ultrasound and hcg levels at 8 weeks pg

[TKAYEOH]

HI THERE... I HAVE A LENGTHY STORY. I AM NOW 8 WEEKS PG AND HAVE HAD 5 TRANSVAG U/S, THE LATEST ONE WAS YESTERDAY.  MY HCG LEVEL ON MONDAY OF THIS WEEK WAS 18210 AND YESTERDAY WAS 18789.  THERE WAS A HEARTBEAT DETECTED ALTHOUGH IT WAS SLOW, AND I AM SCHEDULED TO HAVE ANOTHER IN TWO WEEKS.  MY DRS NURSE SAID THAT THE NUMBERS DO NOT LOOK PROMISING AND WITH ALL MY RESEARCH I AM A LITTLE CONFUSED.  THE CHARTS ON THE INTERNET SHOW THAT HCG LEVELS START TO LEVEL OFF AT ANYWHERE FROM 8-10 WEEKS.  IS THAT THE CASE OR IS THE PREGNANCY DOOMED?  I HAVE HAD A LITTLE SPOTTING, SLIGHTLY PINK MIXED WITH OTHER DISCHARGE, NO CRAMPING AND OR PAIN.  MY DOCTOR TOLD ME ON MONDAY THAT HE THOUGHT THAT THIS WAS A NON-VIABLE PREGNANCY, AND CODED IT A MISSED ABORTION BECAUSE A HEARTBEAT WAS NOT DETECTED.  THEY ARE GOING OFF MY LMP OF 03/24/03, BUT I KNOW THAT THE CONCEPTION WAS FROM 03-10-03 GIVE OR TAKE THREE DAYS ON HOW LONG SPERM IS ALIVE.  I HAVE ALREADY BEEN THROUGH A LOT HAVING SO MANY TESTS AND US EARLY ON AND I AM IN A PANIC.... PLEASE LET ME KNOW WHAT YOU THINK.... I MEASURED 8 WEEKS 1 DAY YESTERDAY AND THE BABY MEASURED 5 WEEKS 6 DAYS WITH A HEART BEAT THAT WAS SLOW.  THE US LADY TOLD ME THAT THIS IS THE EARLIEST YOU CAN SEE A HEARTBEAT AND THAT THEY ARE SLOW WHEN IT IS THIS EARLY. WITH THE SPOTTING AND THE COMMENTS FROM THE NURSE, WHAT IS GOING ON...  PLEASE RESPOND.
MANY BLESSINGS
TKAYEOH

[Kevin Pho, MD]

Hello - thanks for asking your question.

Without examining you or your studies, it is impossible for me to diagnose over the internet.  Here is the normal HCG value chart:
0-1 week: 0-50 IU/L
1-2 weeks: 40 - 300
3-4: 500 - 6,000
1-2 months: 5,000 - 200,000
2-3 months: 10,000 - 100,000
2nd trimester: 3,000 - 50,000
3rd trimester: 1,000 - 50,000
Non-pregnant females: <5.0
Postmenopausal: <9.5

As you can see, after 2 months, the HCG can range from 10,000-100,000.  

There are several ultrasound findings to consider.  After six weeks, the small white gestational ring is so characteristic that failure to identify it raises doubts about the pregnancy. By careful scanning, distinct echoes from the embryonic poles can be demonstrated within the gestational ring by seven weeks after the last period. Fetal heart must be observed by the eighth week, or the pregnancy is in serious doubt.

If the gestational sac appears to be absent, undefined, is unusually small or there are no echoes from the fetus at eight weeks LMP, then it is most likely a blighted ovum (a product of conception that never made it).

In any case, I would continue with the ultrasound to monitor the viability of the pregnancy.  Vaginal ultrasound is better at detecting very early pregnancy - if there is any question with the next ultrasound, you may want to consider this.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Shmu]

Hello,
Here are the details of my case:
1) ovulated on 5/22
2) typically have longer cycles (30-32 days)
3) had first (vaginal) ultrasound on 7/1
I guess technically I'm seven weeks along. The doctor was not able to see anything inside the sac (he was looking for the yolk or white mark). He has scheduled me for another ultrasound (with color) in a week. His findings led him to inform us that I've either miscarried or have a tubal pregnancy. He did some bloodwork on me (yesterday) at which my level was 15,000 (higher than they expected).

My question is it possible that it may have been too soon to see anything visible on the ultrasound?(considering I'm five weeks from the time I ovulated). The doctor also tried looking at my tubes but didn't see anything there. I've had no negative symptoms whatsoever. Please advise.
Thank you,
Shemin Amarshi

[cami825]

A related discussion, hcg levels was started.