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04/10/2003

Still pregnant

After three attempts to end this once and for all, I am still pregnant. Only today, 8 weeks and 3 days after my egg retrieval, was I finally diagnosed with an ectopic.

The doctor's office called and said the pathologist found no chorionic villi in the tissue removed during my D&C. We weren't sure whether I'd passed it during my earlier miscarriages (and how strange is it to make that plural?), or whether it was a more ominous sign, so I went in for bloodwork to make sure my hCG levels had decreased as expected.

Well, they hadn't. In fact, they'd risen — a pretty clear indication of an ectopic pregnancy. Why didn't we know this earlier? I blame society.

No, wait. I blame the pseudosac.

Apparently, in 10 to 20% of ectopic pregnancies, a pseudosac is formed in the uterus, mimicking the appearance of a real gestational sac. I don't know why a pseudosac sometimes develops. Who the hell does it think it's fooling?

In my case, the sac we saw on ultrasound looked like an early intrauterine pregnancy — just one that was far behind where it should have been in size.

As to why this wasn't detected sooner, I can only assume it can be hard to tell the difference. Either you can wait for the development of a yolk sac and a fetal pole to be sure it's a true sac, or an ultrasound can show the characteristic double ring (known as the double decidual sign).

My doctor pored over the ultrasound films and determined that it looked like a real live sac. Because I was eager to move on, we didn't spend any more time waiting for a yolk sac to develop. We concluded it was simply a non-viable uterine pregnancy, and acted accordingly.

What can I say? Mistakes were made.

I've had attentive followup care; otherwise the situation could have become dangerous. I have some mild symptoms (cramps, bleeding), but I would have ignored them because they're also what you'd expect after a D&C.

I go in tomorrow for a shot of methotrexate, which should arrest the growth of the pregnancy, allowing my body to resorb or jettison the remaining tissue. After working so hard to achieve a pregnancy, I never imagined I'd be working just as hard to end one.

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