Small embryo for gestational age
4 Replies
Wesleysmom - January 3

Dr. Jacobs, please provide any information...

I had an u/s today at 7w4d (an FET of 2 excellent quality 5-day blasts on 11/30). We were able to see a hearbeat, but the embryo only measured 4mm. From what I am able to gather from the internet (whether this is a good idea or not), that is way too small. The RE said that it could have implanted late (how late?! Not a whole week, right?!) or that it may not be growing. He said we would just have to wait a week to look again. I am terribly worried. Can you shed any light on this situation?


B. Jacobs, M. D. - January 3

Even a small deviation of the hand holding the ultrasound probe can cause a significant difference in measurement of a fetus that small. If there is good interval growth, you are probably OK.
Good luck.


socaliui - March 1


I am in a somewhat similar situation. Went in for both 6.5 and 8 week transvaginal u/s. CRL were 2 mm and 9 mm respectively with a good strong heart beat at the 8 week appt. This was an IUI conception with known ovidrel trigger date. The nurse seemed to prepare me for a miscarriage giving me a miscarriage rate of 80%. Is this accurate?


B. Jacobs, M. D. - March 1

If the fetal pole is the appropriate size for dates, and there is appropriate interval growth between measurements, and the fetal heart rate is at least 140 beats per minute. You probably have a good pregnancy.


sangkam - August 25


I am seeking advice as I am going through a difficult time, and am not sure I am receiving appropriate medical care in the developing country where I live.

I had a positive ovulation test on day 13 of my cycle and went to see my gynaecologist on day 19 of for a regular check up and I told him we were trying to conceive. He told me I was probably not pregnant as my endometrial lining was quite thin (8mm).

5 weeks after my last period I found out that I was indeed pregnant. My doctor said there was no point doing an u/s at this stage and scheduled me an appointment 2 weeks later.

However, the following week I started having serious cramping and spotting and went to see him. He did an u/s. The sac was very small (4mm sac and no embryo seen) and quite low. He told me I was miscarrying and scheduled another appointment one week later to make sure all pregnancy material had been evacuated.

Followed 4 days of painful cramping and one week of heavy bleeding. Not to mention the emotional hardship.

As I arrived yesterday at my appointment 1 week after the diagnosed miscarriage (still bleeding slightly), the doctor noticed during the u/s that the foetus was not only still there but had grown. It now measures 3 mm and the sac 8mm. It has been 8 weeks and 3 days since my last period. That seems awfully small, isn't it? He could hear a beat but said it wasn’t sure it was actually a heartbeat. It could also have been the sound of a vessel.

So he gave me progesterone 200mg twice a day for one week, and I am scheduled to go again in one week to see if it will have continued to grow.

Is it possible that an embryo that small would still be viable? Isn’t a miscarriage inevitable? Otherwise, with such abnormal growth in the early weeks, wouldn’t the baby have important abnormalities if the pregnancy were to continue?

I am very confused. I don’t want to be happy that I am still pregnant because I have been too disappointed before. But at the same time, I don’t to go through the emotional hardship again, it was hard enough.

Thanks so much in advance for your help and advice.



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