Low HCG levels, but heartbeat at 6 weeks

chloe97 · March 2016

I've posted this on the PGAL board already, but thought I would try here too because I'm going crazy.

I lost all pregnancy symptoms at 5 weeks. My betas were taken and went from 2469 to 2770 in 2 days. My progesterone is 10. The Dr called to diagnose a miscarriage. I went in 2 days later at 6 weeks to get Cytotec and had an ultrasound that showed a strong heartbeat of 123. Dr called back to apologize and told me that this was really good news.

I dont one see how it's good news because my HCG levels are extremely low. To me this seems like it has to be evidence of a chromosomal abnormality.

TW*******

I miscarried in December after seeing a strong HB at 8 weeks. I'm a FTM at almost 37 so I'm feeling very anxious about whether this pregnancy will go on for another few months and I will lose that time to heal and get ready for a new pregnancy. I'm also really worried that this baby will have major health issues. I feel so guilty hoping for a miscarriage to start because I want this baby to be healthy more than anything. I just don't understand how it can be and my doctor has never seen anything like this.

Does anyone have any comforting stories?

AandDM2014 · March 2016

If it makes you feel any better my HCG at 5 weeks was 4762 and at 6 weeks was 5334. Nowhere near doubling like it should be, but I had an ultrasound a week later and baby was looking good, just a few days behind 6 weeks. I've had an ultrasound every week since and my doc is not at all concerned. They stopped checking my HCG because ultrasounds are a better indicator of a healthy or not pregnancy at this point. It seems like your progesterone is low, so I'm surprised your doc didn't prescribe you something for it.

Maybe this will make you feel better:

3 weeks LMP: 5 – 50 mIU/ml
4 weeks LMP: 5 – 426 mIU/ml
5 weeks LMP: 18 – 7,340 mIU/ml
6 weeks LMP: 1,080 – 56,500 mIU/ml
7 – 8 weeks LMP: 7, 650 – 229,000 mIU/ml
9 – 12 weeks LMP: 25,700 – 288,000 mIU/ml
13 – 16 weeks LMP: 13,300 – 254,000 mIU/ml
17 – 24 weeks LMP: 4,060 – 165,400 mIU/ml
25 – 40 weeks LMP: 3,640 – 117,000 mIU/ml

taken from AmericanPregnancy.org

MRSCORKER · March 2016

I'm so sorry you're going through this. Is there a chance that there was a lab error and your levels were reported incorrecly? At 2770 there is no way there would be anything to see on the US and seeing as how it was only 2 days later, I can't see how that number could have been correct. When I went in at 6+2 we saw a hb of 121 and my levels were nearly 30,000. Is it possible your levels were 27,700?
I'm keeping my FX that everything is fine and you have a H&H pregnancy!

wildtot · March 2016

Sorry for your loss and for going through this. I am also very surprised you were not put on progesterone. Have you talked to your doc about that? I hope things work out and you have a healthy 9 months.

juliehollz13 · March 2016

I know HCG levels stop doubling after they reach a certain #. Hoping everything is ok.

hCG levels	Doubling Time
Under 1200 mIU/ml	31-72 hours
Between 1200 to 6000 mIU/ml	72-96 hours
Over 6000 mIU/ml	more than 96 hour

chloe97 · March 2016

I have no idea what to say about my HCG levels and neither did the Dr who I talked to. I thought they they needed to be 10,000 to see a heartbeat. My Dr is on vacation so I'm dealing with the on-call Drs. I've been able to find similar stories online or on the PGAL board and they've all resulted in miscarriage within a week or 2 later. I don't know if I want to take progesterone because that's going to hinder my ability to have a natural miscarriage. The on call dr did offer to write a script for it.

I should also mention that my HCG levels did double from 209 to 588 at 14 and 16 DPO. But then were 2469 8 days later which was discouraging.

I see my Dr Monday for another ultrasound.

wildtot · March 2016

I'm no doctor and just speaking from my own experience and what I have been told. Progesterone will support a viable pregnancy, not prevent miscarriages.

*loss mention*
My first pregnancy last year ended early on despite being on progesterone. Once confirmed I stopped progesterone and things ended natural.

I used progesterone as well with my current pregnancy until 12 weeks.

At the end it's something between you and your doctor. Wish you the best of luck!!

comealongponds · March 2016

Hey @chloe97, I'm sorry you're still stuck in this limbo.

With my loss, I had abnormal betas that did not double in over a week's time yet my ultrasounds continued to measure on schedule. I even saw a strong heartbeat at 6w, but miscarried a few days later. I hope things work out well for you and that bean is very sticky! I agree with everyone else, I'd request progesterone supplementation since your number is so low. Fingers and toes crossed for you!

chloe97 · March 2016

@comealongponds Did you start bleeding on your own?

comealongponds · March 2016

I bled basically on a weekly schedule during that loss. Started at 4.5w and stopped (normal US at 5w), bled again at 5.5w (normal US with heart beat at 6w), then started bleeding heavier at 6w5d that progressed with significant cramping over the next two days. Attempted misprostal x2 because the sac got lodged in my cervical canal (seen at 6w6d), but failed (misprostal doesn't work for me, I'd tried it before for an IUD insertion). Passed the sac on my own at 7w.

I hope things end differently (and happily) for you!

chloe97 · March 2016

Thanks @comealongponds, So far I've not had a single drop of blood. I didn't with my MMC either until 11 days after the fetus passed. I'm assuming I would have another MMC with this one, so I'm hoping to get u/s next week and then hopefully every week after.

KilgraveMadeMeDoIt · April 2016

Beta definitely doesn't need to be 10,000 to see a heartbeat. The discriminatory level usually used (as in, should be able to see embryo on ultrasound) is 1500 and cardiac activity is usually expected around 5000, but those are guidelines with considerable wiggle room and allowance for the particular machine and operator skill. Some pregnancies just have low betas and go on to be totally healthy.

A possibility for a stalled beta that results in a viable pregnancy is an early twin loss. This happened with my second. The pregnancy was diagnosed as a miscarriage but two weeks later, there she was on the ultrasound and everything went fine from there. It can happen and probably does more often than people think. Stats are hard to come by for that.

I wish I could tell you something certainly positive either way. Limbo sucks and I really hope you learn soon that everything is okay.

chloe97 · April 2016

Thanks @KilgraveMadeMeDoIt! That is the best possible answer I've come up with for my issue. The Dr on call didn't mention anything about any evidence of a vanishing twin on the u/s, though. I should get the u/s report today or tomorrow so maybe there will be something on there? It was done at the hospital in the MFM department, so it was probably the highest possible quality machine.

I started progesterone suppositories yesterday and I'm surprised how much more relaxed and optimistic I feel today. I also noticed a bigger bump. Our next u/s is Monday, so I'm just going to breathe and try to make it to then. Hopefully this feeling of relaxation stays with me.

ETA I got the ultrasound report today and the embryo measured exactly on target. I have not had any bleeding. I'm really hoping I'm an anomaly.

allyandbaloo · May 2018

Hi! I know this is an old post, but hoping you can shed some light on your second pregnancy with the low HCG. Did your HCG continue to rise just slowly and then there was no heartbeat? How was your HCG with your latest pregnancy with a healthy baby? My HCG's were low - 330 at 4w5, then went down to 327 at 5w and they said I would miscarry, then 5 days later it went to 800, at 5w6 I had an ultrasound where they saw the gestational sac and yolk sac but heartbeat wasn't detected and they told me to go back at 7w5. I am 7 weeks exactly and since my last HCG test 9 days ago it went from 800 to 27,000, but the dr's nurse thinks it is still low. I am just trying to prepare myself in case it is not a viable pregnancy and I need another D&C (had a miscarriage 4 years ago where no HCG was checked so I can't compare). I read Triploidy can correlate with low HCG, but wondering how low is low.... thanks for your help!

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Low HCG levels, but heartbeat at 6 weeks

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