Change of Plans

I took my second dose of misprostol yesterday and had even less cramping than I did with the first dose and still no bleeding.  I called the clinic first thing this morning to ask about the possibility of a D&C and they called back fairly quickly.  The doctor wanted me to come in for another ultrasound and a consult.

She did another ultrasound and was unable to find anything other than a bit of fluid in my pelvis.  Nothing was visible in my uterus.  However, my HCG level was still high enough to indicate that there was something pregnancy related going on inside me somewhere.  I believe she called it a 'pregnancy of unknown location' aka ectopic pregnancy.

I was pretty surprised to hear this, but I suppose it could make sense.  I tested postive for pregnancy, but before I had my 7 week ultrasound I had the heavy bleeding and cramping.  Then when I went for the ultrasound the next day, there was nothing visible in the uterus.  So we assumed that it had been a uterine pregnancy and that it had been miscarried.

Then when the hormones rose last week, it indicated that something was left over.  When I had the ultrasound last week Dr. Case said it looked like there might be something leftover in the uterus, but she didn't sound really confident.  That is when she suggested the misoprostol. 

I went for MORE bloodwork today.  I think I have been for bloodwork at least 4 times in the last week and a half.  She said if the hormone is starting to drop on its own, we will track it with bloodwork and let it happen naturally.  However, the more likely scenario is that tomorrow the clinic will call and tell me to go to City Hospital to get a shot of Methotrexate which will kill any pregnancy related cells that are left, which will allow the hormones to drop and my body to return to normal.  After I get that shot I will have to go for bloodwork every 3-4 days to make sure the hormones are dropping as they should.  

I knew that it was possible to have an ectopic pregnancy with IVF and frozen embryo transfers....but I always thought it was so strange, that the embryos are deposited right into the uterus, where they need to implant, and sometimes they drift up the tube and settle in there.  I also feel a bit sad, because before I had just assumed that my miscarriage was caused by a chromasomal abnormality in the embryo that would have made it non-viable.  However, now I wonder if it could have been viable, had it implanted in the right place.  I know there is no point in playing the what-if game....but I can't help it.