Ultrasound 1 3.25

It’s a strange position to be in, to fervently wish for a miscarriage.

The evening before leaving for a 7 day Mediterranean cruise, I had a hunch. I peed on the stick and sure enough, two little lines showed up. “Honey,” I called into the bedroom, “bad news about all the wine we bought for the cruise…”

He was ecstatic. I was overjoyed. It was like the movies, where the woman freaks out at the pee stick and the guy gives her a bear hug and a big, sweet kiss. Little C was just turning 18 months, and it seemed the perfect time for him to get a sibling. All vacation we were giggly and happy. I started browsing maternity clothes online and thinking of baby names. I knew it was way too early but couldn’t help blurting out the news to a couple of people. If people asked when we were thinking of having another baby, I started to grin maniacally. I wanted to shriek, “9 months! In 9 months! Wheeeee!!!”

We estimated I was about 6 weeks along, though I’ve never kept track of my periods, so I couldn’t be sure. M actually came with me to the first appointment, having missed most of C’s due to work. I was so excited that he’d be with me when we got to see the little tadpole for the first time. I must have asked 10x while the doctor was going through my medical history, making sure we would do an ultrasound that day. “Yes, yes” he said, although he added that he couldn’t date the embryo– he’d have to make another appointment for the radiologist to do that.

We were all staring intently at the screen when the doctor found the gestational sac. And…. that was it. No embryo. No yolk sac. Not even a shadow. A black, empty hole where everything should be.

In Spanish they call it “huevo vacio” – empty egg. In English it’s known as a blighted ovum or an anembroyonic pregnancy. An egg was fertilized and implanted, and the amniotic sac began to develop, but for some reason the embroyo did not. Because there’s a gestational sac and the beginning of a placenta, the body still reacts as if it’s pregnant – producing the same hormones and symptoms as a genuine pregnancy.

The doctor said it was still possible that the embryo was simply too small to see. He moved my ultrasound appointment up to the next day. But a day’s wait changed nothing, and the radiologist simply confirmed his diagnosis. Back at the doctor to discuss my options, M started asking what would happen if I didn’t miscarry naturally, seeing as how I was scheduled to fly back to the U.S. in less than 2 weeks.

The doctor started outlining my options. Follow up ultrasound in a week, elective surgery or misoprostol immediately after. My brain went numb after that. I simply couldn’t process going from pregnant to not so quickly. What if there was a mistake? Maybe they just didn’t see it. There must be an embryo there. I felt pregnant.

I convinced myself that I had simply misread the calendar. They would definitely find an embryo next time.

Tick tock tick tock…

The appointment dawned. The reality began to set in. My radiologist this time spoke English. She told me, gently, that she saw this in perhaps 25% of pregnancies. That, given the size of the sac, it wasn’t possible for the zygote to simply be too small to see – there ought to be something visible. This all fit with what I’d read online. I’d also asked the doctor to test my hCG. It was back at non-pregnant levels – if I took the pregnancy test now, it wouldn’t even register. (The spike in hCG due to pregnancy is pretty amazing – check out this chart here).

The doctor wrote me a prescription for misoprostol. I took it, my lab results, and my ultrasound print out in hand, and sat in the waiting room studying them while M made another follow up appointment. I fervently wanted to miscarry naturally, but I wasn’t getting much choice about the matter. In another situation, where I would be covered by health insurance for the upcoming month, perhaps. But, looking over the test results in my hand, I stared at the black hole in my uterus and accepted it for what it was. A chromosomal abnormality. A moment of hope and joy quickly crushed and dissipated. A body that wouldn’t accept in time that there was no embryo within the 7 week gestational sac.

I went home and I took the pills.

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