HCG? Help me out here
14 Replies
screweyjen - March 12

I am still VERY confused as to the normalcy of my beta levels. This is my fifth pregnancy with one live birth. I have Factor V Leiden and PCOS. I recently had a miscarriage in December and found I was pregnant again at the end of February. My betas were as follows: 15 days past ovulation - 86.2 17 days past ovulation - 136 19 days past ovulation - 388.1

The nurse originally emailed me after the second reading and didn't sound hopeful. She said my value only rose 60%.....But when I calculated it, it rose 63%. She said they like to see a rise of at least 67%. Then, after my third blood test, the Endocrinologist emailed me and said that all looked normal. Is it still normal for the hcg to kind of slow down and then pick up again? After the doctor, the nurse then sent me another email stating that the pregnancy was considered "normal at this point." So, is the nurse trying to prepare me for something? I'm confused.

 

B. Jacobs, M. D. - March 12

In a normal pregnancy, the hCG level should at least double every 48 hours for the first 8 weeks after last menstrual flow. If you have had ovarian stimulation to achieve the pregnancy, it is possible that more than 1 started, and 1 dropped out. That would explain the less than double in the first 48 hours, and a perfedtly appropriate rise in the second 48 hours.
Good luck.

 

screweyjen - March 13

Thanks for your response Doctor. However, I didn't have any ovarian stimulation, per se. I originally underwent ovarian drilling in 2004 to try to get things back in working order and I also take Metformin for maintenance.

So should I still worry? Is this relatively unheard of when it comes to beta levels? I did do some research online and read that a base rise of at least 50-60% in 48 hours is still considered okay. But there's no mention of a 63% rise and then the value almost tripling for the third test. I'm sorry, I know I'm a bit neurotic. But I honestly would prefer to prepare myself if I'm going to have a fourth miscarriage.....

Thanks so much.

 

B. Jacobs, M. D. - March 13

Your last pair of values were good, so don't give up hope, yet.
Good luck.

 

screweyjen - March 18

Hi Dr. Jacobs -

I wanted to give an update... I went in for my u/s today. I thought I was 6 weeks, but the doc put me at 5.5. We saw a yolk sac, but no fetal pole. I'm assuming the gestational sac was okay because she didn't mention anything. I'm supposed to go back next week. Would you still worry about it? Could it be a blighted ovum, even if there's a yolk sac? Did I mention how much I appreciate your responses? :)

 

B. Jacobs, M. D. - March 19

Normally, at 6 weeks of pregnancy, I would exxpect to see a fetal pole. A fetal heart may be difficult to find, that small. At 7 weeks, you should be able to identify it.
Good luck.

 

RB - March 19

Hi Dr. Jacobs,

My first beta was 12dp3dt and it was 85. My second beta was done 1 week later and it went up to 594...is this ok? I am not scheduled for an U/s until week of April 7th...my lmp was Feb 05 whihc puts me at just about 6weeks right? I have not had any prenatal visits yet...should i? should i do another beta HCG before my scheduled visit in April?
This is my first pregnancy and 1st IVF... i could use some expert advice.

Thanks,
RB

 

B. Jacobs, M. D. - March 19

The hCG level should at least double every 48 hours for the first 8 weeks of a normal pregnancy. I check the hCG level twice at a 48 hour interval. As far as a prenantal visit, most of the OB's I know will probably not see you before 8 weeks, anyway. You may wish to call for an appointment sooner.
Good luck.

 

RB - March 23

Thanks for the prompt reply Doctor, i'll keep my fingers crossed and pray for the best.

RB

 

screweyjen - April 29

[quote author=B. Jacobs, M. D. link=board=5;threadid=5554;start=0#47854 date=1205892324]
Normally, at 6 weeks of pregnancy, I would exxpect to see a fetal pole. A fetal heart may be difficult to find, that small. At 7 weeks, you should be able to identify it.
Good luck.
[/quote]

Hey there Dr. Jacobs!

I'm still pregnant (a bit shocked, but not complaining) - I was wondering what you thought of progesterone supplementation? I've been giving myself injections of progesterone in oil once a day. When I hit the end of ten weeks, my ob told me to give the injections once every other day for a week and then quit all together. Today I'm 11weeks, 5 days pregnant and this was the first day without any progesterone. Pardon my paranoia - but how sure can I be that the placenta is ready to take over at this point?

 

B. Jacobs, M. D. - April 29

I discontinue progesterone supplement after the placenta stars making progesterone at about 8 to 10 weeks of pregnancy.
Good luck.

 

momma04 - April 29

Can you tell me what are the average numbers for 5dp5dt, 6dp5dt, etc?

 

B. Jacobs, M. D. - April 29

If you are asking about progesterone, anything over 20 ng/ml is fine.
Good luck.

 

momma04 - May 2

Dr Jacobs,
I am writing you as I am a little concerned. When I was 6dpt5dt, my Beta was 28! And then exactly 48 hours later on 8dp5dt, my beta was 136! Last night, when I wipe, I had some very very pale spotting.Actually it was just pinkish tinge on the toilet paper. Everyone has said my numbers look great. And considering it isn't red that they are nothing to worry about. Is this true? Also, is it true that the Endometrin suppositories can cause the pale pink on toilet paper.
Thank Yoju very much for your reply!!!!!!!!!!

 

B. Jacobs, M. D. - May 2

Many different things can cause the spotting you noted. In all probability, you do not have anything to worry about.
Good luck.

 

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