Rapid HCG Decline in Early Pregnancy: Causes & Concerns

Question
Hi I just found out I was pregnant last saturday 11/1/08 I passed two urine tests and had and hcg Quant of 160.....today wednesday my hcg level is now 45....I had a period on September 19th then some minor bleeding around October 9th ....could this be an early sign of vanishing twin symdrone or am I defintely going to miscarry...I've never had issues before and I sure do feel pregnant...I'm kinda concerned about ectopic pregnancy, but I have no serious pain.....my doctor wont do anything until I reach 2,000 hcg and people keep on telling me the levels do spike then go down and can even fluctuate...so whats going on?

Answer
Hello,

I'm sorry to hear of your frustration.  HCG levels should not be dropping so this could be a sign that your pregnancy is not developing correctly.  I would request another draw in a few days and an ultrasound in another week or so.  At 5 weeks, they should see a sac and a heartbeat around 6 weeks.