Pregnancy Test Positive, But No Ultrasound Findings? Understanding Possible Miscarriage & HCG Levels

Question
This past June we tried to get pregnant. It appeared as though I got my period on June 30 - so I assumed I wasn't pregnant. Last period was June 2 (usual cycle is 32 days). Had continuous spotting after June 30 bleeding episode. Felt funny and took pregnancy tests on July 9 - all positive. Had a transvaginal US due to spotting on July 11 - couldn't find pregnancy. So, my midwife suspected that I may have miscarried. Send to get Hcg level that same day of US - 27 was the result. Sent again to have hcg done this past Thursday (07/13) - it doubled to 61. Took another urine test and still showing positive. Did I miscarry or not? Will take another hcg this Monday (07/17) and scheduled for another US on August 1 to determine if indeed I miscarried or not and if the pregnancy was just too early to detect in US and that's why hcg has doubled. What's your opinion of what's happening? My June 30 bleeding episode looked like a period but wasn't as heavy as usual.  

Answer
Emily,

In your situation, because we aren't sure exactly when you conceieved, it is impossible to know for sure until you have another ultrasound.  If it doesn't show pregnancy, you could be experiencing a molar pregnancy where HCG levels rise and you may even experience symptoms, but no fetus developes.  However, you may have just been too early to visualize a pregnancy, which would also correspond with your low HCG levels indicating extremely early pregnancy.  The best and hardest thing to do is to wait for your HCG levels and your ultrasound.  They will tell for sure.  Good luck and I hope this helps!