Brown discharge IVF pregnancy

At about 2 weeks after pregnancy test positive from IVF treatment (approx. 6 weeks pregnant), I started to notice some brown discharge/blood on my knicker and on tissues when wipe. It was not a huge amount of dark brown discharge, but it did make me panic when I first saw it one morning.

Given that it was an IVF pregnancy and my first, I did not know what to expect and always thought of the worst scenario.

Is it a start of failed pregnancy?

Am I going to miscarriage?

Or is this to be expected during early pregnancy?

Could it still be implantation bleeding?

The truth is it could be any of the above, or anything else beyond what you can think of, for example, some pregnancy complications such as subchorionic hematoma (SCH) or ectopic pregnancy etc.

Any other accompanied symptoms?

The most important thing is to observe yourself closely for any other symptoms (e.g. cramp, one-sided abdominal pain) and to wait and see how things are progressing. Make sure that you called the clinic, GP or midwifes to report the symptoms and get some advices.

On the first day I noticed the brown discharge, I did not have any other accompanied symptoms. So I calmed myself down and decided to wait and see in a hope that it was something to expect in early days and it would settle down by itself.

On the next day, things were not getting better or worse, still some dark brown discharge only when wipe. I decided to call the IVF clinic and asked for advices. The nurse asked if I had any other symptoms such as abdominal pain or cramp.

Her questions reminded me that I did actually had some shooting sharp pain a few days before noticing the brown discharge. The pain located very low down on the left side. It was so low down that I thought it could be from the cervix or vagina, but I could not be sure.

This shooting pain only lasted for a few seconds and I felt it once or twice a week since the egg transfer day. But never accompanied by bleeding or cramp. I did explain this on and off pain to the nurse and that was when she asked me to come in for an early ultrasound scan to find out what is going on (the original first scan date was at 8 weeks pregnant).

Possible scenarios from the first scan result

I went into the clinic for a scan on the next day to only found out that nothing could be seen on the scan. No sign of intrauterine bleeding, but the shocking news was no heartbeat can be detected either!! The doctor spent quite a while searching for baby heartbeat, but no luck after 20 mins of searching.

According to the doctor, here are the possibilities of what could be the case

Pregnancy was going well and it was too early for a heartbeat to be seen at 6 weeks. That is why the first scan appointment is at 8 weeks pregnant.
A missed miscarriage meaning that I had miscarried so early and my body absorb all the remnants without having a excessive bleed out.
An ectopic pregnancy which means the embryo had implanted outside the uterus. It could be anywhere from fallopian tubes to cervix, vagina or even somewhere else in the abdominal cavity. Risk of pregnancy being ectopic increases with IVF pregnancy. The doctor had not seen heartbeat in cervix or vagina from the scan. Nonetheless, he was not able to see clearly whether the heartbeat was in the fallopian tubes because my swollen ovaries (still swollen from the treatment) had shadowed the tubes.

To determine which one is the case, they needed to do a few blood tests to check the level of pregnancy hormone, HCG. The test needs to be done atleast twice, one on that day and another 48 hours later. If my HCG level is still high and is doubling on the second test, it means that I am still pregnant.

First blood test for HCG level

To me it was like another judgement day, another emotional rollercoaster time. I was waiting so anxiously for a phone call from the clinic that evening for my first blood result. Not able to concentrate on any work.

The clinic eventually rang me at the end of the day around 5pm, saying that my HCG level was still high. Although, non of the above scenarios could be ruled out, it was a bit clearer that I was still pregnant. The second blood test would provide a lot clearer result.

Second blood test and another search for a heartbeat

I went back to the clinic again 48 hours later for another blood test to see whether my serum HCG level was increasing, ideally doubling. If so, we can rule our scenario 2 (missed miscarriage), but still to be determined if the pregnancy is going on the right track.

While I was at the clinic, they wanted to do another scan to check if they can find a heartbeat this time. It was a different doctor and she did a good long 20 mins scan. She gave me a grim face in the end and said she could not see any heartbeat in the womb.

The doctor explained to me that if my HCG is doubling, she would suspect that the embryo was in the tubes. Because it is not easy to see the rubes clearly from the scan, she thinks I should have a key hole surgery (laparoscopy) to rule out ectopic pregnancy.

The blood test result came that evening and my HCG was double the first test HCG level…

So the clinic scheduled me for a surgery 2 days later, but they want me to be stand by in the hospital the next day.

Suspected ectopic pregnancy

At the hospital, they also did a blood test to check my HCG level and every time they checked it has gone higher and higher. They gave me another scan before going into the operation room, but still no heartbeat to be seen.

I went in to the operation room thinking that I would come out with my fallopian tube removed together with the embryo… I was so sad and was crying all the way from the ward to the operation room.

When I woke up again, I was so eager to know what was going on during the operation. Before asking anyone, I first tried to feel my tummy. I was surprised that I had no pain at all. Maybe the anaesthetic is still in action ??

Not long after that, a nurse saw me awaken, the first thing she said to me was

“You are still pregnant”

I was a bit confused, but was really glad to hear that I was still pregnant and burst into tears. So it was not an ectopic pregnancy…? Anyway, I was so happy that I still have my baby.

Later that day, the surgeon came to say to me that they could not see an evidence of embyo being either in the tubes or on other nearby organs on the abdomen. That is why they did not cut or remove anything.

Now the main question is where the baby is???

Searching for a heartbeat

Next day after the surgery, the doctors gave me another scan to look for heartbeat again in the womb as ectopic pregnancy had now been ruled out. The doctors scanned thoroughly and this time they could see a little flickering dot…. a baby heartbeat. It was finally detectable by a scan. I was about 7.5 weeks pregnant at the time.

Although, it was clear that the embryo was inside the womb, the exact location of it still raised doctors’ concern because the embryo was located right at the entrance of the left fallopian tube.

I was sent for a 3D scan to clarify that the embryo was embedded more toward inside the womb and not likely to grow into the tube. Lucky enough that was the case.

Everyone, specially me and my husband, was so pleased with the outcome. More importantly we were still carry on being pregnant….

My tough IVF pregnancy journey did not end there, I started to bleed bright red blood at 8 weeks pregnant all the way up to 18 weeks pregnant. You can read my blog post on bleeding bright red during IVF pregnancy here.