QuestionHello. I am writing in hopes that you can help me. I have missed my period as of 2 weeks ago. I am usually 28-31 days between cycles. I have never been late like this. I have taken 3 HPT, all results neg. I had hCG done this past Thursday. It came back BORDERLINE with my numbers between 5- 20. My first question is, what exactly does borderline mean? Does the fact that my numbers are above 5 mean that I am pregnant and just too early to show up? I heard that less than 5 is neg pregnancy. Secondly, I had an ultrasound done this past Friday. It came back inconclusive. My endometrial sac was 2.28. I was told that for a non preg woman, hers would be 1.2. What does this mean? I have been having symptoms of mild cramping, nausea, lower back ache, extreme sense of smell changes, things like that. Can you please help me figure this out?
Helena
AnswerDear Helena,
Typically the hCG level will rise enough by about one week after the missed period that it is detectable by HPTs (>25 mIU/ml). However, some women do tell me that they have not been able to get a positive until they are as much as 8 weeks along. This would be rare, but I am hearing that it does happen to some.
You are correct that a non-pregnant hCG level would be 0-5 mIU/ml. Your hCG between 5-20 mIU/ml, along with the late/missed period and symptoms, would tend to indicate a very early pregnancy. I would anticipate that they would do an hCG 48 hours after the first, to see if the hCG level is rising (doubling) as it would in early pregnancy. However, your doctor may be one who prefers to wait and see what occurs. Sometimes in these "borderline" cases, the fact that the hCG is not up over that 20-25 mark can indicate a threatened miscarriage situation. Some doctors will simply wait to see if that is what occurs. If a pregnancy is just not healthy from the beginning, this would be very possible.
The ultrasound may have been done too early to see anything conclusive if pregnant and you actually ovulated/conceived late in the last cycle, that would explain much of what you describe. Otherwise, we would anticipate that you would have ovulated about 14 days before the next period was due. If that IS the case, you would calculate to be approximately 6 weeks along now. The gestational sac can typically be visualized as early as 4.5 weeks of gestation and the yolk sac at about 5 weeks. The embryo can usually be observed and measured by about 5.5 weeks. A visible heartbeat can often be seen and detected by ultrasound at about 6 weeks and is usually clearly detectable by 7 weeks.
Now, there are many various causes for amenorrhea (absence of periods) - pregnancy being just one. Others can be:
-Hormonal imbalances, which cause fluctuating levels of the hormones needed to support menstruation
-Emotional or physical stress / Depression
-Rapid weight loss or gain
-Change in diet
-Low body weight
-Obesity
-Frequent or strenuous exercise
-Cysts or tumors in the ovaries
-Thyroid or Pituitary dysfunction
-Certain medications or drug use
-Menopause OR Premature ovarian failure (menopause before age 40)
-Occasionally stopping birth control pills
If you miss three consecutive periods and pregnancy is not the reason, another cause can usually be determined with further testing by your doctor.
I hope this has helped you and answered your question. I wish you well.
Brenda
