No sac seen, sonographer says could be ectopic

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Hi everyone,

I have just been to an early trans vaginal scan , estimated to be around 5 weeks pregnant from LMP and the sonograph said she can’t see no yolk sac and asked if iv had pain or bleeding. She said she could see a small dark mass type thing which could be evidence but that I need to keep an open mind and come back in a weeks time and to ensure I go straight hospital if I have bleeding and one aided pain. An additional nurse took me intoa room and booked me in for a weeks time and also mentioned about ectopic but possibly just to early.

My question is could this dark mass signal a gestation sac or an ecotic pregnancy? I have been getting pelvic pain and hip pain for few weeks but that’s nothing out the normal for me, with pregnancy related symptoms and the tiniest amount of spotting last week.

Thanks in advance

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Dear Shelb,

I am so sorry to hear of the worrying time you are going through.

Not knowing what is happening to our bodies can be extremely overwhelming and you have a friend here who understands.

What you are describing is termed a pregnancy of unknown location as they are not yet able to fully identify the pregnancy. It is indeed possible that It is too early to see the location of the pregnancy in your uterus and in a week’s time there may well be a gestational sac.

It is important to understand that Pregnancy of unknown location - (PUL) is not a diagnosis; it is a label given until the final location of the pregnancy can be identified with certainty. In the event of a PUL, blood is usually taken to measure serum progesterone and hCG and the hCG test repeated 48 hours later. The doctors would also want to repeat the scan. Until the location of the pregnancy is known definitively or the serum hormone levels have decreased to below pregnancy levels, there is a risk of complications associated with an as yet undiagnosed ectopic pregnancy. Whilst I do not wish to alarm you, for every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic; but not all of these will require treatment.

For now, rest, don’t complete any heavy lifting or strenuous exercise and as you have been advised, seek medical advice if you experience worsening pain or develop bleeding or you are experiencing or dizziness and feeling unwell.

I am sorry that I cannot provide you with more precise details but I hope all becomes much clearer over the forthcoming blood tests and scans. We are here for you for as long as you need, and keeping everything crossed for a positive outcome.

Sending much love,

Karen x

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I’ve just been through this exact scenario but before you continue reading sadly it did end as a confirmed ectopic. I ended up having 3 scans because my HCG levels were doubling normally but there was a mass in my left tube that was indeterminate. I was bleeding very lightly. Eventually after lots of repeat HCG levels the last one only increased by 33% which isn’t in keeping with a normally developing pregnancy. I asked for a final scan before my surgery to remove the tube as all my previous scans had been done when my HCG was below 1000 and my understanding is the hcg should be around 1500 to see evidence of a yolk sac in the uterus. My final scan showed the swelling in the tube had grown and the lining of my uterus which was previously thick like in pregnancy had started to break down (assuming because HCG wasn’t rising appropriately). My HCg at this point was 1690. This went on over 2 weeks which personally I dfound the unknown very psychologically traumatic. I really hope you have a different outcome to me and your scan is just too early xx

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Are they doing hcg tests? I’m in the same position but having repeat hcg tests every 48 hours rather than scans. They think they might see something but unsure whether it’s ectopic or just normal ovarian tissue. Hcg is declining so no intervention needed yet, I’ve still got hope it’s a normal miscarriage as any pain I’ve had is normal period cramps, nothing on the sides. No bleeding yet though.