High hcg level with no fetal pole at 6wks

Sannika · February 2014

Hi all,

I'm new to the forums and I decided to write this post seeking help. I had an u/s this morning and a prenatal doctors appt to follow. The u/s showed the gestational sac but nothing inside. After having a talk with the doctor she wanted to do a hcg count to see if my numbers have progressed. Turns out my number is at 23,000.

My doctor tells me this number and the u/s confirms that my pregnancy isn't a viable one. She's pushing me to terminate.

I guess what I want to know is if anyone has experienced a similar issue and has went to on have a normal pregnancy? Should I wait it out another week or two and have another ultrasound to confirm or just do as she wants, terminate and try again?

Helenahhandbasket · February 2014

I think it's odd that your doc is pushing you to terminate at only 6 weeks. If the pregnancy isn't viable (and I hope that dx is wrong!), will they not let you try to have it pass naturally?

ConversationFear · February 2014

I agree with Helen. This is a decision every woman needs to make on her own, of course, but if it were me, I think I would stick it out and see. 6 weeks is awfully early to make such a hasty move.

stephweldon21 · February 2014

I think you need a new Dr. I may be wrong but isnt a 6 week HCG level normal between 1100k-56k? And 6 weeks is still very early. IMO, I would wait atleast another week before making any decisions, 1. to have another US and 2. to atleast give your body a chance to pass it naturally if it is indeed not meant to be.

Sannika · February 2014

She said I could try to let it pass naturally but she mentioned it could take a couple weeks. My lmp was for sure December 23,2013. It's been rocky from the get go. She told me I ovulated later than I thought which puts me at 6 weeks and 1 day today. So I think I will schedule another ultrasound for next week.

Sannika · February 2014

Her reasoning behind it not being viable is she says usually around 10,000 there should be a fetal heart beat.

greeneyed_bride · February 2014

Sannika said:

She said I could try to let it pass naturally but she mentioned it could take a couple weeks. My lmp was for sure December 23,2013. It's been rocky from the get go. She told me I ovulated later than I thought which puts me at 6 weeks and 1 day today. So I think I will schedule another ultrasound for next week.

Also not a doctor, but I'm confused as to how she's able to measure your pregnancy at 6 weeks and 1 day if she's only able to see a sac, not an embryo/fetus. My ultrasounds techs have always done the dating based on the size of the fetus. I agree with PPs who said get a second opinion.

poptart109 · February 2014

At 5w4d my hcg was at 23,000 and they seen only a gestational sac and yolk sac, no fetal pole. It was hard to see the yolk sac. A week later my hcg was 110,000, had an embryo and heartbeat. I'd say schedule another u/s in a week and see what happens.

Sannika · February 2014

Thanks for the feedback. I feel a bit better and have calmed down a lot.

PrimRoseMama · February 2014

I would wait & see if your dates could be off. As long as you show no signs of infection (fever/pain) then seeing where you are in a couple of weeks I don't see being a problem

abb08 · February 2014

I would wait a week and have another ultrasound. Even if nothing has changed at that time, it will at least give you peace of mind and you won't have to wonder. I'm sorry you are going through this. I know how stressful it can be.

Starfish17 · February 2014

I just had the same thing happen last week - went in on Monday and was supposed to be about 6 weeks. Saw only a gestational sac plus maybe a very early yolk sac. HCG level came back very high at 34,000. Had another ultrasound today - showed embryo with heartbeat, measuring 6 weeks 2 days. Still very early for me but the one week did make a big difference in the ultrasound.

Sannika · February 2014

She thinks I ovulated later because my lmp was December 23. I did a home pregnancy test on January 27 and it was positive. Scheduled the first appointment on the 29th thinking I was normal and it would put me at 5 weeks, but she did the ultrasound and said it was too early to see anything, but I had a positive blood test. Did the hcg count 2 days apart 948 and then 2300. So she ordered another ultrasound February 13, she was able to see a gestational sac but nothing else and said based on the measurement it puts me at 4 weeks and 5 days.

4legsRbest · February 2014

I am going to give you the short version of what happened to me, but, terminating now is not what you should do. As long as they have ruled out an ectopic pg, then wait it out.

I did IVF so I KNOW when I conceived but went in for my 6 week u/s and only saw 2 empty sacs measuring 5 weeks. My HCG was 35,000. I immediately thought blighted ovum, because you can get high HCG numbers b/c your body thinks it is a pregnancy. However, my progesterone was 322 (yikes!) and that is not common with a BO, so we held on for one more week. Fast forward to 7 days later and I have 2 fetal poles with hbs measuring 6 weeks, so still a week behind but they are developing.

This early on, a day really can make the difference between a fetal pole and another day the hb. If you are even off by just a few days, this would be normal for now.

Did they take your progesterone too? What dpo was your 23,000 beta on? If you have another blood draw (which I think you should to see the trend and really rule out a BO) then ask for p4 also. An ultrasound can't tell the whole story and I think telling someone with doubling-ish betas and two early u/s to terminate a pregnancy is a fool and I would drop that dr in a heartbeat. I would not trust them with my long term care.

I am not trying to give you false hope, but for every real blighted ovum, there is one that is misdiagnosed (I spent 7 very long days researching this). At this point it can go either way (just like any pregnancy) but you are in my t&ps and I hope things work our for you.

Sannika · February 2014

I was 6w1d when my hcg was 23,000. They didn't take my progesterone. I will talk with the doctor again today! I haven't had any cramping but spotting very light pinkish when I urinate here and there. Thank you for keeping me in your prayers.

MisstoMissus · February 2014

Slightly off-topic, but---

Unless you are high-risk or there are mitigating factors, why would you go to the doc at 6 weeks? (not bashing you, bashing the doc.) It seems like everyone on this board who goes in at 5-6 weeks ends up freaking out and they just end up waiting two weeks to find anything out.

buckeyeki · February 2014

One year ago I went through the same exact thing. My "empty sac" is currently snoring away on my chest. Give it at least a week, two if possible, then request another U/S. My doctor was positive I needed a D&C too. I'm thankful everyday that I waited it out.

poptart109 · February 2014

I went in early because I had bleeding with cramping. OP didn't state she wanted to know the reason we went in early, just if anyone had positive outcomes.

(Hit post too soon)

weddingringsandbabythings · February 2014

hischelseababy said:

I went through something very similar. I was told that my second pregnancy was a missed miscarriage. The ultrasound showed an empty sac while my hormone levels were very high. The ER said I needed to contact my Ob/Gyn for a D&C. I told my doctor that I wouldn't agree to the surgery until we are absolutely positive that the pregnancy was not viable. He agreed to wait, but said that he said it was very unlikely. We had a two more ultrasounds and blood tests every three days for the next three weeks. All the ultrasounds showed the same thing. My doctor apologized and scheduled my D&C for the next Wednesday. The Monday before I had an appointment to go over the procedure and my doctor decided to do one last ultrasound. There, plain as day, was my daughter. She measured right where she was suppose to be. Almost a month after I was told that I lost the baby and just two days before my D&C.

I tell you this not to give false hope. However, if I had gotten a D&C when it was first recommended my daughter wouldn't be here today. You should be absolutely sure.

ETA- We didn't see a heartbeat, or anything else, until 6w6d. A lot can change in a week.

This is beautiful, and made me tear up.

weddingringsandbabythings · February 2014

poptart109 said:

At 5w4d my hcg was at 23,000 and they seen only a gestational sac and yolk sac, no fetal pole. It was hard to see the yolk sac. A week later my hcg was 110,000, had an embryo and heartbeat. I'd say schedule another u/s in a week and see what happens.

Same here. I went into the ER for intense cramping at what I thought was 10 weeks (according to my lmp), but all they found was a sac measuring 5w2d, while my hcg was high. they said it was more than likely a blighted ovum again (I'd had one last year), and that I needed to follow up with my OB. A week later, my OB had me go in for another ultrasound, where my baby was there. My cycle was just way off. Quite a bit off. Hopefully it works out for you op!

High hcg level with no fetal pole at 6wks

Re: High hcg level with no fetal pole at 6wks

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