Cytotec or wait it out?

southisland06 · 05-07-2007, 11:15 PM

What a horrible day. I had my ultrasound this morning that showed a 4.3mm sac in my uterus (I am 7 weeks). I have been told it isn't a viable pregnancy and is a blighted ovum.

I have seen three different doctors over the past week and each one has their own suggestion for what I should do:

1st doc: Get a shot of methodextrate even though it isn't ectopic.
2nd doc: Use the vaginal suppositories to help speed up a miscarriage.
3rd doc: Says suppositories won't work and will make me sick so I should just sit and wait to miscarry naturally.

I was so confused because by the time I saw the 3rd doc I was so upset and when he told me I had to sit and wait to miscarry I wanted to burst out crying. He told me it could take weeks but it is the best choice for my body.

Could this really take weeks? I was on PIO injections up until 2 days ago when I stopped them. Will stopping the progesterone help me miscarry?

My hcg is around 2500...is it true it is too low for cytotec (suppositories) to work?

I am an emotional wreck and I feel like this is just dragging on and on and I am being passed from one doctor to the next.

Can I have some advice....should I take the cytotec or just wait?

Tensei · 05-07-2007, 11:57 PM

This is a very personal decision. There is so much to weigh, and the truth is that no option is a good option.

I thought I had 3 choices: Wait, induce, or D&C. I wanted to wait, but wasn't wild about how long it could take (weeks). I asked for cytotec, but the dr said I was too far along (10 weeks) to use it, so I have to D&C.

All I can offer you is that the sooner this is over, the sooner you can find closure. I personally wanted it to be over sooner than later, but that doesn't make it the right decision. It's the right decision for me.

*hugs* I'm so sorry.

RunnerDuck · 05-08-2007, 01:00 AM

Stopping the progesterone MIGHT bring about the loss, but not always. With both of my blighted ovums (actually I guess this one technically wasn't a BO), I was not on progesterone but the loss still showed no signs of happening on its own.

I am not a fan of waiting. Not for any medical reason, just personal comfort level. I took cytotec both times. First time I took it orally (did nothing so I took it vaginally 48 hours later and it worked 15 hours or so after that.

This time I took 3 doses (all vaginally) and it hasn't worked. I have a doctor's appointment tomorrow to check if the "products of conception" are still in there - it's possible I just missed their passing - will probably need a D&C if they are still in there.

I have never heard of a beta being too low to use cytotec. It's possible that yours is low enough that the wait wouldn't be too long but I don't know, I would still be in favor of cytotec, personally. It causes cramping but 1. at least in my case it was no worse than a bad period as far as pain and 2. they usually give you vicodin anyway for it. I wouldn't worry about the "making you sick" part of things. It's better to have some control over things, is how i see it. If you sit around waiting, you feel like you don't want to go anywhere because you don't want it to happen in public. With the cytotec, ideally, you can take it and the loss will happen in the next 24 hours. Not always, but usually.

So I vote "cytotec."

southisland06 · 05-08-2007, 03:31 PM

I'm really scared to take the cytotec because I may bleed a lot and be in lots of pain (so I have been told). The doctor said if I take it I will get really sick and there is no guarantee it will work. PLUS, he said that since the sac is only 4.3 mm I won't even know I am miscarrying and it will feel just like a period. I have read enough stories of women on here to know it will be worse than a period. Am I right? Somehow I don't think I will be that lucky.

He told me to wait a week with no progesterone injections and see if I miscarry naturally. If by next Monday my hcg is still going up then I will take the Cytotec.

But the problem is I want this over NOW. I don't want to wait a week. It is a blighted ovum with no chance of this working out so I sit knowing I have an empty sac growing inside of me making me feel pregnant even though it isn't a baby. I am depressed and need to know this is going to end. My doc was so uncaring to how I was feeling yesterday.

What would you do?

RunnerDuck · 05-08-2007, 04:04 PM

I just got back from the doctor and learned the cytotec did work after all. I don't know how I missed it but oh well. It's out, there is still some lining, but my betas are fifteen-hundred-something now (8,000 at last check, before we saw a heartbeat so we know it got even higher) so they are on the way down. Blood test again next week.

Seriously, this time was not bad at all physically. I had some cramping the first night after the first dose of cytotec but no worse than a normal period. It was worse with my miscarriage last spring but still no worse than a "bad" period. What I had imagined happening that time was, I would be out and about somewhere - at the gym, at target, whatever - and be overtaken by cramps and gush of blood. I was so afraid of that happening. But it wasn't like that at all, not that time, not this time. It was really like a period, both times, but with a clottier flow, and longer duration. Normally my periods are 5 days or so, 7 tops, and that includes that tail-end, not sure the bleeding is over stuff. With the last miscarriage, I seem to think I had heavy bleeding for a week and then the dribbly not-sure-it's-over bleeding for another week. This time, I had mild to moderate bleeding for 2 days, stopped, took more cytotec, heavier bleeding for 2-3 days but still quite light for what you'd think a miscarriage would be, and now I am still bleeding, lightly... It's been about 1 1/2 weeks at this point.

Both times I was given vicodin and both times I used it but both times ibuprofin would have been quite enough for the pain. But I figure if I am going to have a miscarriage and they're gonna give me narcotics then I am going to enjoy some narcotic brain relief.

Seriously, physically, not bad. I think your doctor is being an @$$ to try to disuade you like this - I don't think the arguments are valid. Who cares if what you have to pass is large or small? There is SOMETHING there and it is mental torture to wait on these things. You still want to get the ball rolling and get it over with.

I am sorry this has to drag out for you.

Is this your IVF doctor who is telling you these things? Do you have an ob/gyn you could call up? Maybe they would help? It was my ob/gyn I was seeing with my first miscarriage, she prescribed the cytotec that time.

If I were paying someone for IVF and they were giving me this kind of run-around, I would be seriously livid.

eta - maybe men are just bigger jerks about this than women??? Because when this miscarriage was confirmed, they had the doctor come in to verify, and he was like, oh, yeah, PCOS, this happens all the time, yada yada yada, no need to step in, you can just wait it out, what did you do last time? Cytotec, oh, yeah, well I guess if you want to go that route again...

But both the nurse who did my scan that day (female, not my usual nurse) AND my usual nurse are like, OK, let's get the show on the road, cytotec, let's get it over with, let's move on, let's try again...

I think even in the medical field, men just don't get it. I mean, our husbands don't get it sometimes, and they LIVE with us, and these losses are their losses, too, but they still don't feel quite the same.

southisland06 · 05-08-2007, 04:43 PM

Runner - I am glad to hear your miscarriage is almost over. I hope I am lucky and it can end fast so I can start TTc again. To me, the only way to heal right now is to move on and try again.

Is it really true that this happens all the time with women who have PCOS? I mean, I thought miscarriages happen all the time to any women. Why do doctors say that kind of stuff, do they not have any compassion or feelings? Many, many women get pregnant with PCOS. We just have to work a little harder at it. But I think it makes us better people and great parents when the time comes.

I have been less than thrilled with the doctor who has been treating me. My regular IVF doc is away on vacation right now so he has his collegue filling in for him. He is a strong believer in sitting back and doing nothing. Last time I checked he isn't a woman and he has never been through the emotional up and down of this.

I asked for a prescription for the Cytotec yesterday and he reluctantly gave it to me but wants me to wait a week. The big cherry on top is he says as he hands the prescription to me " is this to help a physical or psychological problem?"....so I replied..."ummmm....both". I'm going to be honest! Well, he wasn't all that amused. So now I feel like I can't take the Cytotec because if something were to go wrong and I were in need of seeing a doctor I would be going behind his back and taking the med. Then I would be a bad patient....sighhhh

southisland06 · 05-08-2007, 04:47 PM

O, by the way, the OBGYN that I was seeing last week spoke to my IVF doc and said he wants to give me a shot of methodextrate even though it isn't ectopic. Huh?! So as you can see I have a bunch of conflicting opinions being given to me.....I'm starting to think I should make these decision on my own.

I think the confusion and lack of caring from the doctors has been the worst part of this whole experience. I have just been passed around from one doc to the next with nobody giving me the same answer.

RunnerDuck · 05-09-2007, 07:26 PM

Quote:

Originally Posted by southisland06

I asked for a prescription for the Cytotec yesterday and he reluctantly gave it to me but wants me to wait a week. The big cherry on top is he says as he hands the prescription to me " is this to help a physical or psychological problem?"....

My god. Would a doctor say this to a man asking for Viagra? Your doctor is such an ass!!!

You know what this has made me think about, why the heck is it that all the IVF doctors seem to be MEN? Out of all the IVF doctors and clinics I have been looking in to around here, there are a FEW women, but it seems like they are overwhelmingly run by male doctors. And most REs seem to be male, too. I mean I know they are in it because the money is there but still why aren't more women in this field?

There is a support group that people at my clinic can attend and it's weird, the new patients come in and they complain that once you are in, the doctor meets with you once, and then all your care is pretty much run by the nurse practitioners. But those of us who have been there a while, we know the NPs know more than enough to give us good medical care, and as uterus owners and often past miscarriage sufferers, they also know enough to treat us well emotionally. Man... I am not an avid man hater or anything but it just boggles my mind, the dumb things male doctors say in these cases.

Anyway as for this happening more with PCOS... yeah, it is true, sadly. We are more prone to miscarriage. The hormonal imbalance can cause us to produce poorer quality eggs. Getting the PCOS under control is supposed to help but mine is not under control, I am a carb and caffeine junkie... thing is I was the same way when I got pregnant with my son so I think part of my brain thinks, eh, it doesn't matter, if it's meant to be, it's meant to be... so I pursue treatment at the same time I pursue my lousy habits.

But dietarily speaking I have been soooooooo good since this miscarriage, if I can keep it up, who knows, maybe it will help.

I hope so. If it doesn't at least I won't have the guilty feeling that I am sabbatoging (sp) myself with every move I make.

If you take the cytotec I think the worst that can go wrong is it won't work, so no harm done.

I can't quite believe the ob/gyn offering methotrexate, either. I don't even know if that would do anything in this case.

Do you have any other options in doctors to see? I know sometimes there aren't a lot of clinics where people live, or they have coverage at this clinic but not that one... I really hope you have some other options.

Tensei · 05-09-2007, 08:31 PM

Holy crap. SouthIsland, I just read everything you've written since I last checked this thread and I am in absolute shock at your doctors. I don't even know what to say, besides FIRE THEM!!!

As far as what to do now, could you just ask for a D&C and get it over with? Pay no mind to my experience... the complications were pretty specific to me, and even though it went that way, I am SO glad that I got it done. What pain I had only lasted as long as it took for the pain meds to start working, and they do send you home with pain meds, too (which I haven't needed very much).

It is so cruel for your doctors to put you through this. I would just love to kick them for you. They don't deserve to be doctors.

*HUGS* I hope everything works out. I hope that you are able to do something that you are comfortable with WITHOUT being harrassed by your doctors.