elevated hCG levels

  I have miscarried twice.  Once in early September, and again in late November.  
  After my second miscarriage, tests of my hCG levels show that they have remained elevated.  
  Since the second miscarriage, the highest hCG level I have had is 14, the lowest, 10.  
  My Dr. wanted to see that level at 4 or below.  I had a D&C in January, to remove any
  remaining tissue.  When that failed to lower my hCG levels, I was given a dose of MethylTrexate,
  hoping that would kill off any remaining cells or tissue and lower my
  hCG levels.  My levels have remained constant, always within one point of the previous
  test.  My Dr. now believes that my body may simply produce this hormone, but
  it is the first time he has come across a situation like this.  Has anyone else
  dealt with a situation like this?  We are ready to try to get pregnant again, but are
  concerned.  Any help or information would be greatly appreciated!

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Dear Jackie:
Trophoblast cells have been found 5 months following pregnancy. Why some cells are able to persist for this extended time is unclear.
Despite this known longevity of some normal cells, the concern whenever there ispersisting hCG production is an uncommon occurence following pregnancy, trophoblastic disease. In this setting, trophoblast cells become unregulated and can become a type of cancer. The drug most commonly usedto treat these cells is methotrexate; however, sometimes other drugs are necessary to eliminate the cells.
Consultation with a Gynecologic Oncologist is the next step. There are also several centers in the USA where registry of trophoblastic diseases pulls together the experience with this pathology.
The work of Vaitikatus from the 1970s tells us that many cell types can make hCG; however, it is only detectable with "research assays" and the levels are very low. This is not a good explanation for the levels that you have reported.
Unitil the cause of the hCG has been clarified and corrected, it is unwise to become pregnant.
Keywords: persistent hCG
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please speak with your physician.