The test is positive, but the ultrasound does not show pregnancy

06.07.2020 24132 0

A woman planning a pregnancy looks forward to its onset and tries to find characteristic signs of successful conception. In the second week of embryonic development, certain symptoms may appear, but most women are not even aware of their situation. Moreover, some girls, feeling a nagging pain in the lower abdomen, attribute this to the onset of menstruation and do not in any way associate it with possible conception. We will tell you in this article what happens in the early stages of embryonic development and how gestation can be determined.

Early signs of pregnancy

The second week of pregnancy may provoke some symptoms that can be confused with menstruation. Some expectant mothers seriously wonder about the shape of their belly in the early stages. However, at this time there will be no changes; it will remain flat. It is worth paying attention to other symptoms.

Unpleasant sensations in the lower abdomen.

In the second week of gestation, nagging pain in the lower abdomen may appear. Doctors explain their appearance by the ovulation process: such ailment should not cause concern and is often perceived by women as a sign of the imminent onset of menstruation. In the second week of pregnancy, the stomach may not hurt at all: this is also one of the normal options.

Uncharacteristic discharge.

By the time of the second week of embryonic development, any discharge associated with the menstrual cycle should have ended. If the level of the hCG hormone increased, and now has stopped at one level or has begun to decrease, this may be a sign of spontaneous termination of pregnancy. At such an early stage, a woman, as a rule, is not even aware of conception, so spotting is perceived as normal. A successful pregnancy is more characterized by increased formation of mucous secretions.

Frequent urination.

Another sign of increased progesterone levels. Urination can become not only frequent, but also painful. However, we should not forget that such symptoms are characteristic of some diseases of the genitourinary system, for example, cystitis.

Increased breast sensitivity.

Some women experience discomfort in the area of ​​the mammary glands before the onset of menstruation. However, even in the case of pregnancy, increased sensitivity of the nipples is an absolute norm, associated with hormonal changes in the body.

Mood swings.

Increased hormone levels lead to emotional changes. Pregnant women note that they become more sensitive, and their mood changes without the influence of external factors. In addition, the expectant mother may feel an incredible surge of strength and euphoria, and after half an hour become completely exhausted and fall into an anxious state.

Ultrasound monitoring of ovulation

This method is quite effective and visual.

Briefly about physiology. On days 10-12 of the menstrual cycle (a standard menstrual cycle lasting 28-30 days), a dominant follicle appears in the ovary - this is the largest follicle in which the egg will mature. The follicle grows approximately 2 mm per day; ovulation can occur when the follicle size is 17-25 mm. The follicle secretes a very important hormone called estradiol. In the uterus, under the influence of estradiol, the endometrium grows (this is the inner lining of the uterus where the processes of embryo attachment occur). The endometrium immediately after menstruation is approximately 5 mm; as the follicle grows (the concentration of estradiol increases), the thickness of the endometrium increases from 5 mm to 8-12 mm; this stage is called the proliferation phase. If ovulation has taken place, the follicle turns into a “corpus luteum”, and the “corpus luteum” begins to produce progesterone. Under the influence of progesterone, characteristic changes occur in the uterus, in the endometrium - the secretion phase begins.

You and I will be able to see these changes that occur with the follicle and endometrium on an ultrasound!

If you come on the 12th day of your cycle, I will see a large follicle in the ovary, 10-12 mm in size - that’s great! Then, in 2-3 days, we will look at his growth and the growth of the endometrium, remembering that the growth rate of the follicle and endometrium is approximately 2 mm per day. Having done an ultrasound on days 14-15, we will see that the follicle, which was 17-20 mm yesterday, has disappeared. This means ovulation has occurred.

We will see fluid behind the uterus, which also indicates that the follicle has burst. Next, having done an ultrasound on days 17-19-21 of the cycle, we note that a corpus luteum has formed at the site of the burst follicle and characteristic changes have occurred in the endometrium. And if you were still doing ovulation tests at this time, and if you also donate blood to determine the amount of the hormone progesterone, we will most likely decide that you were ovulating. This means we need to look for another reason for the lack of pregnancy.

It is very important to do ultrasound monitoring along with performing tests.

This will allow you to most accurately determine the presence of ovulation. An ultrasound machine is the most important assistant for a reproductologist. Make an appointment for an ultrasound with a fertility specialist.

Ultrasound picture if there is no ovulation

It is important to do ultrasound monitoring for more than one month, but preferably 2-3. In general, a healthy woman can have cycles without ovulation 1-2 times a year. With age, towards 40 years, the number of anovulatory cycles increases and this is the norm.

Earlier I told you what we see on ultrasound if everything goes correctly. Now let's talk about what's wrong...

1. We can record that the dominant follicle exists and is growing normally, but at a certain stage its growth stops before reaching 17-20 mm. And then it begins to decrease (regress). This is an ovulation disorder similar to follicular atresia.
2. The dominant follicle grows and reaches ovulatory size, but ovulation does not occur and it continues to grow further, secreting estrogens, affecting the endometrium. Since the “corpus luteum” is not formed, the proliferation stage remains in the uterus. And long-term stimulation of the endometrium by estrogen can lead to the formation of polyps in the uterus. This is an ovulation disorder based on the persistence of the follicle. We often see such a follicle in the next cycle. And very often a follicular cyst ranging in size from 3 to 8 cm is formed. This frightens my patients. But, as a rule, such cysts disappear after 1-2 months. If we want to speed up this process, then gynecologists prescribe birth control pills.
3. And the last option, the dominant follicle has grown to ovulatory, but ovulation has not occurred, premature luteinization occurs, slow, gradual shrinkage of the follicle. The main cause of hormonal dysfunction: increased prolactin, thyroid-stimulating hormone, androgens.

What happens in the body

The baby in the second week of pregnancy is not yet formed. This is not even a full-fledged embryo: only by the end of the first week, after successful fertilization, the zygote, which has begun to divide, moves to the uterus. The 8th–13th day of gestation becomes the period of implantation of the fertilized egg, its consolidation and the formation of the necessary connections with the maternal body. If everything went well, the development of the chorion (the precursor of the placenta) begins. At this same stage, the formation of future tissues and internal organs begins. And only at the end of the second week will a fertilized egg be formed with a tiny embryo, the size of which does not exceed 1 mm. In the photo during an ultrasound, the embryo will look like a dot the size of a poppy seed. This is a critical period of pregnancy: at this stage, spontaneous miscarriage can occur due to any negative factor.

Pathological causes of absence of menstruation

If menstruation does not begin within 10 days, the etiology of the delay may indicate an exacerbation in the female body of a pathological process that is prone to its chronic course. In medical practice, the following diagnoses are known, which are accompanied by a ten-day delay in menstruation:

• Polycystic ovary syndrome;
• Endometriosis;
• Medical termination of pregnancy and other types of abortions;
• Mechanical cleaning of the uterus;
• Previous miscarriage;
• Adenomyosis;
• Uterine fibroids;
• Malignant tumors of the cervix or uterus.

It is difficult to determine the disease by its symptoms, so the local gynecologist refers the patient to an ultrasound to accurately identify the etiology of this pathology. Additionally, a number of laboratory tests are required to clarify and confirm the diagnosis.

How to determine gestational age

There is no point in carrying out any tests in the first week: they will not show a positive result, even if certain changes have already begun in the body. However, from the second week a woman can already find out about her situation. In order to detect pregnancy, you can use several analysis options.

Using modern rapid tests.

Some strips are very sensitive to hCG levels: in the second week of pregnancy, only such rapid tests are suitable. You can buy them at any pharmacy, and to carry out the analysis, just follow the instructions on the package. The most modern versions of test strips can not only confirm or deny the fact of pregnancy, but even indicate its approximate timing.

When taking the hCG test.

Human chorionic gonadotropin is the “pregnancy hormone”. It is the change in its level that shows that hormonal changes have begun in the body of the expectant mother. During pregnancy, it rises every two days, so that by the beginning of the second week its level can reach 100–150 units.

On ultrasound.

Ultrasound examination is not carried out at this stage if we are talking about a healthy woman: it is still impossible to examine the fertilized egg. If the expectant mother has already encountered problems conceiving or spontaneous abortion, an ultrasound will help determine whether the endometrium is ready for conception. In addition, additional diagnostics are indicated for women who have resorted to IVF.

Features of the test

When to test after embryo transfer

? As already mentioned, tests should be taken 14 days after the IVF procedure. Reproduction specialists identify several rules that must be taken into account before conducting the test:

1. Only the first morning urine is used for testing;
2. the test results are assessed after a few minutes;
3. The test should be carried out at a temperature of 23-26 degrees;
4. The test strip is placed in the urine for 5-7 seconds.

Decoding the results

After using cassette, inkjet and other express tests, the following results are obtained:

• negative – most often indicates the absence of pregnancy or fetal death;
• doubtful - signals late penetration of blastocysts into the endometrium, ectopic pregnancy or premature rapid test;
• positive – highly likely indicates successful IVF.

To get a reliable result, it is recommended to do a blood test at a fertility center. Laboratory techniques are more sensitive and also allow you to determine the content of hCG in the blood serum. Based on the results, one can judge the characteristics of the course of gestation, the likelihood of multiple or ectopic pregnancy.

Nutrition in the second week of pregnancy

In order for the entire gestation period to proceed normally, you need to adhere to the recommendations developed by modern obstetricians and gynecologists. For example, WHO notes the need for a healthy diet, which includes adequate energy intake and the consumption of sufficient amounts of proteins, vitamins and minerals*. In this regard, entire tables of proper nutrition for pregnant women have been developed, taking into account the region of their residence, social status and physical activity.

Products recommended for consumption.

In order to reduce possible risks during pregnancy, you should include more protein, “slow” carbohydrates and healthy fats in your diet. You can get valuable protein from dairy products, fish and meat. If for some reason you cannot eat the foods shown, choose alternative sources of protein in the form of special mixtures designed for pregnant women. For example, Nutrilak Premium offers a whole line of food products for expectant mothers.

What is better to refuse?

First of all, from any bad habits. We are talking about smoking and drinking alcoholic beverages. Moreover, this recommendation applies not only to expectant mothers: during pregnancy planning, fathers should also give up any bad habits. These factors also affect a man's ability to fertilize, and passive smoking in a pregnant woman increases the risk of having a low birth weight baby by 20%**.

Qualities and benefits of ultrasound

Ultrasound examination is a widespread, painless, very effective method for determining pregnancy and its timing.

The very first ultrasound machines were bulky and unable to produce a clear image on the screen. Therefore, studies often gave inaccurate conclusions. But modern devices are capable of transmitting more detailed information about the state of the human body.

In the modern world, there are various technologies for examining internal organs.

But it is ultrasound that is ideal for determining the timing of conception and the course of pregnancy for the following reasons:

• Determination of conception in the early stages;
• Ultrasonic waves do not harm mother and child;
• Clear visualization of the fetus;
• You can do an ultrasound at any time convenient for the expectant mother;
• No rehabilitation period;

Ultrasound radiation makes it possible to eliminate various types of damage to the skin and mucous membranes. Nowadays, a woman does not have to torment herself with the question “Where to get an ultrasound during pregnancy”?

Because there are a lot of possibilities. An ultrasound scan for pregnancy can be done from private medical institutions to local clinics.

Should I take vitamins in the second week of pregnancy?

Nutrition during pregnancy depends on many factors. Taking vitamins is indicated for women who cannot get the required amount of nutrients from their regular diet. For example, expectant mothers who eat 3-4 times a day, including various foods rich in vitamins and minerals in their menu, practically do not need any supplements***. At the same time, the following are recommended as additives:

• Iron. It is necessary for the normal development of the fetus and placenta, as well as for the support of the bone marrow of a pregnant woman.
• Calcium and vitamin D. It is recommended to use them in combination, since vitamin D ensures increased absorption of calcium. These elements are necessary for the normal development of the baby’s internal organs and bones, as well as to support the mother’s musculoskeletal system.
• Folic acid. Necessary for the prevention of fetal neural tube defects.

Advice from doctors if pregnancy is not confirmed by ultrasound

You cannot trust the 1st ultrasound examination one hundred percent. To determine a successful pregnancy in the early period, highly qualified uzist and extensive experience are required. When the fetal sac is already large, it is difficult to confuse it with a tumor. An inexperienced specialist may well mistake a small embryo for a neoplasm.

In addition, the cause of the error may be inflammation in the uterus. At the same time, it swells greatly, and it becomes difficult to see the still small fetal sac. Even if the first test showed two stripes, gynecologists advise waiting a couple more weeks and then doing an ultrasound (even if it was performed earlier and did not confirm pregnancy).

During this time, you can do several more tests. Moreover, it is better to take them from different manufacturers and from an expensive line. If even at 4-6 weeks the ultrasound does not confirm pregnancy, then it is worth checking for oncology.

Also, equipment errors cannot be ruled out. Any technique can make mistakes, especially old ones. If the tests show pregnancy and at the same time all the signs inherent in it are observed, then you can do a repeat ultrasound in another clinic using more modern equipment. Early diagnosis (before the first screening - 10th week) is recommended for women at risk:

• the parents of the unborn child are close relatives;
• women who became pregnant after 35 years of age;
• if there were relatives in the family with severe hereditary diseases or deformities;
• women with diabetes mellitus and cardiovascular pathologies;
• the parents of the unborn baby are alcoholics, drug addicts;
• complicated gynecological and obstetric history (stillborn children, miscarriages, ectopic pregnancy, etc.);
• women who live in environmentally polluted areas with high background radiation, working in hazardous industries.

If not in the third week of pregnancy hCG is more than 1800 mU/ml, then this indicator may indicate the presence of an ectopic location of the fertilized egg if it is not visible in the uterine cavity. When the embryo is already noticeable and an ultrasound examination has confirmed the fact of a successful conception, then it is imperative to register with a gynecologist. The doctor will prescribe mandatory screenings, which are done to monitor the proper development of the fetus and exclude a frozen pregnancy.

Is it possible to exercise in the second week of pregnancy?

Moderate physical activity is recommended for pregnant women. This will keep the body in good shape, as well as prevent congestion in the limbs. WHO recommends including aerobic and strength exercises in your training program to help you stay in good shape. At the same time, it is also not recommended to abuse loads: women should choose exercises with minimal risk of imbalance and injury to the fetus. Modern fitness centers offer a variety of programs for pregnant women that will help keep the body in good shape. Which is better to choose?

• Yoga.
• Pilates.
• Swimming.
• Some types of dances.
• Aerobics for pregnant women.

In addition, you can practice at home. However, before this, it is recommended to consult with a specialist who will identify possible contraindications and tell you which exercises are suitable for pregnant women. Another great way to moderate exercise is regular walks in the fresh air.

Causes of delayed menstruation in teenage girls

In the teenage body, physiological changes in hormonal levels are observed, so for this category of “women” a delay of 10 days in menstruation is not a global problem. It takes time for hormonal levels to establish, and by the age of 14–15, a teenage girl has a regular menstrual cycle. Further deviation indicates a problem, and it is important to visit a medical center.

One way or another, a delay in monthly menstruation requires high-quality diagnosis. The fact of pregnancy (during sexual activity) and diseases of the reproductive system should not be ruled out. A genetic predisposition is also relevant, when instability of the menstrual cycle is transmitted from mother to mature daughter. In any case, a visit to the doctor will not be in vain.

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Is sex life dangerous in the second week of pregnancy?

Not all women know about pregnancy at such an early stage. In addition, it is during this period that libido may increase: this is due to hormonal changes in the body of the expectant mother. If a pregnant woman feels well, there are no contraindications for being sexually active. However, if after a delay in menstruation you notice characteristic signs of pathologies (bloody discharge, hypertonicity of the uterus, you are aware of the risks of a possible miscarriage), you should urgently visit a gynecologist. It is the doctor who diagnoses possible disorders and conducts the necessary tests. If you are unsure about your own health, consult your healthcare professional. He will tell you whether sexual activity is possible in the early stages of pregnancy. It is worth noting that most gynecologists do not prohibit women from having sex: sex helps increase the elasticity of the uterus and trains the muscles of the vagina, preparing them for labor.

Equipment

Our clinic is equipped with the latest technology. Everything is according to modern standards. Let us explain the advantages of modern equipment using an ultrasound scanner as an example. The third generation model is capable of producing a fully color image that can be viewed from various planes. This approach has significantly increased the efficiency of doctors, since the method is practically error-free. With its help, you can see foci of the disease at an early stage.

Our extremely caring staff is ready to advise you on any matter.