5 week ultrasound: What to expect from early pregnancy scans

5 weeks is an important milestone in pregnancy. This is the time when an embryo enters the embryonic period and starts developing its major body systems and organs. Nevertheless, this is still a very early stage of pregnancy, which is why 5 week ultrasound is rarely recommended without a specific medical reason.

Commonly, routine scanning only begins around 6-9 weeks. Still, an ultrasound at 5 weeks might be scheduled due to one of the following reasons:

• Bleeding or pain
• Suspicion of ectopic pregnancy
• Suspicion of multiple pregnancy
• IVF or assisted reproductive technology

Sometimes, early ultrasound scans are performed based on a personal request. However, it’s generally not recommended because such an early examination often doesn’t show much because the embryo is still small.

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When you cross the point of 5 weeks in your pregnancy, this is still a rather early stage. At this time, the embryo is as small as an apple seed and is just entering the embryonic period, in which the major body systems and organs are developing.

Although this is still early into pregnancy, it’s natural if you want to have some reassurance and see if your baby is developing healthily. Possibly, you’ve been thinking about scheduling a 5 week ultrasound soon to receive this reassurance. But can you get an ultrasound at 5 weeks? And can you actually see anything so early?

This guide will answer all your questions to help you understand your journey better and reduce anxiety.

What Is “5 Weeks” of Pregnancy?

Before we delve into the details of a 5 week ultrasound, it’s important to understand how the early pregnancy timeline is calculated.

Until you get pregnant, you will typically count your TTC journey based on the number of days post ovulation (DPO). The earliest days, from 1 DPO to around 8 DPO, are the time when the egg might be fertilized, travel to the uterus, and implant. After this happens, your body starts shifting hormones and producing human chorionic gonadotropin (hCG) hormone that needs to build up to be detected by a pregnancy test. Typically, hCG levels get high enough by around 15 DPO, which is the first day of an expected period in a 28-day cycle. This is when you may miss your period and confirm pregnancy with a test.

Weeks of pregnancy, however, are counted slightly differently. Instead of using ovulation in which conception occurred as a starting point, you will be counting from the first day of your last menstrual period (LMP). This is done to simplify the calculation of gestational duration because the exact ovulation time may fluctuate.

Respectively, 5 weeks of pregnancy means that you’re currently 5 weeks away from your LMP. At this time, the embryo is still very small, around the size of an apple seed. Starting from week 5, it enters the embryonic period, which stands for several important developmental milestones, such as:

• The formation of a gestational sac – a fluid-filled structure, which can be seen on an ultrasound scan.
• The formation of a yolk sac – a structure that nourishes the embryo and provides early pregnancy support.
• The rapid development of major body systems and organs, such as the spinal cord, brain, heart, limb buds, and others.

Can You Get an Ultrasound at 5 Weeks?

When you already know that you’re pregnant, it’s natural if you want to see your baby as early as possible and make sure that the development goes well. From this perspective, this might not be what you expected or wanted to hear at this stage, but an ultrasound at 5 weeks doesn't tell you much. In most cases, it’s still considered too early for an ultrasound. The earliest scans usually take place around 6-9 weeks.

Although routine examinations typically begin later, it’s still possible to have a 5 weeks pregnant ultrasound. However, often, it’s done earlier due to a certain underlying cause.

Common Causes for a 5 Week Ultrasound

Most often, healthcare providers schedule an ultrasound at 5 weeks if there are any medical concerns. The most common causes include:

• Bleeding or pain – Roughly 15% to 25% of all pregnant women experience some bleeding in the first 12 weeks of pregnancy. Often, this is a normal occurrence caused by implantation, hormonal changes, or changes in the cervix. Still, it’s important to notify a healthcare provider about any bleeding in early pregnancy in order to exclude the possibility of negative causes, such as infections, cervical polyps, and others. And a doctor may use an ultrasound as one of the tools to confirm that everything’s okay. In the same way, a healthcare provider may schedule an ultrasound if you experience continuous or severe pain at week 5.
• Suspicion of ectopic pregnancy – If there are any reasons to suspect that implantation occurred outside of the uterus, a healthcare provider may also schedule a 5 week ultrasound. An ultrasound scan should help verify an intra-uterine pregnancy in the early stages.

Although medical concerns can be a big reason to schedule an ultrasound early, it’s not always the case. Sometimes, you may face an ultrasound at 5 weeks, even when there are no specific complaints or medical concerns. For example, it’s common to use early scans in the following cases:

• Suspicion of multiple pregnancy – Family history and some early pregnancy symptoms, such as a greater-than-average appetite, more prominent weight gain, or intense morning sickness, can indicate the possibility of carrying multiples. In this case, a doctor may schedule an ultrasound earlier than usual to locate a gestational sac and verify the number of sacs (if indeed pregnant with multiples).
• IVF or assisted reproductive technology – Pregnancies that occur from assisted technology typically require more frequent and close monitoring than those occurring naturally. This is associated with a higher chance of multiples and generally increased risks. In this case, early doctor visits and ultrasounds are needed to detect any possible issues and address them in a timely manner.
• Personal request – Some women request a 5 weeks pregnant ultrasound themselves, and some doctors may approve these requests. However, it’s important to remember that early scans aren’t generally recommended without the need to avoid unnecessary worries and stress. The thing is that 5 weeks is still quite early to be able to see a fetus clearly, which can cause anxiety for some pregnant women.

5 Week Ultrasound: What to Expect and What It Shows

If you have your first ultrasound at 5 weeks (regardless of the reason), it can be a very exciting and yet anxious stage in your journey. So, it’s natural if you want to know what to expect from it.

Firstly, let’s get clear on the scan type. In 5 weeks, you shouldn’t expect to have a habitual transabdominal ultrasound because these are usually performed later. Instead, a healthcare provider will likely use a transvaginal ultrasound because the embryo is still very small to see clearly without an internal probe.

You also need to prepare for what you can (and can’t see) on a 5 weeks pregnant ultrasound. Generally, there are four structures that might be visible in early pregnancy ultrasound scans:

• Gestational sac – This is a sac filled with fluid that protects the embryo. In ultrasounds, it’s seen as a black area inside the uterus, and it's also one of the first pregnancy structures that can be detected by a scan.
• Yolk sac – This is a small, membranous structure located outside the embryo. It is responsible for supplying nutrients and oxygen to the fetus. It develops early in pregnancy and is typically seen in an ultrasound as a small white or round structure in the gestational sac.
• Embryo/fetal pole – This is one of the earliest visible structures of a developing embryo. First, it appears as a thickened area (dot) within the gestational sac and then transforms into a small curved shape located next to the yolk sac.
• Heartbeat – Fetal heartbeat is also one of the first things detected via an ultrasound. Usually, doctors can detect the beating of cardiac tissue as early as weeks 5-6. A more pronounced heartbeat is detected within the next few weeks when the heart fully develops.

It’s possible to see some of the aforementioned structures in a 5 week ultrasound. However, it’s also important to remember that routine examinations are typically held later in the first trimester because scans may not show everything so early. At this stage of pregnancy, ultrasound is mainly used to locate the gestational sac, detect the number of sacs (to see if it’s a multiple pregnancy), and examine the size of the sac.

What Does It Mean if 5 Weeks Pregnant Ultrasound Showed Nothing?

So, you’ve had an ultrasound at 5 weeks, and it showed very little or nothing at all. This situation can surely feel confusing and disturbing. However, it’s not necessarily a cause for concern.

The truth is that seeing nothing in an ultrasound at such an early stage is generally common and normal. Often, a silhouette of an embryo and its heartbeat are detected later, when it grows and develops a little more. In a normal 5 weeks pregnant ultrasound, you’ll likely only see a tiny dot.

If you don’t see anything at all, this also may not be definitive yet. There is a possibility that your gestational dating is incorrect and the pregnancy is still less advanced than thought. Other possible reasons for not seeing anything in an ultrasound include:

• Ectopic pregnancy
• Early miscarriage
• Blighted ovum

But these are not always definitive either. The results from a 5 week ultrasound typically require further evaluation and follow-up in 1-2 weeks. Although this can feel anxious, many pregnancies progress healthily even if early examination is inconclusive.

FAQ

Can you see anything on an ultrasound at 5 weeks?

Although it’s still early in your pregnancy, it is possible to see some evidence of a developing baby in an ultrasound at 5 weeks. Some things you may see at this point are a gestational sac, yolk sac, fetal pole, and heartbeat. More prominent signs of a developing baby, such as its limbs or features, aren’t seen at such an early stage.

Is it common not to hear a heartbeat at 5 weeks?

Yes. Although it’s potentially possible to detect a heartbeat early, it’s quite rare. In most pregnancies, it’s detected around 6-7 weeks. So if you have a 5 week ultrasound and don’t hear a heartbeat, this is usually not a cause for concern.

Should I be worried if a 5 weeks pregnant ultrasound showed nothing?

No. Often, 5 weeks is too early to worry if an ultrasound doesn't show much or shows nothing at all. Usually, it's recommended to have a follow-up in 1-2 weeks for clarity because there is a chance that your pregnancy is less advanced than thought.

Conclusion

As you now know, a 5 week ultrasound is generally quite early. In most pregnancies, women have their first screenings between 6-9 weeks, when an embryo develops the major systems and can be clearly detected via transabdominal ultrasound.

Still, it’s possible to have your first scan earlier in one of the following cases:

• Bleeding or pain
• Suspicion of ectopic pregnancy
• Suspicion of multiple pregnancy
• IVF or assisted reproductive technology

If you do have it, there are a few important things to remember. Firstly, a normal 5 weeks pregnant ultrasound may only show a tiny dot, so it’s okay if you don’t really see your baby yet or can’t detect a heartbeat. Secondly, it’s important to remember that such an early scan is still not decisive and requires a follow-up, so it’s often too early to worry.

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