QuestionI am 28 years old, and have had 3 pregnancies and 3 live births. I found out I am pregnant a 4th time just one week ago today. The first day of my last menstrual period was October 13th, 2005.
I have had low progesterone with all 3 of my previous pregnancies and was put on progesterone supplementation via pills with all of them, and have 3 healthy children now. I have never been followed on my hcg levels, so I do not know what they have normally been like. With this pregnancy they did a quantitative hcg level last Tuesday and it was 1531, and my progesterone was only 6. They started me on the vaginal suppositories for the progesterone. They also did a vaginal u/s this last Tuesday and it did not show anything. I went back today and they did another hcg level, but no progesterone level. My hcg level today was aprroximately 1876. The vaginal u/s from today showed a gestational sac measuring 7.6mm. Can you please explain to me what all of this means, and if it is normal for a woman that corpus luteal failure to have her hcg levels not double as a normal woman's would? Please help me understand what everything means, because the doctors did not really explain it all to me. Thank you.
AnswerBased on the date of your last period, you should now be approximately 7 weeks 4 days gestational age. By now, a sonogram should show a gestational sac, a fetus, and a fetal heartbeat. (Prior to 6 weeks gestation, it only shows an empty gestational sac). At this point, HCG values usually double every 48 hours. If you have a very small increase in HCG value and a low progesterone level, it may indicate a non-viable pregnancy. I would continue the progesterone supplementation and repeat the HCG assay in another week. I would also repeat the sonogram in two weeks to see if there is adequate growth or if there is a fetus or a heartbeat. If there is no heartbeat or adequate growth, it is a non-viable pregnancy and you should have a D&C to remove the contents of the uterus.
