HCG Levels and Potential Miscarriage: What to Know

Question
I believe I was pregnant (only 3.5 weeks) when I had very strong cramping and heavy bleeding for one day. That very day, i took a home pregnancy test; it was negative.  My regular period was do five days after this episode.  I have yet to get it.  I had a blood test at my doctor's office three days after the heavy bleeding and it showed a small amount of hcG (not pregnant).  My question is, was I pregnant and miscarried?  It would have been very early.  This would be my second miscarriage in several months. (My first I was approximately 7 weeks along).

Answer
Dear Elizabeth

I do not think you had a clinical pregnancy. However, the small amount of hCG in the blood test at your doctor's office can be due to a chemical pregnancy. This means that you had a pregnancy around the time of ovulation and then you had a bleeding at the time of menstruation. This is abortion bleeding and is mistaken by many women as normal menses since pregnancy went unrecognized. This occurence is quite common and it occurs at least once during lifetime in more than 30% of women. Home pregnancy tests are not sensitive enough to detect this type of pregnancy in contrast to hCG level in blood. It is important to be aware that the normal range for hCG is wide and that a sporadic single abortion occurs in 15% of the general population.

Good Luck