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Dr. Andrew Rynne

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Underwent surgery for infertility. HCG level is not increased. Getting pinking bleeding. Whats going on?

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Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3768 Questions

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Posted on Wed, 23 Jan 2013 in Infertility Problem
Question: Hi. On 7th December I underwent ET of two blastocysts following ICSI with PGD for male factor infertility. 17 days post transfer beta hcg was 317 after doubling steadily as expected but on the lower end. However five days later the value was only 753 so didn't double as expected. Also ten days ago I started getting pinkish bleeding when wiping and a mild amount on a panty liner. This is still going on. No cramps or pain. What is going on do you think ? Thanks.
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Answered by Dr. Mahesh Koregol 1 hour later
Hi,
Thanks for writing to us.
I read your query and I understand your concerns.
There are 2 possibilities for the bleeding :
1) Implantation bleeding : Generally occurs as embryo is getting implanted XXXXXXX into endometrium.
2) Abortion due to implantation failure.
The best way to diagnose is to get an ultrasound done along with hCG value. I think a gestational sac should be seen by now.
I hope its just implantation bleeding.
Please get back to me with the USG report.
Regards, Dr. Mahesh Koregol. IVF and infertility specialist
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Mahesh Koregol 34 hours later
Hi Doctor,

Thanks for the prompt reply. Yesterday I got a call from the clinic with the result of the latest beta HCG taken 2 days ago. Unfortunately the value dropped from 753 to 300 so my doctor told me to stop the estrogen and progesterone supplements I was taking and to expect a period in 2 days. She said it must have been a chemical pregnancy.

Obviously initially I was distraught but I do realise that IVF is not 100% and this was only our first attempt. Better luck next time hopefully.

What I don't understand is that the embryos were shown to be normal from the PGD and my uterus lining was looking very healthy in the scans done prior to transfer, so I don't know why they did not implant and what I could have done differently?

If you have any tips regarding how I can improve my chances next time please do share them with me.

Regards

XXXXXXX
doctor
Answered by Dr. Mahesh Koregol 5 hours later
Hi,

Yes, you seem to have had a biochemical pregnancy.

PGD tells about embryos only. And though the endometrial lining on scan looked good, there is no way that we could study the endometrium completely; the molecular factors affecting endometrium cannot be studied too - perhaps resulting in implantation failure.

You been worked up well; only thing that can be done is hysteroscopy (if not done) earlier. They can add more value to your treatment.

I am sorry for your loss and wish you success for your next cycle.

Let me know if you need further assistance.
If all your queries are answered, please close this discussion.

Regards,
Dr. Mahesh Koregol

Above answer was peer-reviewed by : Dr. Prasad
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