A few hours later, it was my turn to be a patient. I reviewed the dates with my RE. I was 6 weeks by my last menstrual period, but by date of conception, I was actually 6 weeks and 2 days. I knew exactly what I should see on the ultrasound monitor. I had an initial sigh of relief when I saw a single sac inside the uterus, but then a larger concern set in. The sac was too small. It looked more consistent with five weeks. There was no yolk sac nor fetal pole to be identified. There was little decidual reaction and the sac appeared closer to the lower segment of the uterus. Everything about the image looked wrong and I knew it. I might as well have been looking at a Magic 8 ball to return a verdict of "Outlook not so good".
The RE reviewed the findings with me. He couldn't exclude the possibility that ovulation or implantation could have been delayed and this may be an early pregnancy, but he also couldn't rule out an ectopic pregnancy. We would have to come back in a week to see if there is any progression. It's the dance of due diligence. The pregnancy is most likely non-viable, but more time is required to make that determination. I've been in the same situation with some of my patients and it is the shittiest thing to do to a couple. It is the worst wait of all. I would almost rather be able to give the bad news at that moment, than make them go through a week of agony before the eventual disappointment. I've seen things work out well if the woman truly has irregular cycles and often the couple wasn't trying to conceive at that time, so they don't have a refernece for conception dates. I knew there was no possible error in my dates. The following week, Husband was away in Seattle for a night and then to Santa Barbara for the weekend. I don't think we had sex until after I learned I was pregnant, but I was too embarrassed to disclose that to my RE. I nodded and smiled in front of him and at least for that moment, I believed that maybe this could be an early pregnancy and we weren't doomed yet.
As soon as I got in my car to drive home, the realisation set in. This pregnancy wasn't viable. I was going to miscarry. I went to the coping method I often use after a bad day at work; listen to some good music loud and sing at the top of my lungs. I recently participated in an 80s themed run and made a playlist for the occasion. I figured any song that came up on the random selection would be sufficient, but the one that came up was especially fitting:
Ain't nothin' gonna break my stride
Nobody gonna slow me down,
I got to keep on movin'