QuestionI am trying to have my 2nd child. My first is 3 years old. Before getting pregnant with her I had 2 miscarriages. They found I had low progesterone and hormone imbalance/ luteal phase defect. I took clomid one month and got pregnant with her. This time I took clomid again and got pregnant. I should be 5 weeks 5 days pregnant. At first my HCG started out great but has now started only slowly increasing. Here are my levels:
10dpo-20
12dpo-65
14dpo-185
24dpo-2200
My Dr. was not impressed with my last level and told me to prepare for possibly another miscarriage. We did an U/S with the levels at 2200 and only saw a sac measuring only 5 weeks (was 5w4d), which he also thought we would see more. I go for another U/S in 10 days. Just wanting a 2nd opinion and see if this did sound like a impending miscarriage. Thanks
AnswerHello Lauren from the U.S.,
It is difficult to make an "exact" decision based on HCG levels, but the levels are within acceptable range. Doctors usually use the rule that the HCG should "double" every 48 hrs, but it does not exactly double (100% increase). In fact, the minimum change is an 80% increase. So for day#24, it should be 2960, but I think that 2200 is close enough.
In terms of the ultrasound, with a level of 2200, the ONLY thing that can be seen that early in the pregnancy is a gestational sac. The pregnancy certainly has not developed far enough to see more. At 6.5 weeks sometimes a fetal pole with fetal heart motion can be seen. I don't know how this pregnancy will turn out but at this point, I would not doom it yet. There is still hope for this pregnancy.
In addition, I hope your doctor has you on progesterone supplementation for the LPD. Clomid can be adequate but is not always enough. Progesterone is very easy to use.
Good Luck,
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
