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Taking clomid. IUI procedure done. Positive for pregnancy. Started spotting with cramps. Miscarriage?

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Hi, after 2 rounds of Clomid 50mg & no pregnancy, I decided to do iui with my 3rd round of clomid, still on 50mg. I had one mature follicle on day 10 of my cycle. We did the iui treatment the next day, along with a shot of ovidrell. On day 13 of my cycle I had some bleeding (definitely not spotting), along with stomach cramps & back pain. The next day it was only light spotting & It lasted for 5 days. I was already starting to feel hopeless that the treatment worked. But after some research I did online I thought it may have been an ovulation bleed. (Your thoughts?). Then on day 16 of my cycle, I noticed that I had a blue belly button which got darker over the next couple of days & then after a week I noticed it changing in color to pink & clearly it was healing. Called my gynae who said it very likely XXXXXXX bleeding but couldn't say why or if the iui or ovidrel caused it. Told me to wait two weeks to see if I'm pregnant. Then on day 24 of my cycle or day 11 past ovulation, I had more bleeding. Looked like a clot of blood in the morning & it cleared up on the same day. Well, thought it may be implantation bleed & got excited again. Did a pregnancy test the next day & it was positive. The following day, did another home pregnancy test & it was positive again... So the following day did a blood test & that result was positive. All these test were positive prior to my mentrual cycle due date. I should now be 5 weeks pregnant & started bleeding on Saturday, first thing in the morning, looked like a clot of blood, very dark (dark red & later turned into brownish spotting). same thing happend the next day, Sunday & again today, Monday 1 April 2013. Saturday when it happened would have been 4werks & 4 days pregnant or day 32 of my cycle, which is when i would normally have menstruated. Very sore lower back, tender breasts, light cramping & not all the time, sometimes have a pulling feeling over ovary area, on both sides... Had headaches the week that I first got the blue belly button. Also feeling morning sickness in the morning... And later afternoon/early evening... Nothing serious or severe. Did the iui & ovidrell cause these crazy events? Do you think this is an ectopic pregnancy or perhaps multiples or worse... Impending miscarriage? What is going on or can explain all my symptoms?
Posted Sun, 21 Apr 2013 in Women's Health
Answered by Dr. Timothy Raichle 1 hour later
Hello, I would be happy to help you with your question. Thank you for the extensive details. Here is my basic summary of the events:

1. You did a round of clomid / IUI / ovidrell
2. You had some mid-cycle spotting – yes this was most likely related to a small drop in estrogen mid-cycle that causes some spotting
3. Day 16 you noticed bluish discoloration of the belly button – this was not related to XXXXXXX bleeding. If this were the case, it would have to be a very large bleed and associated with an immense amount of pain. I have no way to explain this part of the story.
4. Day 24 you had bleeding and a positive pregnancy test
5. You had a confirmatory blood test for pregnancy
6. You had additional bleeding on Sat/Sun between 4-5
7. You continue to have normal pregnancy related symptoms

This all sounds very normal and exciting for you given that the IUI was successful. I am not sure how to explain the belly button issue, but if it is resolved, it is probably nothing to worry about. In any pregnancy with recurrent bleeding, ectopic should be a consideration. And yes, multiples is a definite risk and could cause an exaggeration of what are otherwise normal symptoms and ‘implantation bleeding’.

Here is what I would recommend should happen:
1. You need a quantitative HCG level – this will help determine exactly how far along you are and will also help to determine what should be seen on ultrasound (the value needs to be >2000 to see a sac, and >10,000 to see a heartbeat
2. You should ask for an ultrasound to evaluate for an intrauterine pregnancy vs. ectopic, especially given the recurrent episodes of bleeding
3. Understand that an early ultrasound (before 6 weeks) is only useful in determining the location of the pregnancy, and it is likely that it might be too early to see a heart beat.

Please tell me if this helps and if you have additional questions!!
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