###Human: Fourth ultrasound after IVF has no signs of fetal pole. Please help. ###Assistant: Hi. It seems it was anembryonic pregnancy means the sac was formed but without a fetal pole. Sac is not growing inside to have a fetal pole and gradually towards further stages of pregnancy even after hormonal support. It is a bit depressing but if you want to wait for some time more to have nature to react rather then your own initiative then you can quit hormonal support and wait. Cramps indicate that natural miscarriage is soon to happen. Be positive. Things that meant to come to you will come to you. It is your decision that you want to wait or want evacuation now. In case of bleeding, severe abdominal pain or dizziness report to the hospital. After this pregnancy, start folic acid daily 5 mg if you want to try again for IVF (in-vitro fertilization). Have healthy nutritious diet with daily exercise and some relaxing recreational activities. Quit recreational drugs if you want to conceive again as these reduce fertility. For more information consult an obstetrician and gynaecologist online -->