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Pregnancy Bliss | Reproductive Health Hub

Could I be pregnant?

Question:  I feel pregnant. Went to the doctor, he said the ultrasound looks like an early  pregnancy,but he will have to say it is an endometrial polyp. I still feel pregnant, pregnancy test negative. Can i be pregnant? N.P.

Answer: On balance, I think it is unlikely you are pregnant. I am assuming from your doctor’s comment that the scan showed what appeared to be a thickened lining (endometrium). That is to be expected if your period is due or even late. The fact that the scan did not show any pregnancy and, more significantly, that the pregnancy test is negative means it is unlikely that you are. Chances of a falsely negative pregnancy tests with modern kits are really quite low.

Short cycle and conception

Question:  I finished my periods on 17th Oct and made love on 20th  October. My cycle is 21 days. Am I pregnant? I. (Kenya)

Answer: The important missing information here is when your period started. When the period finishes is actually not important. The menstrual cycle is calculated from the first day of the period. If your described cycle is correctly calculated and lasts 21 days, it means your most fertile phase is around Day 7 and will range from Day 5 to Day 9. If you had sex on the 20th, you need to count backwards to see if that falls within that ‘fertile’ phase of the cycle. If it does, it means your chances of having conceived might be considerable but not guaranteed. If it falls outside that phase, you could still have conceived but chances are much lower.

Blood pregnancy test and calculation of due date

Question: When taking blood pregnancy test will you be told date you got pregnant and when baby be born? R.S. (The Netherlands)

Answer: The short answer is No. It is not possible to use the results of a blood ‘pregnancy test’ to determine the gestational age. It is, therefore, not possible to use this to estimate the due date for the baby. The only test that can accurately estimate the due date is an ultrasound scan performed in the first half of the pregnancy.

Miscarriage at 5 weeks

Question: I had a miscarriage at 5 weeks and 2 days should i have a dnc or will the baby just remove its self from my body? L. (USA)

Answer: A miscarriage at such an early gestation rarely requires surgical intervention (D&C). In most cases, the preferable way of dealing with this is what is termed as ‘expectant’ or ‘conservative’ management. In other words: do nothing. In almost all cases, the contents of the uterus which include the products of conception and the broken down lining of the womb will come away spontaneously and fully, akin to a heavy period. Remember, at 5 weeks, the gestational sac is quite small at no more than 7 cm (2½ inches) across and the contents of the sac are minuscule. A surgical evacuation (D&C) of the womb is therefore rarely necessary. Best wishes for the future.

Possible early miscarriage

Question:  Two weeks ago i took a hpt and it was positive. My last period was september 14. October 25 I had severe cramping and had started bleeding so i went to the emergency room and they told me my hcg level was low,my cervix was closed. I then saw my dr two days later and then had an ultra sound and they couldnt see anything in my uterus, have to get more blood work done this monday and then go back to see my dr november 10th and i am still bleeding now. I just dont know what to think at this point cause the doctors said they cant tell me anything at this point. Should they be able to tell me something? Should i get a second opinion from another doctor and what is your personal opinion? i just need answers im going crazy!! D.M. (USA)

Answer: This is a tricky one and I sympathize with both you and your doctors. Was I to assume your cycles are the standard 28 days or so, your dates would suggest you are supposed to be about 7 weeks pregnant. Two weeks ago, when you went to the emergency room, you were (or should have been) around 5 weeks.

A transvaginal scan at 5 weeks can just about identify a pregnancy inside the womb as well as the pulsation of the fetal heart. However, if the gestation was even a few days less, a scan will not show anything. Your doctors are therefore right in allowing for a decent interval before attempting to repeat the scan. Even though this causes you understandable anxiety and stress, it is the right thing to do. The serial monitoring of the blood pregnancy hormone (hCG) levels will also help give clarity as to what might be happening. The crampy pains with bleeding is obviously a worrying sign and may very well mean you have had an early miscarriage. However, this is by no means certain. You should therefore try to be patient until the situation is clear. This should be clear in the next few days. My best wishes.

Cause of molar pregnancy

Question: What causes molar pregnancy? D.J. (The Gambia)

Answer: There is no specific cause of molar pregnancy. It is not actually known what triggers the abnormal cell proliferation that characterises molar pregnancy. What is known is that the trigger is at a genetic level. We therefore talk of risk factors rather than causes. We have discussed the risk factors here:

‘Symptoms’ of pregnancy

Question: This is the second time I have had symptoms like pregnancy. I do not have any strong desire to have a child although I do not have any children. I am 45 yrs old and my doctor says my hormone levels are so low that it is unlikely I would ever get pregnant. what could be going on ? A.M. (UK)

Answer: This is a question I am unable to answer. This is because you have not clarified what those “pregnancy-like symptoms” are. I am not sure whether you mean morning sickness, breast changes, urinary frequency, aversion to some types of foods or any of the disparate types of symptoms that different women experience during their pregnancies. In any case, if pregnancy has been ruled out and the symptoms persist, you will need to have that checked out by your doctor to see what the underlying cause is.