The Possibility of a Heterotopic Pregnancy

Monday, 15 April 2013

Every time we get answers, we also get more questions.

I am so thankful today that we got a good report, even though it came with some concerns. The doctor found the baby right away this time! He said that my HCG levels had increased even more than he expected and that the baby (well, he said the sac) had grown appropriately. “You’re pregnant!” he said and then gave me a high five. He’s so excited and hopeful for me because of everything I’ve been through and my fertility problems. It was so nice to be able to make him happy!

The smiles were short-lived though. He needed to check my tube to be sure that what he had been concerned about was not an ectopic pregnancy. I think he looked for about five minutes before he said a single word. For Dr. N, that is a long time. I could see that he looked perplexed. Finally he told me that he still saw something in the tube that had him very concerned. He thinks I could have a heterotopic pregnancy. That would mean that I would have one baby implanted in the uterus and another in the tube. The chances of this happening are about 1 in 20,000. The longer he looked, the more concerned he seemed to be, but he still wasn’t sure.

Finally, he called in the PA, who was an ultrasound tech for many years. She didn’t look much less confused than he did. The ultrasound lasted for fifteen or twenty minutes - a long time! So finally they told me that they were concerned that my pregnancy is heterotopic but that there was also a possibility that perhaps I have a cyst on my ovary or tube, or even some bad tissue buildup in my tube. There is definitely something there, but they weren’t able to determine what it was. My doctor also said that since my HCG levels went up more than he had anticipated, that could be an indicator of a twin pregnancy, or in my case, a heterotopic one. But he just couldn’t say for sure. He really thinks, though, that it is heterotopic.

1 in 20,000. Of course. Somehow, if this is the case, I won’t be surprised. Nothing surprises me anymore.

I was very concerned for the safety of the baby in my uterus. I asked Dr. N. what would happen to it if I did have an ectopic in the tube. He said that if we confirm an ectopic, he should be able to use a scope to remove the ectopic and my left tube without harming the baby in the uterus. (After I got home I looked at the statistics and wished I hadn’t - the chances of losing the baby in the uterus would be 25%.)

So for now, as much as I want to be excited, I’m just too afraid to go there. I’m anxious for more answers (and hopefully fewer questions) on Thursday.