Positive @ 2+4, very slow rising HCG w/ spotting, Doctor recc D&C @3+6

jenniep213

I feel like I'm a huge question mark right now. I had a miscarriage in December and literally the week that would've been my due date, I started spotting and then lightly bleeding. My friend suggested it was implantation bleeding and to take a pregnancy test. I scoffed at her because my LMP was 7/13/16 and this would be WAY too early to be positive, right?! Well, 3 pregnancy tests later that day, they all came up as positive & a digital said 1-2 weeks. At 2+4, I had high enough HCG to register on a pregnancy test! That so far has been the only good news that I've gotten with this pregnancy.

Because I'm high risk due to my age (36), history of miscarriage, & the oddity of my testing positive so early, they started running my HCG levels immediately.
8/1 (2+5): 24.1
8/3 (3+0): 25
8/5 (3+2): 28

Because of my slow rising HCG and the spotting (very minimal, only when wiping), my OBGYN scheduled me for a D&C on Tuesday and I refused to go.  He suspects it's an ectopic pregnancy and that I'm harming myself by not doing the procedure where he'd do a D&C, test the tissue & then if nothing was found then that would mean it's in my tubes and would give me the shot. I feel like I'm way too early to make a decision to abort the baby without a medical necessity.  Am I wrong in thinking that HCG doesn't normally double until week 4 and today is my first day starting week 4.  My general practitioner agrees with me that there's no harm in waiting 2-3 weeks before making a decision because I have no cramping, and warned me on what signs I need to look out for and not to get my hopes up but that there's no reason to be pressured right this minute.  I get one more level results today from my OBGYN and my general practitioner ordered 2 more HCG tests since I told him that I couldn't get my OBGYN to agree to any more tests.

With my miscarriage in December, I knew something was the matter from the beginning, and with this pregnancy I feel it in my bones like I need to fight for it. I have major bloating in my belly, breasts have grown, nausea, and an aversion to smells so I have strong pregnancy symptoms already with such a low HCG level. I don't think anything is the matter but that I just tested positive too early. Does anyone have any advice for me if you came up positive this early too and ran into problems with your doctor?

Thank you,
Jennie

NiceyMeany

I'm so sorry you're going through so much uncertainty.  A few things stick out to me:

1. I get why you say you got a BFP at 2+4, but that is not medically possible.  You are saying 2+4 based on LMP, but you need to be at least 8DPO to get a BFP, which would put you, gestationally speaking, at 3+1 or more.  You most likely ovulated earlier than you think - probably around 7/24, or CD12.  It is by no means unheard of to not ovulate on CD14 - in fact, most women are off by at least a few days.  CD14 ovulation is just an average.  
2. Not to scare you, but an early BFP (<8DPO) is sometimes a sign of ectopic pregnancy.
3. HCG levels start doubling more or less right away.  If you Google Image search "HCG doubling times," you will see tons of charts that show this.
4. If your OB is not treating you to a level you feel is appropriate, you should see another OB.  GPs are great, but they're not specialists in this area, and you should really be taking your advice from a specialist.
5. The reason your OB doesn't want to do more than the standard blood tests is that, unfortunately, they are pretty telling.  More screening, such as an ultrasound, wouldn't show anything at this point.  

I'm really, really sorry that you're struggling with this, and I hope the best for you.  If it turns out that you this pregnancy is not viable, perhaps it's time to look into RPL testing.  It sounds like you should be seeing an RE given your age and your history.

Best of luck to you.

ChaoticWolf

So... A cryptic pregnancy? 


But no, in all seriousness, like @NiceyMeany said, you probably just ovulated earlier than you think. You can't get a positive test until about 8dpo, which means you'd be more than 3 weeks along. I'd get a second opinion from another medical doctor, not just people on the internet.

clairemwalker

Sorry i dont have any advice for you, except to make sure you stay level headed. I totally understand you wanting to wait and see, but dont start trying to explain away ectopic symptoms as other things in case you do yourself damage. As PPs said, even if you count only the quickest time possible for fertilization, travel, implantation, and HCG  secretion, you are looking at least at 8dpo, most likely 10dpo so you are most likely further along then you think and those numbers dont look so promising. - that being said, and remember im NOT a doctor, if you are truly experiencing no symptoms of ectopic pregnancy then i dont see the harm in waiting a bit longer to see what happens. - you should be aware though that if it is ectopic, you can go from no symptoms to tube rupture in one day. One of the girls at my work didnt even know she was pregnant until her tube ruptured so you need to be aware that by waiting you are gambling. Good luck though, and i hope it works out. 

Wishilivedinflorida

I agree with all PP, but want to add that presence of symptoms doesn't mean a pregnancy is going well. Those betas are unfortunately very concerning for a nonviable pregnancy. If you don't trust your OB, I would urge you to get a second opinion from another one ASAP. If you indeed do have an ectopic, it's not something to mess around with. 

I find it very concerning that you won't listen to your OB and turn to Internet strangers for advice instead of seeking out a second opinion.

jenniep213

Thank you for the advice from everyone who gave it. Even if my situation is very strange, I wasn't so much as looking for medical advice but possibly a sympathetic "me too" from someone with a similar story. I'm a very levelheaded person and my doctor didn't mention ectopic until *after* I refused the D&C on the phone with his nurse. The whole "we don't know what's going on with you so it's just a process of elimination" doesn't sit well with me, so yes I asked the Internet if this had happened to anyone before. If there was actual proof of an ectopic pregnancy, I wouldn't be asking the question. 

I have been seen by a medical professional (either my Obgyn or my general practitioner almost every weekday for the past week and a half so it's not like I'm just acting like there's nothing the matter with me. I was even seen by my Obgyn today, who told me that my levels are now at 23 so it looks like they're finally decreasing on their own. As of today, he's ordered more testing to see if I miscarry on my own and he says my levels are so low that even if it was ectopic that the chances of a rupture by waiting a few days to see if I miscarry naturally are very minimal. The only reason I'm waiting is to avoid a medical procedure that I might not actually need. Rest assured, I will schedule the procedure if I don't miscarry in the next few days. 

jenniep213

@NiceyMeany
Thanks for all the information, it really helped. I wish my doctor had mentioned your #2 to me because that would have made WAY more sense to me on why he was thinking it was ectopic. 

I will definitely be looking for a fertility specialist after this. Most want to wait for the 3rd miscarriage but because of my age, I don't want to wait until then.