Dr. Deepika Joshi
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hello doctor,
We have had four scans at 5 weeks-4 days, 6 weeks-4 days, 7 weeks-4 days, and 8 weeks-5 days. The doctor has said that everything is normal so far. The growth has been normal, and the size is okay. So what are the chances of success? We are worried because we keep reading about risks.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
I would like to know some more details. Is this your first pregnancy? Do you have any other illnesses like diabetes or hypertension?
Please answer the above questions.
Thanks and take care.
Patient's Query
Hello doctor,
Thank you for your reply.
Yes, this is our first pregnancy. No other illnesses like diabetes or hypertension.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
First of all, stop worrying too much, as stress itself affects the pregnancy adversely. Presently, the gestational age is 8 weeks 5 days, and at this stage, an ultrasound can tell you the heartbeat and the gestational sac and if the growth is adequate for this gestational age.
Pregnancy is an ongoing process. There will be various physiological changes in the mother throughout pregnancy. Though the fetus's organs have started to develop, they have not been formed completely at this stage. Therefore, do not worry so much about complications because stressing about this would not do any good.
Hope this helps.
Thanks and take care.
Patient's Query
Hello doctor,
Thank you for your reply.
Our doctor said the size and growth looked normal and appropriate for the gestational sac and fetus. We had the last scan at eight weeks and five days. It is nine weeks and two days now. I wanted to understand the chances of success from here on. From your experience, are our chances good? Please advise.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Any woman who conceives for the first time after the age of 35 years is referred to as elderly primigravida when there is a slightly increased risk of maternal and fetal complications at an increasing rate. However, if supervised properly, the majority of pregnancies have a good outcome. Suppose there is no pre-existing illness like diabetes, hypertension, or other chronic illness, there is a very good chance of success, but nobody can tell the exact percentage. Do not browse the internet too much. Enjoy the journey and take good care of your wife and the most important thing is to follow the advice of your healthcare provider.
Your wife is just nine weeks, so this is her first trimester. The main symptom that a pregnant female has is nausea and vomiting at this stage, which is a normal symptom of pregnancy. So definitely, this might affect her dietary intake but do not worry about it. Let her eat whatever she feels like. Ask her to take small frequent meals. There will be a dual marker and ultrasound at 12 weeks, an early anomaly scan that is important for assessing the risk of some genetic defects (aneuploidies). Then at around 18 weeks, a detailed scan of the baby is performed to rule out any structural defect. This scan would identify most of the major structural defects in babies. After that, scans to monitor fetal growth would be required. It is an ongoing process, so please be patient. Do not read too much about complications. Many conditions can complicate pregnancy, but that does not mean it will happen with every pregnancy.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you so much for your detailed note.
In your experience with all the details I have told you, do you think the chances of success are good? I am nervous about our next scan which is tomorrow (it will be nine weeks and four days). I have read about some situations where the development stops after eight or nine weeks (sometimes a little earlier). Have you seen any situations like that?
Hello,
Welcome back to icliniq.com.
Yes, there are situations like that. But do not think too much. Since your wife does not have any other comorbidities, there is a high chance that everything will be fine. Do not be nervous. Get the scan done by tomorrow and everything will be fine.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
The scan was done and the doctor said that it was normal. My wife takes progesterone shots every day (we used IVF). The doctor said that they will slowly reduce the progesterone shots and the body should be producing progesterone on its own from now on. Is there a possibility or concern that enough progesterone might not be there? Does that happen?
Hello,
Welcome back to icliniq.com.
Glad to hear that. Do not worry. The body will produce progesterone. Just trust your doctor's decision. Progesterone supplement is usually given to prepare the uterine lining for implantation. In lVF (invitro fertilization) pregnancies, it is usually continued for 10 weeks and then tapered. Her ultrasound is fine so everything will be fine.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
Will there be any bleeding if progesterone levels are tapered or stopped? Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
No, after around 12 weeks placenta starts producing Progesterone. So this is the reason they are decreasing the dose of progesterone.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for your help. At nine weeks and four days, they measured progesterone and it was 65.9 ng/ml. Is that normal? What should be the expected value? Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, that is normal. Progesterone levels in the first trimester (that is, up to 12 weeks) should be between 11 to 90 ng/ml. Do not worry about progesterone levels, as the pregnancy advances placenta will start producing progesterone. Do not take so much stress. Your wife is just around 10 weeks. If you continue to take stress it will affect your health as well. It is a long journey. If you have any doubts you can get back to me anytime but stop stressing. You are in good hands. They will do whatever is best for your pregnancy. Everything is perfectly fine till now so just be positive.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
My wife has been taking 2 cc progesterone injections until the completion of 10 weeks (which was three days ago). And for the last three days, it is 1.5 cc. Tomorrow it is supposed to go down to 1 cc. We have the next scan day after tomorrow. This is the plan now.
Hello,
Welcome back to icliniq.com.
Yes, that is absolutely fine. In most of the IVF cycle, we prefer to continue progesterone till 9 weeks, and then after 9-week luteoplacental shift takes place (that is the placenta will start progesterone production). So, after that, there are not many roles in giving progesterone. That is why it is being tapered now. All the best for your scan the day after tomorrow and do let me know about the scan.
Thank you.
Patient's Query
Hello doctor,
I am nervous about the scan. Is there any reason to be worried? Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
Just get it done. Do not overthink if she is not having any problems. It is a routine ultrasound.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
At nine weeks and four days, the size was 25.5 mm. Is that fine?
Thank you.
Hello,
Welcome back to icliniq.com.
To tell you about the ultrasound, I need to see the report. Kindly attach the ultrasound reports.
Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
What details would you need? This is the only detail I remember. Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
Kindly attach the entire ultrasound report.
Thank you.
Patient's Query
Hello doctor,
We do not have a report. The doctor only gave us the pictures. Is the size normal? Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
Even a picture would do.
Thank you.
Patient's Query
Hello doctor,
My wife has nausea, and general tummy discomfort (feeling full). Are these normal now? (10 weeks three days). Please advise.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, these are normal symptoms of pregnancy.
Thank you.
Patient's Query
Hello doctor,
We completed the scan. The doctor said everything was normal. Today is 10 weeks and four days. We are continuing progesterone of 1 cc for the next few days and the plan is to completely stop by early next week. Today (10 weeks 4 days) my wife said that nausea has been milder than the previous days. Is it normal for it to become milder now? Is it also because the progesterone was reduced to 1 cc?
Hello,
Welcome back to icliniq.com.
Yes, progesterone can cause nausea and bloating. In fact, nausea would decrease as the gestational age increases. Nausea usually subsides by 12 weeks. Progesterone is usually stopped by 11 weeks so do not worry about that.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
I have a question regarding progesterone. Progesterone level at 9 weeks and four days was 65.9 ng/ml. Progesterone level at 10 weeks and four days is 40 ng/ml. This is after the progesterone was reduced a bit to 1.5 cc from 2 cc and then to 1 cc for a day before the test. Is the progesterone level normal at 10 weeks and four days? The dosage is reduced still more (yesterday, today and tomorrow it is 0.5 cc). And progesterone is stopped after tomorrow, which is 11 weeks and one day. Are the progesterone levels normal? Is there anything that we should look out for? Also, I was wondering if there are age-related concerns that might cause the placenta to not produce enough amounts of progesterone.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, the progesterone levels are normal. It should be in the range of 11 to 90 ng/ ml in the first trimester of pregnancy. No, there is no age-related concern. All you need is an ultrasound at 11 to 14 weeks, which would evaluate some important parameters of the fetus like nuchal translucency and nasal bone.
Thank you.
Patient's Query
Hello doctor,
What is nuchal translucency and nasal bone? Please guide.
Thank you.
Hello,
Welcome back to icliniq.com.
Nuchal translucency is the measurement of the thickness of the nape of the neck of a baby. It is done between 11 to 14 weeks and is a screening test for some abnormalities.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
We have our anatomy scan tomorrow and will be 18 weeks and four days. Is there anything we should know about? We have had scans at 12 weeks 4 days, 13 weeks three days, and 14 weeks four days most recently. Our most recent scan was at 14 weeks four days. The doctor said it was normal. In addition, we did genetic testing (NIPS) to screen for genetic abnormalities like 21,18,13 trisomy. The tests came back as normal, which is negative for 21,18, and 13 trisomies. Sex chromosome aneuploidy was also negative.
After our last scan, we are going back tomorrow. We have not had any scans for the previous four weeks. We are nervous about the anatomy scan as we are not sure what to expect. Nausea has mostly subsided but it does happen from time to time. She commonly feels bloated and has feelings of indigestion and general stomach discomfort. Is this normal and expected? She also does not feel the baby and the pregnancy belly does look pregnant. So we are sometimes worried if everything is normal. Is everything normal? Is there anything we should be worried about for the anatomy scan? Really nervous about it. Please help.
Thank you.
Hello,
Welcome to back icliniq.com.
Do not worry about fetal movement as movements are usually perceived after 18 weeks. In fact sometimes in the first pregnancy, some females perceive movements after 20 weeks. It is absolutely normal if she does not look pregnant because till 18 weeks baby bump is visible only in very thin females. As far as an anatomy scan is concerned, this scan would be a detailed scan of the baby's organs to rule out any structural defect. At 18 weeks almost all the organs like kidneys heart lungs and facial structures have developed so this scan would tell about the anatomy of the baby. This is the most important scan during pregnancy. Do not worry about the results. Get it done tomorrow and be positive everything would be fine.
Patient's Query
Hi doctor,
Thanks for the reply doctor.
She has had no symptoms like bleeding, spotting, cramps, etc. and she has symptoms like stomach unease, acid reflux, indigestion, etc. Does this mean that the pregnancy is developing normally? Since we cannot perceive any movements, how do we know that everything is normal?
Hi,
Welcome back to icliniq.com.
These are normal signs of pregnancy. She will start perceiving fetal movement by 20 to 22 weeks. Tomorrow she will have an ultrasound so the doctor would come to know if everything is developing normally. And if there is no bleeding or pain then the pregnancy would be growing and the exact growth can be ascertained by ultrasound.
Patient's Query
Hi doctor,
Thank you for the reply.
So can we assume the pregnancy is growing normally now?
Also, how common is it that they find any anomalies in the scan? And if they find anything, can it be treated? Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
The risk of structural birth defects in the general population is three to five percent. Yes, a few defects can be treated and a few can not. It depends on the type of defect.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
Would you say that the risk of missed miscarriage or anything like that for us is low now?
Is that something we should worry about?
Hi,
Welcome back to icliniq.com.
You get today's ultrasound done and that would give us the exact idea of what is going on. If the anatomy scan is fine then after second trimester there are other factors that can affect pregnancy. Pregnancy is an ongoing process. So we can just tell you what we can expect depending on today's condition. So if the fetus is structurally normal and maternal factors are fine then definitely there would be a good outcome.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello Doctor, We have had anatomy scans at 18 weeks 4 days, 22 weeks 4 days and 26 weeks four days. So far, they have said everything is fine. The growth is also fine so far. The 26 weeks four days scan was yesterday. My wife's BP has also been normal so far. We have measured at home and they did at the hospital yesterday. We did a blood sugar test yesterday (26 weeks 4 days). It was the '1 hour' test, where she had to drink the glucose drink and they took the blood sample one hour later. The issue was that just prior to the doctor's appointment, my wife ate an avocado sandwich for lunch. We mentioned this to the doctor - the doctor suggested to do the test anyway, but said there could be a false positive, in which case we might need to do more tests. The results came today and it was 175, which is higher than the limit. So we are waiting for the follow-up. I have a few questions: 1) Will the lunch that she ate have caused the result to be higher than normal? Is that possible? 2) Is 175 very high? What should the limit be? 3) What do we need to do now? 4) Should this be something we worry about? Thank you for your help!
Hello, Welcome back to icliniq.com. The sugar test that was done might be 'The Glucose challenge' test. It is the screening test to identify individuals who are at risk of developing gestational diabetes. It should be less than 140 but it is a screening test, not confirmatory. This test does not require fasting but since it is above the normal threshold in your wife so a 100 gm OGTT (oral glucose tolerance test) would be required If this come out to be normal, then that means that she does not have GDM (gestational diabetes mellites or pregnancy induced diabetes). If it is deranged then it is diagnostic of gestational diabetes mellitus, which can be managed by diet and lifestyle.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
Obstetrics and Gynecology
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
