What Does This Transvaginal Ultrasound Report Indicate?

Posted on Wed, 8 Oct 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 8 Oct 2014 Answered on

Fri, 31 Oct 2014 Last reviewed on

Question : History of 3 chemical pregnancies last year.
sore breasts, nausea and diarrhea since 4DPO
9 DPO BHCG 32
unbearable pain for an hour on 16DPO followed by brown discharge.
17DPO brown discharge subsides. Did TVS and report attached

Need advise on what I should understand.

Answered by Dr. Aarti Abraham (2 hours later)

Brief Answer:
EVALUATION NEEDED

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
The clinical picture is suggestive of a chemical pregnancy.
Actually B HCG should have been done on the 15th or 16th day post ovulation also, then it would have been even more clear.
The scan now shows an empty uterus.
Regarding your issues of pregnancy, you should consult a Specialist now.
Get the following evaluation done -
1. Husband semen analysis.
2. Hormonal evaluation for yourself - FSH, LH, TSH, Prolactin, OGTT, DHEAS, Free testosterone.
3. What is your height and weight ?
4. Your and your husband's blood groups, viral markers, your blood pressure.
5. Karyotype for you and your husband.
6. Take folic acid tablets for 3 months atleast.
If all investigations are normal, and you are still failing to achieve a viable pregnancy, go for follicular monitoring, where exact ovulation is pinpointed by ultrasound scan.
Then you should be taking heavy support for the pregnancy right from the post ovulatory phase.
THis would include - low dose aspirin , injectable low molecular weight heparin, high dosage of progesterone and B HCG injections.
All the best
Please feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar