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Fertility / Infertility (Expert Forum)
hcg levels not correlating with us findings
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 correlating with us findings
by newbieG, Jul 07, 2007 12:00AM
i am currently about 6 wks pg with lmp 5/25. (chemical pg and missed mc at 7 wks) i have mthfr and factor V leidien. am on lovenox and foltx as well as prenatals.
hcgs 6/27 3197
6/30 10,000ish
7/1 15,269 went to er for vomiting abd pain dehydration us showed empty gestational sac, and fluid in ovary r/o ectopic. also had free fluid in uterus admitted for obsv, got better repeat us showed no change hgc 7/2 15932, 7/3 16255. sent home with probable mc to return if any pain/bleeding, ectopic not ruled out. off lovenox. md agreed to wait and see, follow hcg. 7/5 27,128. repeat us showed "faint yolk sac and fetal pole hb 94bpm. heterogenous area resolving subchorionc hemmorhage, left ovarian cyst and ectopic ruled out" i was told questionable viability due to hcg levels not correlating with us findings. are there any explnations for high hcg levels and not seeing anything above discriminatory levels? does it ever happen and have a successful outcome? can lovenox have anything to do with the subch hemm? i am now back on the lovenox and have hcg tomorrow and repeat us next week. all us were tvus. thank you
hcgs 6/27 3197
6/30 10,000ish
7/1 15,269 went to er for vomiting abd pain dehydration us showed empty gestational sac, and fluid in ovary r/o ectopic. also had free fluid in uterus admitted for obsv, got better repeat us showed no change hgc 7/2 15932, 7/3 16255. sent home with probable mc to return if any pain/bleeding, ectopic not ruled out. off lovenox. md agreed to wait and see, follow hcg. 7/5 27,128. repeat us showed "faint yolk sac and fetal pole hb 94bpm. heterogenous area resolving subchorionc hemmorhage, left ovarian cyst and ectopic ruled out" i was told questionable viability due to hcg levels not correlating with us findings. are there any explnations for high hcg levels and not seeing anything above discriminatory levels? does it ever happen and have a successful outcome? can lovenox have anything to do with the subch hemm? i am now back on the lovenox and have hcg tomorrow and repeat us next week. all us were tvus. thank you
Doctor's Answer
by Forum-M.D.-SP, Jul 08, 2007 12:00AM
Dear newbieG-
Once an ultrasound shows that the pregnancy is in the uterus, the HCG values become irrelevent for several reasons. First, the ultrasound has confirmed that you do not have an ectopic, which is important because now we know that you are safe and not at risk from a ruptured ectopic.
Second, once HCG levels reach a high value, they actually plateau and then decline. They do not continue to increase throughout pregnancy.
Third, the values for HCG quotes as 'normal' are for normally developing pregnancies, and will not always follow the expected curve of increase if the pregnancy is abnormal.
As I write this on July 8, you are 6 weeks 2 days based on your May 25 lmp. At that stage, ultrasound should be able to see a gestational sac, and a yolksac. At 6 weeks 2 days the pregnancy will not always be far enough along to see a heartbeat 100% of the time. For that, one needs to wait until 6 1/2 weeks (say 6 weeks 4 days). The fact that on your July 5 ultrasound a heartbeat was seen is if anything encouraging - one does not always see a heartbeat on ultrasound this early in pregnancy.
Let's keep our fingers crossed. At this stage, the beta levels no longer matter. What really matters is what is seen on ultrasound. I would recommend waiting a week, and repeating the ultrasound on July 12. That ultrasound will tell the story once and for all.
Once an ultrasound shows that the pregnancy is in the uterus, the HCG values become irrelevent for several reasons. First, the ultrasound has confirmed that you do not have an ectopic, which is important because now we know that you are safe and not at risk from a ruptured ectopic.
Second, once HCG levels reach a high value, they actually plateau and then decline. They do not continue to increase throughout pregnancy.
Third, the values for HCG quotes as 'normal' are for normally developing pregnancies, and will not always follow the expected curve of increase if the pregnancy is abnormal.
As I write this on July 8, you are 6 weeks 2 days based on your May 25 lmp. At that stage, ultrasound should be able to see a gestational sac, and a yolksac. At 6 weeks 2 days the pregnancy will not always be far enough along to see a heartbeat 100% of the time. For that, one needs to wait until 6 1/2 weeks (say 6 weeks 4 days). The fact that on your July 5 ultrasound a heartbeat was seen is if anything encouraging - one does not always see a heartbeat on ultrasound this early in pregnancy.
Let's keep our fingers crossed. At this stage, the beta levels no longer matter. What really matters is what is seen on ultrasound. I would recommend waiting a week, and repeating the ultrasound on July 12. That ultrasound will tell the story once and for all.
Member Comments (2)
by newbieG, Jul 08, 2007 12:00AM
To: md
thanks so much for the info. hcg today was 53,127..will have us later this week. but i feel better about everything.
