low hcg levels

[BG-MN]

I am pregnant without fertility treatments for the second time in five months.  In June, I had a miscarriage at 9 and 1/2 weeks.  My husband and I waited two cycles after the D&C to try to conceive.  First cycle after that wait, we didn't conceive.  Second cycle, I got pregnant, and I am now at exactly 4 weeks since my last period.  During these past two cycles, my RE has been having me use progesterone suppositories (100 mg. total per day) for 12 days during the luteal phase (starting 3 days after ovulation) in the event I might possibly conceive.  (I am being seen by an RE due to my age; my FSH is 10-11, no other fertility issues.)  So here's my question:  I had a positive ovulation test on 9/7, which was day 11 of this cycle.  Exactly two weeks later, on 9/21 (day 25 of this cycle), I had a blood test that showed my hcg was 27, and my progesterone was 27.  The RE's nurse said that those numbers indicated a very early pregnancy.  Three days later, at day 28 since my last period, my hcg was 63, and my progesterone was 23.  The RE's nurse said that although the hcg number had more than doubled in 72 hours, the RE suspects the pregnancy is not succeeding, as the hcg number should have gone up more. What do you think?  Could the implantation just have happened late?  Most sites I can find online say that as long as the hcg doubles in 48-72 hours, things look fine, so I'm confused as to why my RE is concerned about the number.  Thank you!  

[Forum-M.D.-SP]

Dear BG-MN-

The good news is that you are pregnant! Beta-HCG increases as little as 53% in 48 hours have been assoiciated with viable healthy pregnancies. The need for HCG to double every 48h is overstated and misunderstood.  Also, we do not really know much about doubling time of HCG even before an anticipated period.

All in all, it will be what it will be. You are pregnant, which is great! Your are on progesterone, which covers that base. There is nothing anyone can do now except wait.

If I had to choose between 'normal' or 'not normal' for your HCG increase, I would choose 'normal.'

Good luck!

[beb5733]

I just finished my second cycle of IVF (first actually IUI) and preg test came back negative. I was on progesterone in oil and still have not gotten my period.  although i have two children who are in there teens i'm glad to hear that 45 year old (i'm actually 44) are getting pregnant without major issues.  How are you doing now? any other news?  I am going to get off all these meds and try on my own. I obviously produced two -grade 3 eggs that fertilized effectively (as per the embryologist) up until the transfer, but don't know what happened.  I was very dissapointed.

[BG-MN]

Well, I was told my getting pregnant the first time was about a 1 in 200 chance, so I don't think one can count on getting pregnant at my age.  I'm not sure what the odds are this second time, but my RE has said that at least several factors appear to be working in my favor (i.e., I am ovulating monthly, my tubes are open, my uterus is normal, and my husband seems to have powerful sperm!).  But at age 45-46, the miscarriage rate is about 75-80% because the egg quality is so poor, which is why this is all so nerve-wracking.  My RE has said that older eggs don't stand up well in ivf, so I think it's not surprising your ivf didn't work out.  Still, that must be terribly disappointing for you--you have my sympathy!  We already have an adoption in progress.  I think if this pregnancy doesn't work, we'll either adopt a second child or maybe try donor eggs later.  Best wishes for your success!

[beb5733]

I understand the whole process but the embryologist said the egss were pretty good quality considering my age but no luck.  I guess I'll keep trying and hopefully will have the same luck as you. Is your pregnancy still progressng well?

[BG-MN]

If you look in this forum's archives, there are several questions posted by "Mature Momma" about her failed ivf cycle.  She had several of the highest grade embryos, but none of them worked out, so she has since decided to go with donor eggs.  There are also several questions posted by me, both about my pregnancy last spring and my fertility options.  As you will see, the REs on this forum are not very positive about the possibility of women in their mid-40s conceiving.  I did not mention  my age in my recent question, as I wanted to see if my current hcg numbers are alarming in themselves, or if my RE is concerned in light of my age.  It appears that the latter situation is the case.  I will have another hcg/progesterone test tomorrow, so there is not much for me to do but wait and pray in the meantime!  I've started to feel really, really tired, which is how I felt as my numbers went up in my last pregnancy, so I'm cautiously optimistic.  As for your situation, I think you should definitely try on your own.  I'll tell you what has helped us conceive, in case it's helpful.  I've found it helpful to use the digital ovulation tests (with the smiley face).  I know I ovulate on days 11-12 of a given cycle, so on those two days I use the test every 12 hours to narrow down the window in which I'm likely to be ovulating.  Once I get a positive test, then we try to conceive 12 hours later, and then 24 hours after that.  (We were told it is also helpful not to have sex in the 3 days prior to ovulation.)  I know you feel bad about your failed ivf cycle, but at least now you know you tried it!  My RE doesn't do ivf on women over 43 because of the very low success rate (like 1% nationwide).  (He was reluctantly going to try it on me in October because of my natural conception last spring and because our insurance would cover it.)  I have a friend who at age 44 went through four failed ivf cycles, and each time, the embryos were of the highest quality.  She is now pregnant with twins from donor eggs.  Most REs will do ivf with donor eggs until a woman is 50, so thankfully you and I both have more time to think that through whether we want to go that route!

[beb5733]

Thank you for your responses.  I am grateful that I have two beuatiful daughters but really would like to have another biological child with my husband.  But if all else fails I will probably go that route of using donor eggs.  Thanks again for your support, good luck to you and I truly hope and pray you conitnue to progress and stay healthy. keep you posted on my situation.

[mature momma]

Hi,
It really is amazing how many of us past 40 are TTC. I wish you all the good fortune possible. As BG-MN has told you I had great quality eggs on my first IVF cycle. Produced 7, 3 made it to transfer, 1 was a grade 1, the other 2 grade 2's. My RE said it is very rare to see eggs of such high quality in someone my age (45). I had what he said was a text book cycle and if he didin't know my age would have never guessed I was 45. Still it didn't work. As BG-MN has said the odds are just against us. We have decided to use donor eggs this cycle for several reasons: Our insurance does not cover infertility, so financially and emotional we can not take the low odds again. IVF success with older eggs 3% vs donor eggs 50-75%. Some of us beat the odds like BG-MN. concieving twice on her which is outstanding. Its not for everyone but donor is the way for our dream of having a child to come true. Best of luck. Debra :):)

[beb5733]

What I don't get is that if donor eggs are better becuase of quality, therefore if our eggs were considered quality. then why don't they take?  The theory just doesn't make any sense between quality donor eggs and quality owned eggs. I wish you all the best and I'm also in the same boat as you financially and emotionally. To be out all that money and nothing to show for it is very painful. Good luck to you....Barb