-resolving”. Also hCG levels rising by less than 66% over 48 hours means it is likely (but not certain) that it is ectopic. If levels rise normally, they suggest the pregnancy is implanted in the uterus. You may see from this that hCG levels only indicate certain possibilities and are not in themselves a definitive guide.

It is possible, as your last period was some weeks ago, that you have sadly had an ectopic pregnancy that is self resolving which is why your levels are back below 5. In some instances, the fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink and, occasionally, it may not shrink and will leave a blockage in the tube by way of a small cyst, which can be visible on scans. You mention however, that they have viewed other structures they cannot identify, I am sorry I am unable to advice you further on this as I am not medically trained.

I understand how frustrating this is, especially not having all the answers but diagnosing and treating ectopic pregnancy can sometimes be difficult. It is however good to hear that you are being followed up with more scans.

In the meantime, be kind to yourself, do not do any heavy lifting or strenuous exercise and if you are currently feeling pain which is worsening or seems unusual and is concerning you and, in particular, if you experience any bleeding or spotting, it is better to get checked out to be on the safe side. As pain is unique to each person and I have such limited information, it would be better to get professional medical assistance by someone who can examine you. Visiting the hospital would give you peace of mind and, if you explain your previous ectopic pregnancy and the pains you are experiencing now, they would be able to check your symptoms and assist you.

I am not sure what the plan of action will be for you if you do not get any clear answers on your next scan but please do ask your medical team. I always advise writing down questions you have so you can go through them with your specialist medical team who have access to your medical notes.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

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