HCG Levels After Miscarriage: What to Expect & When to Worry

Question
Brenda -

I miscarried at 15w5d this past April 16th.  I delivered my baby, and have had no less than 4 ultrasounds since:

- One immediately after the delivery
- Two during an ER visit (for a degenerating fibroid) about two weeks after my delivery (one done by a u/s tech, the other by an obgyn familiar with my case)
- One during the follow up visit (1 week after ER visit/3 weeks post delivery) done by my obgyn

I am now 34 days post m/c, and have had two positive hpts within the last 4 days, with no signs of AF.  At my f/u appt, my obgyn mentioned that she saw a "developing follicle" during the u/s.  I had what felt like ovulation pains a couple days later.  

I spotted *once* two days after my fibroid shrank, but otherwise have had absolutely no bleeding, spotting, or pain since April 27th.

Is this just HCG still lingering?  If so, why haven't my docs seen or mentioned retained products with all my exams?  Or could I be pregnant?


Answer
Dear Aja,

Many doctors will monitor hCG levels after a pregnancy loss to make sure that those levels come back down between 0-5 mIU/ml - whether or not they suspect any tissue was retained or not. You need to ask your doctor whether this was done. If they did and your level was previously back down to a non-pregnant level, then this is likely a new pregnancy. (Although it would be quite early to get a positive on a HPT at approximately 11-13 days after ovulation.) If they have not done these follow-up hCG levels, I would explain the circumstances and request a serum beta hCG level be drawn in order to determine an actual amount of hCG in your bloodstream.

At 4+ weeks post-miscarriage, it would be unusual to still have an hCG higher than 25 mIU/ml, but not impossible.

I hope this has helped you and answered your question. I wish you well.

Brenda