low and slow HCG levels
5 Replies
psy - September 10

Hi. I am 41 years old, have a 5 year old daughter from first IVF cycle, and have been through several IVF cycles since, that have either failed or resulted in early misscarriage.
This last attempt I got pregnant but am seriously concerned.
My first Beta HCG was 37
40 hours later 51
48 hours later 80.4
48 hours later 144
48 hours later 440
48 hours later 780
48 hours later (today) 1650 - and a small sac (3.7 mm) seen in uterus. MD is suspicious if it is a real gestational sac.
How suspicious does this sound? IF betas start low and slow, but pick up speed, should we forever expect this pregnancy to miscarry?


Barry Jacobs, M. D. - September 10

In a normal pregnancy, the hCG level will at least double every 48 hours for about the first 8 weeks. If more than 1 embryo implants, but fails to continue to grow, ther may not be doubling for a period of time, but the remainig embryo may produce a subsequent doubling.
Good luck.


psy - September 11

Many thanks. Interesting. How likely is such a scenario? are there other indicators?
If that is not the explanation would a blighted ovum or other kind of failing pregnancy look this way?
Is there a correlation between the early HCG low/slow read and later chromosomal abnormalities?


Barry Jacobs, M. D. - September 12

The only thing to do at this time is to wait. At 3 weeks after retrieval, all you can see on ultrasound is a gestational sac, and not the fetus. I suggest you wait until 5 weeks after retrieval to do an ultrasound. You will see a fetal heart beat in a living pregnancy.
Good luck.


psy - September 12

Thanks again.
I am in a very confusing state.
As of tomorrow we will be exactly 4 weeks post day 3 Transfer.
2 days ago we went in and there was just a qustionable sac on US (3.7 mm). Beta was in the 1600's (doubled since 48 hours prior). Today we went in and a larger and clear sac was seen (6.8 mm - with clear ring etc). The monitoring physician seemed pleased and claimed it would be too early to see fetal pole. Beta came back at 2750.
--Our nurse emailed us that the pregnancy is clearly over and we should stop meds (prog + est.). Upon questioning their rationale was that at 4 weeks post transfer we must be able to see the heartbeat - otherwise it is definitely not a viable pregnancy.
I do not want to hold on to false hopes here, just to be sure we are not rushing to call it quits.
Could you share your opinion please?
Many Thanks,


Barry Jacobs, M D. - September 13

By 4 weeks after egg retrieval, you should be able to see a fetal pole and fetal heart on vaginal ultrasound.
Good luck.



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