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Fertility / Infertility (Expert Forum)
HCG Levels Not Doubling IVF
Answered by
Elaine Brown, MD - Pregnancy, Gynecology
Elaine Brown, MD - BLOG
Billings - MT
Questions in the Fertility/Infertility forum are answered by doctors affiliated with USF Health. Topics covered include fertility or infertility issues, egg quality, fertility drugs and side effects, fertility tests, genetic testing, in-vitro fertilization (IVF), ovulation, relationship issues, risk factors, sperm count/quality, and surgery.
HCG Levels Not Doubling IVF
by whitljo, Jul 02, 2009 01:39PM
2 failed IVF/ICSI cycles before I naturally conceived my son who will be 3 in August. I am 35 yrs old w/ a low egg reserve and my husband has a low sperm count and low motility.
This is our 4th IVF/ICSI cycle. Our last IVF/ICSI cycle ended w/ a miscarriage over 6 months ago. Two beta tests were performed and after my hcg levels did not double (75 initial test only increased to 113 two days later), I was told that it was not a good sign and to wait it out for 2 wks until the ultrasound at 6 wks. I was diagnosed w/ a blighted ovum when 2 empty sacs were seen during the ultrasound. I ultimately elected to have a D&C at 13 weeks since I had no bleeding, cramps or other signs of miscarriage.
Unfortunately, I find myself in a similar position w/ our 4th IVF/ICSI cycle. Here are the key dates:
LMP - May 28th
June 8 - Egg retrieval
June 11 - 3 embryos transferred (1 good, 1 average, 1 below average)
June 22 - hcg level 98
June 24 - hcg level 154 (different lab used)
June 26 - hcg level 221 (same lab as 6/24 beta)
June 30 - hcg level 754 (same lab as 6/24 & 6/26 beta)
I had very strong nausea leading up to my 1st beta on 6/22 up until my 3rd beta on 6/26, but no nausea since then even though my beta has thankfully increased. Mild cramping consistent w/ early pregnancy and no bleeding, but I never bled or miscarried naturally the first time.
Ultrasound scheduled for 6/10 when I will be 6 wks and 4 days. My RE is taking a wait & see approach and have told me it's probably another miscarriage (blighted ovum or ectopic). There is a very small chance that it's a vanishing twin causing my hcg levels to be skewed.
Any hope or should I mentally prepare myself for the worse case scenario? Thank you for your assistance.
This is our 4th IVF/ICSI cycle. Our last IVF/ICSI cycle ended w/ a miscarriage over 6 months ago. Two beta tests were performed and after my hcg levels did not double (75 initial test only increased to 113 two days later), I was told that it was not a good sign and to wait it out for 2 wks until the ultrasound at 6 wks. I was diagnosed w/ a blighted ovum when 2 empty sacs were seen during the ultrasound. I ultimately elected to have a D&C at 13 weeks since I had no bleeding, cramps or other signs of miscarriage.
Unfortunately, I find myself in a similar position w/ our 4th IVF/ICSI cycle. Here are the key dates:
LMP - May 28th
June 8 - Egg retrieval
June 11 - 3 embryos transferred (1 good, 1 average, 1 below average)
June 22 - hcg level 98
June 24 - hcg level 154 (different lab used)
June 26 - hcg level 221 (same lab as 6/24 beta)
June 30 - hcg level 754 (same lab as 6/24 & 6/26 beta)
I had very strong nausea leading up to my 1st beta on 6/22 up until my 3rd beta on 6/26, but no nausea since then even though my beta has thankfully increased. Mild cramping consistent w/ early pregnancy and no bleeding, but I never bled or miscarried naturally the first time.
Ultrasound scheduled for 6/10 when I will be 6 wks and 4 days. My RE is taking a wait & see approach and have told me it's probably another miscarriage (blighted ovum or ectopic). There is a very small chance that it's a vanishing twin causing my hcg levels to be skewed.
Any hope or should I mentally prepare myself for the worse case scenario? Thank you for your assistance.
Doctor's Answer
by Elaine Brown, MD, Jul 04, 2009 03:10PM
, Jul 04, 2009 03:10PMTo: whitljo
Hi!
If we could just take out that beta of 154 and move each of the others up one slot, things would look pretty good. Unfortunately, its not possible to do that. With the quants rising as slowly as they are, I think being prepared for the worst is your best bet. It is so unpredictable with IVF, that I would never rule out the possibility of a nice surprise, but I also wouldn't but a lot of diapers yet. I hope everything works out OK, and at least you have one wonderful healthy child to console you. Also, don't rule out the possibility of donor eggs--something to consider if this IVF cycle doesn't turn out.
Good luck!
Dr B
If we could just take out that beta of 154 and move each of the others up one slot, things would look pretty good. Unfortunately, its not possible to do that. With the quants rising as slowly as they are, I think being prepared for the worst is your best bet. It is so unpredictable with IVF, that I would never rule out the possibility of a nice surprise, but I also wouldn't but a lot of diapers yet. I hope everything works out OK, and at least you have one wonderful healthy child to console you. Also, don't rule out the possibility of donor eggs--something to consider if this IVF cycle doesn't turn out.
Good luck!
Dr B
