QuestionHi Dr. Ramirez, I got a positive HPT on 9DPO after having 8 losses in the past 2 years (including a suspected ectopic in June after numbers didn't rise correctly). I had bloodwork on 15 DPO and HCG was 73.8. I went back on 17 DPO and the results were 130, which was a doubling time of 60 hrs (50 hrs btwn draw times). Progesterone was 22. Of course I was hoping for my numbers to double for reassurance, but they didn't. I have to go back for labs on 21 DPO, but I am concerned about my numbers. Is <72 hours or an increase by 60% really acceptable? I want so badly to believe it will work this time, but my gut tells me that the numbers aren't doubling fast enough and I am on my way to losing another baby. What rule of thumb do you go by when deciding that a pregnancy is not viable? Would you be concerned with these initial labs? Thank you so much for your reply.
AnswerHello Karri from the U.S.(New York),
In general the rule of thumb is to see a bHCG double every 48 hrs. But that is a rule of thumb. With only two results, no conclusions can be made yet. I would recommend that you continue to have bHCG's done every 48 hours and follow the trend. It will declare itself eventually. If it continues going up, unless the number flattens, then the best recommendation is to wait and see how it goes. That is all you can do. Once the bHCG reaches 2500, and ultrasound can be done to rule out an ectopic by making sure the gestational sac is within the uterus.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf. Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate
