Decreasing HCG level... ANY hope??

[myee612]

I found out on Sunday, December 5th that I was pregnant. I took three test that showed up poistive almost right away. At that time i would have been about 4 1/2 wks pregnant. On Monday, Decemeber 6th my boyfriend and I had intercourse... and immediately after I started spotting. It was very light, and only when i wiped. I called my nurse and she said the spotting could just be from the intercourse. A few days later i was still spotting and the color was changing from different shades of red to brown..back and forth. I went in on Friday, December 10th to have mg hcg levels tested. They camed back low at 109. She said it could either be that the wrong dates were determined, or signs of miscarriage. I went back for more blood test on Monday, December 13th and the hcg level at droped to 90's. The doctor pretty much told me i could expect to miscarry, and if i dont naturally miscarry i would have the d&c surgery. It is now Wednesday, December 15th and i am still spotting, it changes to very light to mediumish... and it still mainly when i wipe. I have had no cramps, no heavy flow, and no clots pass through, just spotting. Is there any hope that i can still continue with this pregnancy? Can my hcg level increase after decreasing? (even if they started out low) I have heard of the "vanishing twin" and my boyfriend does have twins in his family, his 1st cousins are twins... but then would my hcg level start out higher?  I feel like the doctor i was talking to was too much in a rush to explain further into things.,.. she just kept assuring me that i should expect to miscarry... but i've been reading some girls are told that, then go on to deliver healthy babies. Advice PLEASE!  

[Pyo432]

I am a nurse for an OBGYN and have never seen a decrease go on to have a normal pregnancy. As for the rush your doc had, I'm sorry she or he didn't explain much. In earlypregnancy, there is a very strict or set way things happen. Yes the hcg level is very good indication as to how the pregnancy will turn out. Generally an hcg should double every 48 hrs. (around double) if at any point the numbers are less then they got to, then unfortunately yes, you should expect to miscarry. Now, if your numbers increase, just maybe not the full double, then there is still hope. As for the vanishing twin theory/ blighted ovum, your numbers would still continue to increase. When someone is pregnant with multiples. Then the hcg level increases been faster than the normal "double". Another good I dication of a normal pregnancy is the rise of progesterone to at least 15 or more. 20+ is really good. Although a 15 can still be healthy. When your hcg level reaches 2000 you should have an ultrasound to ensure the pregnancy is in the uterus. (all u will see at this point is a sac) Again, a 20+ progesterone is highly almost extremely rare to be ectopic or in the tubes.  The spotting also does not always indicate a miscarriage. So when u do try again, don't lose hope if u do spot again. Intercourse is safe in pregnancy. With the exception of having a placenta previa or an incompetent cervix or if you have a risk for preterm labor. When a pregnant woman spots, an ultrasound is necessary to ensure there is not a sub chorionic bleed. This is where the baby's sac has t completely fused onto the wall of the uterus. Causing a pocket of blood to form. Again, can continue and bee healthy. However a supplement of progesterone "prometrium" will help stabilize the lining until the placenta develops and takes over at about 12 13 weeks. Then you should be slowly wean off of the supplement.
I'm sorry, this isn't what we want to hear when this happens.  I myself have lost 2 pregnancies. Also you should know that once you are past 12 weeks, the risk of miscarriage greatly decreases. In general, a pregnancy loss after 12 weeks is generally caused by something - a blood clotting disease, an autoimmune antibody, sever uncontrolled diabetes, a genetic problem(that generally end in more heartache if the pregnancy did continue) for example a severely handicapped or severe birth defect) I'm sorry this happened to you, it is never easy. Know there is NOTHING a mother can do to cause this. Not this early in pregnancy.
I hope this helps you have some closure and feel informed so that when you decide you may want to try again, you can do so knowing what to expect or what can or can't be done.

[Elaine Brown, MD]

Hi!
I'm sorry to hear that your levels are so low, and dropping. This means that you have what is called a chemical pregnancy. Back in the days before the super sensitive pregnancy tests, we never would have known you were pregnant.  Typically this happens because of some problem in the development of the embryo -- in other words the embryo wasn't normal.
I always look at this as a good sign though -- to me it signals that you CAN get pregnant, and probably will soon with a healthy pregnancy next time.
I'm sorry that things didn't go better this time around.
Dr B