Six weeks pregnant - empty sac and two weeks behind in size. is this viable?

Patient

Q: I am 6 weeks 6 days pregnant, the transvaginal ultrasound yesterday shows an empty sac at a size of 4 weeks  or so , I wasn't given exact numbers in terms of size. 10 days ago I had my first scan and the sac measured 3 weeks but I was 5 weeks along.  My obgyn hasn't asked for a blood test and think we should hold off, he's not saying which way this will go.... I am worried. I am not sure why he didn't perform a blood test, I want to find out, what are my chances that this is not a viable pregnancy in cases like mine?  (my periods range from 28 days and 30 days, I am 100% sure I conceived on 18 Jan, this is my first pregnancy) Thank you 

Doctor

A:   I am sorry to hear what you have been experiencing. It is difficult at this moment to say what chances are there for a viable pregnancy. Sometimes it may take serial ultrasounds to confirm a diagnosis. Sometimes an ultrasound will give uncertain results and repeat ultrasound is ordered. The wait for the repeated ultrasound can be emotionally very difficult, but it may be necessary in order to avoid a misdiagnosis. You may even consult your doctor for quantitative HCG analysis. A rising level of HCG will indicate a viable pregnancy. If the next ultrasound shows nothing in the sac, it is either a blighted ovum (which means a baby did not form, only the sac) or it is a pseudo sac (fake sac). I wish you well and do hope for a positive outcome.

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