Low initial hcg
11 Replies
gmv4753 - December 20

I am cd 35, 19/20 dp iui. I tested faint positive on a hpt Monday. Had a beta done Monday afternoon. The results yesterday were 61. I go again today for my second one.
My question is is the number too low?
This is my 3rd pregnancy- the other two were uneventful, although they were 12 and 9 years ago.
I am 40- just turned. This is my third round of clomid, we have done 5 rounds of iui.


B. Jacobs, M. D. - December 20

There is a very broad range of normal hCG levels in early pregnancy. The important thing is that the level at least double in 48 hours. If this is not a successful pregnancy, I would suggest that you use an FSH protocol if you choose to stimulate your ovaries, again. For more information, please see our web site, <www.texasfertility.com>.
Good luck.


gmv4753 - December 20

Thanks for the reply-
I just found out that my second beta was only 101.
So it didn't double.
It seems like I read somewhere that with late implantations- which is what I suspect this is- that there is a higher chance of miscarriage- is that true?
I'm guessing that I will go in for another beta on Friday.
When is the earliest that they could do an ultrasound? I have read 5 weeks- but is that lmp or conception?


B. Jacobs, M. D. - December 21

I wait until 6 to 8 weeks of pregnancy to do an ultrasound. Before that it is too early to reliably see fetal heart activity.
Good luck.


gmv4753 - December 21

Just got off the phone with my dr- she said not to worry- that she was glad it was going up- another beta tomorrow.


gmv4753 - December 23

My third beta came back at 195. It was only 47 hours from the previous draw.
I'm wondering if this is viable.


B. Jacobs, M. D. - December 24

The fact that your hCG did not quite double does not assure failure, any more than doubling assures a healthy pregnancy. It is suggestive of outcome, only. Since your hCG came so close to doubling, it is difficult to make a valid judgement. I am afraid you will have to wait for the ultrasound.
Good luck.


gmv4753 - January 5

I had another beta on 12/28- came back at 1756.
U/S today showed only a sac.
Nurse said maybe because the iui was on the 2nd, that I'm only 4 wks 4 days?
Did another beta today and u/s next friday.

Do the numbers look better if I'm only 4 wks?
My last cycle was longer than usual- I didn't O until day 16.

What do you think?


B. Jacobs, M. D. - January 5

All of the data I have seen related to prognostic value of hCG determinations iare based on comparing to determinations at 48 hour intervals. An ultrasound at 4 weeks of pregnancy will not demonstrate more than a sac. I recommend waiting until at least 6 weeks to loook for fetal cardiac activity.
Good luck.


teri-chan - January 11

I'm a little confused by your answers to gmv4753--both with regard to the dating of the pregnancy and with regard to the hCG values.

As I understood it, she told you that at four weeks and four days AFTER HER IUI, the ultrasound showed only a sac. (If I've got the facts right, her IUI was on 12/2/06. Her ultrasound was on 1/5/07.) I was under the impression that the length of a pregnancy is dated from the first day of the last menstrual period or two weeks before ovulation. If that's right, then since gmv4753 ovulated on day 16, doesn't that mean she was 6 weeks 6 days pregnant (if dating from first day of the last menstrual period) or 6 weeks 4 days pregnant (if dating from two weeks before ovulation) at her 1/5/07 ultrasound? If so, should she have seen more than a sac then, if the pregnancy was progressing well?

Now, about the hCG values. On 12/20 she was at 101 mIU/ml. On 12/22 at 195. If doubling occurred every 48 hours between the 12/22 and the 12/28 measurement, then you would have expected about 1600 mIU/ml on 12/28. Her hCG was 1756 on 12/28. So isn't it safe to say her hCG was increasing in the way it would in a healthy pregnancy?

Thank you.


B. Jacobs, M. D. - January 11

At 6 weeks of pregnancy (dated from first day of last menses), you should be able to see fetal cardiac activity. Although doubling of hCG in a 48 hour interval is reassuring, it is not a guarantee of a healthy pregnancy. No, medicine is not a perfect science.


teri-chan - January 12

Thanks for confirming that pregnancy is dated as I thought it was, so that the ultrasound that gmv4753 asked you about was one that was done at six+ weeks pregnancy and not four+ weeks pregnancy. It makes a HUGE difference!

I realize that the doubling of hCG in 24 hours does not guarantee a healthy pregnancy. That is why I wrote "Isn't it safe to say that her hCG was increasing in THE WAY IT WOULD in a healthy pregnancy?" A yes answer certainly leaves room for the pregnancy not to be a healthy one, but for the hCG value to be increasing in the way it would in a healthy pregnancy.



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