Pregnancy/IVF complications

[CJH1218]

I am a 34 years old, mother of twin girls from an IVF cycle 10 years ago and now pregnant for a second time with IVF having significant complications.  retrieval was on 6/14, transfer 3 embryos on day 3, 6/17.  6/29 confirmed BP with 295 HCG, 7/1 1,179 and 7/5 3,439.  I had started some spotting and bleeding on 7/4.  on 7/12 my HCG plummeted to 398.  On 7/13 had an ultrasound, just 6 weeks and the doctors told me I had or was Miscarrying.  I went of all meds., had the rhogam shot and left devastated with my husband.  I then started to pass more clots and blood.  Went  in to have my blood checked on 7/19 and my HCG is 722.  So on 7/19 they did an ultrasound.  They couldn't see a heartbeat but thought maybe I have an implantation in the uterus and in the right fallopian tube.  Going back for blood work and ultrasound on 7/21.  The rise in HCG threw me for a loop as I had left the DR's accepting the outcome, mourning our loss and so now I'm full of hope, completely in despair and worried about my tube, not sure to take the shot or wait it out a week longer as they are not clear or sure of any of what they are telling me is accurate yet.  Hoping things will naturally happen, just so confused.  Help if you can please....thank you
I went to the Dr.'s today and found out my hcg is now at 922.  They did an ultrasound and are now saying the pregnancy is in an undisclosed location.  They think two implantation, one uterus and one in the F.tube.  They are not sure, no real change in the uterus lining or right tube from Tuesday.  They want to do a biopsy of my uterus.  Draw blood the next day and then give M. shot if the HCG continues to go up. I'm just devastated and confused.  I wanted this to all resolve naturally but of course I understand the ruptured tube and it's threat so I'm not wanting to wait past the point where it is to dangerous.  I'm looking for balance and some emotional readiness and still holding hope that a miracle could happen.  I'm 7 weeks and some days now.  Anyone have suggestions or comments please, please send them my way.    

[CJH1218]

I did have two pregnancies one in the uterus and one in my right fallopian tube.  I bleed out in my abdomen and ended up needing surgery.  I had that yesterday.  Hopefully now on the way to recovery.  They had to take the entire right tube out.  This has been a very emotional process.  My HCG continued to go up after the Friday procedure and so they confirmed the ectopic on Tuesday.  

[CJH1218]

AnnieBrooke, thank you for writing.  I really appreciate your comments.  In the end I'm not sure I did the right thing but my doctor and husband definitely feel we did.  There is just so much that happens to us on the infertility journey.  All I know is I'm very sad and awaiting more results and blood work tomorrow and maybe a shot and then more blood work.  Thank you again for commenting.
Quite the week.  HCG went up to 1376 in 24 hours from 922 on Thursday.  Dr's were unsure the location didn't do another ultrasound, said progesterone went to .4 so they advised a I have biopsy of my uterus, check for fetal tissue and then hcg test in the morning and Methotrexe shot if still going up.  horrible experience and we're devastated.  Was holding hope for a viable preg.  but the doctors said the risk of my life was to great and the procedures were the right thing to do.  Just awful.  

[CJH1218]

AnnieBrooke, thank you for writing.  I really appreciate your comments.  In the end I'm not sure I did the right thing but my doctor and husband definitely feel we did.  There is just so much that happens to us on the infertility journey.  All I know is I'm very sad and awaiting more results and blood work tomorrow and maybe a shot and then more blood work.  Thank you again for commenting.
Quite the week.  HCG went up to 1376 in 24 hours from 922 on Thursday.  Dr's were unsure the location didn't do another ultrasound, said progesterone went to .4 so they advised a I have biopsy of my uterus, check for fetal tissue and then hcg test in the morning and Methotrexe shot if still going up.  horrible experience and we're devastated.  Was holding hope for a viable preg.  but the doctors said the risk of my life was to great and the procedures were the right thing to do.  Just awful.  

[AnnieBrooke]

I answered your other post, but also wanted to say that somehow, they absolutely need to find the embryo(s).  I would push for more ultrasounds, right away, or an MRI of the abdomen if they are willing to do one on a pregnant woman, and if your regular doctor is not doing a good job I would insist on a specialist.  If they do find for sure that there is an ectopic in the tube and a viable embryo in the uterus, I would refuse the methotrexate and ask for surgical removal of the ectopic (and risk the loss of the tube if need be, in order to save the pregnancy in the uterus).  But for this to all work, they really need to find the embryo(s).  They should not be invisible at 7 weeks.  The problem with methotrexate is that it is not always effective.  If there is a uterine embryo, it would be a shame to lose it to the methotrexate and not lose the ectopic pregnancy, and then lose the tube anyway with a surgical removal of the ectopic.