“Pregnancy?”
I had an early ultrasound and they found 2 yolk sacs but unable to see a baby yet. My Dr. said one of the yolk sacs looked abnormal so she has me go in for blood testing to test my HCG levels and I’ll be going back for another ultrasound in a couple of weeks. My question is, does this mean twins, and is there any chance of miscarrying one and the other twin surviving?
Female | 35 years old
2 Answers
I do not have the statistics at hand, but a number of pregnancies start out as twins and only one survives to term. A twin may be “absorbed” by the mother’s body very early in the first 3 months of pregnancy. This situation is not uncommon. Genetic abnormalities occur more frequently in twins and this may be one reason why one twin does not go on to survive. There may be other reasons. This can be followed by ultrasounds to give you more information.
Dr. Victoria Mondloch
OB-GYN (Obstetrician-Gynecologist) | Gynecology
You are correct, 2 yolk sacs means 2 pregnancies. But there are several questions that need to be answered. How many weeks pregnant was the 1st ultrasound done at? Typically, a fetus can be seen by 5wks along with a beating heart; so if the yolk sacs are different sizes, it could mean 2 separate times that conception and therefore implantation occurred. If one of the yolk sacs looks abnormal, then it likely may either resorb by itself with or without spotting and you may not even pass anything vaginally. Or you may actually pass the abnormal sac which may or may not trigger the healthy yolk sac to be compromised and possibly passed, even if it is healthy. If your ultrasound was done after 5-6wks and there was no fetus inside the yolk sac, then that is a pregnancy but without a fetus; this is called a blighted ovum and it will not progress past 10-12wks because there is no fetus to support.
Following an HCG level is always a good approach; but remember, if one of the sacs is supporting a healthy placenta/implantation, whether there is a fetus or not, that HCG level will increase appropriately and it doesn’t mean there is a fetus, just a healthy placenta. You should ask for a weekly ultrasound as your OB likely has an ultrasound in their office and they can do a ‘quick look US’ for a less expensive cost as they are not doing fetal measurements. If your OB tells you that the ultrasounds weekly are too expensive, then they are charging you full cost and you need to ask why they cannot do it more inexpensively. If your OB only has the option to do ultrasounds at the hospital, then you can still have your doctor request the quick look US vs all of the measurements of a regular US.
Another blood test to check at this time is a progesterone level; if your level is not at 20, then this alone may mean you could miscarry, whether or not you have a good HCG level or not.
Hope this helps put a little more clarity to your situation.
Following an HCG level is always a good approach; but remember, if one of the sacs is supporting a healthy placenta/implantation, whether there is a fetus or not, that HCG level will increase appropriately and it doesn’t mean there is a fetus, just a healthy placenta. You should ask for a weekly ultrasound as your OB likely has an ultrasound in their office and they can do a ‘quick look US’ for a less expensive cost as they are not doing fetal measurements. If your OB tells you that the ultrasounds weekly are too expensive, then they are charging you full cost and you need to ask why they cannot do it more inexpensively. If your OB only has the option to do ultrasounds at the hospital, then you can still have your doctor request the quick look US vs all of the measurements of a regular US.
Another blood test to check at this time is a progesterone level; if your level is not at 20, then this alone may mean you could miscarry, whether or not you have a good HCG level or not.
Hope this helps put a little more clarity to your situation.
