Pregnant or Miscarriage? Your Symptoms and Concerns

Is it a pregnancy or another natural miscarriage?

Hello, Doctor.
I have polycystic ovary syndrome and have been married for five years.
I had a natural miscarriage early last year.
I started seriously preparing for pregnancy three months ago.
My last menstrual period was from July 24 to July 28 (my cycles are irregular).
On August 10, an ultrasound showed a 24mm follicle, and I received an ovulation trigger shot.
That night, we had intercourse, and again the next day.
On the third morning, I suddenly experienced severe abdominal pain.
In the afternoon, I tested with an ovulation test strip, and the line was faint.
That evening, we had intercourse again.
After that, I experienced intermittent mild abdominal pain for several days.

Starting from August 25, I had three days of bleeding that I’m unsure if it’s my period; the blood was a very dark brown (almost black) with some clots (a bit like tissue), and it was only noticeable when wiping.
I used about one sanitary pad per day.
However, it only lasted three days, and today is the fourth day with almost no bleeding.
Over the past three days, including today, I have taken home pregnancy tests, but they only show one line.
This situation is somewhat similar to my natural miscarriage last year.
Could there be a possibility that I am pregnant this time, or is it just my period? Thank you for your patience in reading this.
I am really anxious, and I am currently abroad, so I hope you can help me.

xiang huaiyun, 30~39 year old female. Ask Date: 2017/08/28

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if the pregnancy test shows only one line, it is likely that your period is approaching.
If you still experience discomfort, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2017/08/28

More Info

It sounds like you are going through a very challenging time, especially with your history of polycystic ovary syndrome (PCOS) and a previous miscarriage. Your concerns about your current symptoms and whether they indicate a pregnancy or a potential miscarriage are completely valid and understandable.

Based on the information you've provided, it seems that you are experiencing some unusual symptoms that could be indicative of several things. The deep brown discharge you described, especially if it is accompanied by pain, can sometimes be a sign of implantation bleeding, which occurs when a fertilized egg attaches to the lining of the uterus. However, it can also indicate the onset of a menstrual period or even a miscarriage, particularly given your history.

The fact that you have had a previous miscarriage and are now experiencing similar symptoms can understandably heighten your anxiety. It's important to remember that while the symptoms may seem similar, each pregnancy is unique, and not all experiences will mirror past ones. The absence of a positive pregnancy test, despite your symptoms, does suggest that you may not be pregnant, but it's not definitive. Home pregnancy tests can sometimes yield false negatives, especially if taken too early or if the hormone levels are not yet high enough to detect.

Given your situation, here are a few recommendations:
1. Consult a Healthcare Provider: Since you are currently abroad, seek out a local healthcare provider who can perform a blood test to check your hCG levels. This is a more sensitive method of determining pregnancy than a home test and can provide you with clearer answers.

2. Monitor Your Symptoms: Keep track of your symptoms, including any changes in pain or bleeding. If the pain becomes severe or if you experience heavy bleeding, seek medical attention immediately.

3. Emotional Support: It's completely normal to feel anxious, especially after experiencing a loss. Consider reaching out to a support group or a mental health professional who specializes in reproductive health. They can provide you with coping strategies and emotional support during this uncertain time.

4. Educate Yourself: Understanding your condition, PCOS, and how it can affect your menstrual cycle and pregnancy can empower you. Knowledge can help alleviate some anxiety by providing you with realistic expectations and understanding of your body.

5. Stay Positive: While it’s easy to focus on the negative, try to remain hopeful. Many women with PCOS go on to have successful pregnancies. It may take time and patience, but it is possible.

In summary, while your symptoms are concerning, they do not definitively indicate a miscarriage or pregnancy. The best course of action is to consult with a healthcare provider who can give you a thorough evaluation and the necessary tests. Remember to take care of your emotional well-being during this time, as it is just as important as your physical health.

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