Question about early pg measurements
1 Replies
ICSI hopes - September 6

Hi Dr. Jacobs,

I posted this on Timothy Smith's embryology forum already but now realizer that thsi is likely in your area of expertise.

We had four three-day embryos frozen (all 8-cell low- or no- fragmentation when frozen). Thawed all four, two survived. Transferred both in a natural (unmediated) ovulatory cycle. Got positive beta hCG at 11dp3dt. Repeat at 13 and 15dp3dt and levels were rising adequately, but not steller (above 66% increase, but not quite doubling in two days). Yesterday, ultrasound at 6w3d showed one gest sac measuring only 6mm mean daimeter (very symetrical sac, all three dimentions were around 6mm). No fetal pole observed yet. RE sent me away until 8w to give embryo some time to grow before repeat u/s. RE told me he would like to see a larger gest sac at this stage, but he was not ruling us out yet. But 6mm seems awfully small for 6w3d to my (untrained) thinking. Do you think there is any chance for a healthy pregnancy to result from this slow-starting embryonic growth? Or is this certain to be chromosomal abnormality with arrested growth to occur soon? I am not looking for false hope here, just a reality check. I’ve had two 9-10 week miscarriages and one live birth (3yo daughter) before my husband’s testicular failure was diagnosed. This is our last shot as it took our surgical urologist 2 hours to find testicular sperm last time, found just barely enough to fertilize the 11 mature eggs we had retrieved and I agreed not to ask DH to go through this surgery again (and urologist gives us a low probability of finding sperm next time).

So- this is it. It was a long shot from the start. Just want to get your thoughts on whether a frozen (thawed) transferred embryo that gets this slow of a start has any chance of making it or is my RE just waiting because there is not harm to me, but no real chance of successful pg?

Thanks in advance.


B. Jacobs, M. D. - September 6

An adequate hCG rise is at least doubling every 48 hours. To be 6 weeks pregnant, you would be3 weeks after transfer. You should be able to see a fetal pole and fetal heart, at that time. They will be very small, and difficult to find, but should be detectable with a vaginal ultrasound evaluation.
Good luck.



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