Little growth from 2mm to 2.54mm in 10 days & drop in HCG from 26K to 24K over 2 days

[jpper]

The true test will be your beta number as you already know. As long as the number is still rising you are okay.

Hi I was wondering if anyone had heard of slightly falling HCG's ending in an OK pregnancy. 12 days ago my HCG was 21584.8, and the u/s tech saw a yolk sac with 2mm fetal pole, and the hint of a heartbeat which might have been at 90bpm. 10 days later this rose to 26211.9 but a different u/s tech measured the fetus to have only grown to 2.54mm. The u/s report said there was a "regular hearbeat but not clear" (although I don't know how something can be seen to be regular and still not be clear). So it looks like my baby is still alive, but just growing very slowly from the last u/s to this one. They said this wasn't good and could indicate chromosomal abnormalities and probably an impending miscarriage. 2 days after that (today) I went in for another blood test and the HCG has fallen slightly to 24662.5.

I had minor cramping during the first few weeks after + pregnancy test, which I think was more a sign of my newly expanding uterus. But none at all in almost the last 2 weeks and no bleeding. I kind of thought maybe my body was getting used to being pregnant, and didn't worry about it. But with the recent u/s results and the latest revelation of a small dip in HCG levels, I'm wondering if my body is just shutting that shop down, so to speak. I've had no bleeding whatsoever this entire time, and no significant cramps to speak of. I am on progesterone (Duphaston 20mg/day) since the last 3 weeks because of falling progesterone levels. My pre-pregnancy levels were around 60 and they dipped down to 38 when my Dr. put me on supplements. Then they went back up to 60 at the time of the u/s 12 days ago. But now they are at 30, even with the supplements.

I'm supposed to go in for another u/s next week, but I'll be in NYC so I still trying to find a good fetal medicine Dr. who can do very good ultrasounds.

Any comments or suggestions would be greatly appreciated for such a Dr! I guess it would help if that same Dr. could do a D&C if needed and analyze the fetal tissue. This is my first pregnancy after 2 failed IVF's. Am so sad this might turn into a miscarriage. Has anyone else heard of numbers at 20,000+ dipping and then going back up again, and things turned out fine? Or am I just leading myself down the yellow brick road of false hopes and even more copious tears?

Thanks in advance for anyone who can comment!

[BC-GoMom]

It has been a while- but once HCG #s get to a certain point- they do not keep increasing..... once they start doing u/s then they usually stop doing betas to look at hcg. The lack of growth would be of more concern. maybe someone else can chime in- hang in there.....

[jpper]

Thanks so much. I have a few appointments lines up at NY Presbyterian in NYC and at St. Barnabas in NJ. Hopefully they'll be able to tell us definitively what's going on by then.

Incidentally, NY Presbyterian has a fantastic International Patient Services that has helped me tremendously with suggesting Dr.'s., and setting up coordinated appointments between u/s, maternal-fetal medicine, and RE for me. They've been fantastic and such a help!

[jpper]

Went to see Dr. Berkowitz at Columbia Eastside (NY Presbyterian). I must say, he was not pleasant. In fact, frankly, he was a ****. After getting the u/s done by a tech, he took a detailed history. When I tried to offer information and a printed out table of my recent hormone tests, he said "You know, this'll go a LOT better if I ask the questions." Then after the history, he sat back and declared my pregnancy not viable. And he got super annoyed and defensive when I asked him to explain what the basis was for his conclusion. My husband had to intervene and said, "this is not a challenge, we're not challenging you. We just want to know the reasons why you think this pregnancy is not viable." He went on to make another 7 or 8 comments that were just inappropriate and callous. Luckily I didn't get riled up, I could see he was jerk and nothing was goign to change that, so all I wanted was as much information as I could get to justify the $550 fee I was paying him to get his "expert opinion."

Basically I would not wish him on ANYONE.

Re: my pregnancy, I've managed to schedule a D&C tomorrow at noon with fetal tissue analysis. I called a bunch of different places, Columbia Family Planning (CFP), St. Barnabas in NJ, and Park Med in NYC.

CFP charges $1400USD for a D&C and I wasn't able to find out from them what the pathology analysis would cost. The Pathology Billing dept insisted I needed a CPT Code from the Dr before they could look up what the cost was. The Dr.'s office didn't know and told me to call the Main Billing #. Main Billing didn't know and told me they had no idea who I should talk to. Total runaround.

Yvette Bridges at St. Barnabas would charge $950 + whatever the anesthesiologist and other charges would be for the D&C. Pathology would then charge $334 for the labwork to analyze the fetal tissue and then another $350 for a pathologist to interpret the results. She only does D&C's on Tuesday's though.

Park Med was the only one that could fit me in on short notice and I got their number from Dr. Berkowitz's office after I told them that Columbia Family Planning couldn't fit me in. Park Med charges $450 for the D&C (no extra hidden charges) and then CytogenX is the lab that does the fetal tissue analysis which charges $325 for cash pay, or $1900 for direct billing through insurance.

I was like, I'll pay $325 cash and get that reimbursed later from my insurance, thank you very much! I only have 10,000USD per claim year for maternity benefits and don't need that eaten into unnecessarily. After all, I'm hoping I get pregnant again asap after this D&C.

CytogenX says they can get the results back in 3-7 days which is much better than the 2-3 (up to 6) weeks I was told by the Presbyterian and St. Barnabas labs.

Anyway, am wondering if anyone else has experience getting a D&C through Park Med. I am a little concerned about how much lower their prices are than Columbia or St. Barnabas. Maybe the latter 2 just completely overcharge and Park Med is charging fairly. Or (shudder) they have "bargain rates" for cut-rate D&C's that may end up being botched and leaving me with scar tissue that will lessen my chances of conceiving even more.

It's hard not to let my imagination run a little wild right now. It's so disturbing being told my fetus isn't viable because of no heartbeat and the lack of growth in the last 3 weeks.

[BC-GoMom]

I am so sorry- he does sound like a jerk- I am hoping your d & c had better , kinder clinicians. many hugs-

[jpper]

Thanks BC-GoMom. I had the D&C today at Park Med and was really impressed with the staff and Dr. who did the procedure. Really nice guy, seemed very competent, very reassuring. This is basically all he does and he's also associated with 2 big hospitals here in NYC. I think they were really professional and definitely affordable. Not everyone can spend $10,000 on a D&C ($6000 just for the hospital costs!) at Cornell Weill.

In any case, I'm so happy I went to Zev Rosenwak the RE at Cornell Weill. He completely restored my faith in the NY medical profession. And his costs are very reasonable for the amount of time he spent with us and the quality of his feedback. His $550 consultation fee included a transvaginal sonogram (that he did HIMSELF!) and he spent almost 2 hours with me and my husband!

Unlike Dr. Berkowitz's clinic (incidentally, his first name is actually ****! ha ha.) which charged $200 for the transabdominal, $350 for the transvaginal, and then another $375 for his consult which should have lasted close to an hour but was only 15 curt minutes.

I actually got into a conversation with a random woman with a stroller that I shared a table with at a busy cafe yesterday. She'd been to the same Columbia Eastside clinic that Berkowitz is at but saw a different Dr. She told me that EVERYONE in that clinic is great except for Berkowitz, and they all know how bad he is, but for some reason they just can't get rid of him. My guess is with him being older he has a lot of seniority and history there. But all the other Dr's in that clinic are supposed to be great, especially her's which was Dr....Gapatti or something? Anyway....

In the end, I got the same info about my pregnancy from Rev Rosenwaks as I did from **** Berkowitz, yet I felt so much more settled and resolved and happy to accept what was going on when it came from Rev as opposed to (the) ****. It's amazing what a difference it makes having a good Dr!

I actually feel quite good now after the D&C, lighter physically, mentally, emotionally and ready to heal. I'm very much looking forward to getting myself in shape to try again. Feeling really thankful for the support of friends and family too. For anyone else out there going through this wrenching experience my heart goes out to you and I send you hope and hugs and all the luck in the world for future success.