low HCG - pregnancy with luteal phase defect?

[surfergirl602]

Hello, I just found out a few days ago that I am pregnant once again.  In December I had a miscarriage at 9 to 10 weeks from a blighted ovum.  After lots of testing and biopsies because I could not get pregnant again, I was “diagnosed” with luteal phase defect and my ovulation was way off.  I was set to start clomid this cycle and was waiting for it to start.  5 days later with no period in site, I took an HPT.  I got two postives.  I became concerned because I didn’t want the same thing to happen again because of my cycles being so off.  I got my HCG level checked on wed 6/28, they were at 760.  My last LMP was 5/30, so that would put me at 4 weeks pregnant.  My doctor said my levels were low and wants me to get checked again next week.  What should I be expecting for numbers and is 760 really that low?  Any advice?
Thanks!

[stillwaiting]

I agree with duehring. I believe the numbers really can't be a definate thing.  Look at misdiagnosed miscarriage.com and you'll see lots of proof of this same thing.  God is in ultimate control. Try and not worry. :)

[mslkpage]

One hcg level doesn't tell you much. Do you know what your endometrium was measuring at?

[Trentonsmom]

I know that when I was about 4 weeks pregnant my numbers went from 306 to 750 in 48 hours. I thought that was low too. I asked my Dr. about it and he said that he isn't too concerned with how low the numbers were as long as they were increasing as they should be.

Did you get another HCG test done 48 hours after the first one? 1 test doesn't really give you that much insight.

[AnnieBrooke]

There are HCG charts with ranges all over the place, the one I trust most would not consider your number low.  (I think at 4 weeks it might consider 560 low.)  Also, did the doc check your progesterone?  It would not have helped a blighted ovum at all to have progesterone supplementation, but if your progesterone count is unusually low and you have an otherwise normal pregnancy, it would not hurt to supplement with suppositories.  Good luck!

[stillwaiting]

What Do the Numbers Mean?
The problem is, once a pregnancy is confirmed, you need to know if it progressing along normally.  Keeping track of HCG numbers is one way of measuring fetal viability.  HCG is measured in milli-international units per millimeter (mIU/ml).  HCG is first detectable in the blood as early as seven or eight days after ovulation by very sensitive HCG assays.  Blood pregnancy tests will be positive (> 2 mIU/ml) by 10 or 11 days after HCG injection or LH surge, and levels vary with gestational age during pregnancy.

There is a large variation in a "normal" HCG level for any given time in pregnancy.  Caution must be used in making too much of HCG "numbers."  Ultrasound findings after five or six weeks of pregnancy are much more predictive of pregnancy outcome than are HCG levels.  You won't expect to see a gestational sac or the fetus until the HCG level reaches at least 1,200 mIU/ml.

However, a single HCG level cannot indicate a normal pregnancy.  In a normal pregnancy there is a regular increase of the HCG, so you need to see more than one value before you can better understand what's going on.  Additionally, a single value cannot always tell you how far along the pregnancy is, because of the wide range of blood HCG levels in pregnancy.  To illustrate the limitations of looking at a single measurement, here is a sample reference list for HCG levels in singleton pregnancies, based on days past ovulation (DPO):

* At 14 DPO, the average HCG level is 48 mIU/ml, with a typical range of 17-119 mIU/ml.
* At 15 DPO, the average HCG level is 59 mIU/ml, with a typical range of 17-147 mIU/ml.
* At 16 DPO, the average HCG level is 95 mIU/ml, with a typical range of 33-223 mIU/ml.
* At 17 DPO, the average HCG level is 132 mIU/ml, with a typical range of 17-429 mIU/ml.
* At 18 DPO, the average HCG level is 292 mIU/ml, with a typical range of 70-758 mIU/ml.
* At 19 DPO, the average HCG level is 303 mIU/ml, with a typical range of 111-514 mIU/ml.
* At 20 DPO, the average HCG level is 522 mIU/ml, with a typical range of 135-1690 mIU/ml.
* At 21 DPO, the average HCG level is 1061 mIU/ml, with a typical range of 324-4130 mIU/ml.
* At 22 DPO, the average HCG level is 1287 mIU/ml, with a typical range of 185-3279 mIU/ml.
* At 23 DPO, the average HCG level is 2034 mIU/ml, with a typical range of 506-4660 mIU/ml.
* At 24 DPO, the average HCG level is 2637 mIU/ml, with a typical range of 540-10,000 mIU/ml.

Accordingly, the key to interpreting the true value of HCG measurements is to look at their progression.  In general, the HCG level will double every two to three days in early pregnancy.  Approximately 85 percent of normal pregnancies will have the HCG level double every 72 hours.  However, as you get further along in your pregnancy and the HCG levels get higher, the expected doubling time increases.

* For HCG levels <1200 mIU/ml, the expected doubling time is 48-72 hours.
* For HCG levels 1200 to 6000 mIU/ml, the expected doubling time is 72-96 hours.
* For HCG levels >6000 mIU/ml, the expected doubling time is >96 hours.

HCG levels peak at about eight to 10 weeks of pregnancy and then decline, remaining at lower levels for the rest of the pregnancy.  Here is a sample listing of expected HCG levels based on time after conception:

* 0-1 week: 0-50 mIU/ml
* 1-2 weeks: 40-300 mIU/ml
* 3-4 weeks: 500-6,000 mIU/ml
* 1-2 months: 5,000-200,000 mIU/ml
* 2-3 months: 10,000-100,000 mIU/ml
* 2nd trimester: 3,000-50,000 mIU/ml
* 3rd trimester: 1,000-50,000 mIU/ml
* Non-pregnant females: <5.0 mIU/ml
* Postmenopausal females: <9.5 mIU/ml

Abnormal Numbers
An HCG level that increases but is less than double the previous one is considered abnormal and suspicious of an ectopic pregnancy.  Pregnancies that are both low in level and slow to rise are almost certain to fail.  Singleton and
vanishing twin pregnancies have a wide range of acceptable HCG levels on a given day.

Greater-than-normal levels may indicate choriocarcinoma of the uterus, ectopic pregnancy, hydatidiform mole of the uterus, normal pregnancy, or ovarian cancer.  Once you have had an ectopic prgnancy, you have an increased risk for another, so your HCG numbers may be monitored more carefully.

Lower-than-normal levels may indicate dead fetus, incomplete miscarriage, or threatened spontaneous abortion. Pregnancies destined to miscarry or to be ectopic (tubal) pregnancies tend to show lower levels (eventually), but often have normal levels initially.   Some normal pregnancies will have quite low levels of HCG ň and deliver perfect babies.

Twins or Higher Pregnancies
Twin pregnancies tend to show higher HCG levels on a given day of pregnancy.  Twin HCG levels fall within the reported range of singletons, so, you can't assume anything based on the level alone.  A higher level on a given day does increase your chances for twins, but there's no level above which you're guaranteed twins.

Your HCG Levels
Check with your physician about your own levels.  In addition, do not try to draw conclusions on either the viability of your fetus or the possibility of multiples, unless youhave a series of HCG tests done that clearly indicate a pattern.

[surfergirl602]

my progesterone levels are fine, I have had them tested twice.  My biggest issue is the LPD.  My endometrium does not match up with ovulation, therefore the uterus is not ready and connot sustain a pregnancy and results in misscariage.  I will have my HCG levels checked again in one week to see how much they rise.  They do not want to do the 48 hour test for some reason.  With my misscarriage before, I had them checked in 48 hours and again in 72, and they were rising, but the pregnancy resulted in a misscarriage anyway.  So they want to test in a week, and then do a vaginal ultrasound.

[duehring]

I think they check the hcg's too much which causes too much stress. My sister had her hcg taken on day 28 (14 days after supposedly ovulating). Her count was 11. Well, that sure wasn't too promising. She had just had 3 miscarriages in a row. They kept checking her hcg's and they were not doubling properly and was told she would prob miscarry. She went on to carry her baby to term and had a 9 lb baby boy.

[sameerah73]

I just wanted to say that I"m impressed to high heaven with your post. It was informative, and beautifully delivered. Thank god for people like you!

I'm new to his board, and its one of the best I've ever been on, great stuff ladies

[surfergirl602]

That post is taken off the web.  I've seen it before, but glad it was posted again.  its great for quick reference.

[RachnGus]

I too just had 2 previous miscarriages back to back. We have been on fertility treatments for over a year now and have just become pregnant a 3rd time. Started off good and then just received news that our HCG level is low and not doubling the way that it should. Because of our history my doc thinks it is a result of an ectopic pregnancy and/or a possible miscarriage again. We go in for a vaginal ultra sound to get a better determination of where the baby is (if there is a baby) so we know what to do. I am hoping and praying for a success story of a full term 9 lb. baby. I would like to say we beat all odds and have finally been able to start our family.