Understanding Elevated hCG Levels and Potential Pregnancy Concerns

Question
I'm 34, 2 previous 1st trimester SAB followed by normal preganacy and delivery after using progestrone suppositories due to possible luteal phase defect. Positive pregnancy test April 9th. I have very irregular periods ranging from 28-45 day cycles.Transvaginal US on April 19 showed GS of not quite 5 weeks and had HCG levels of 9000. Transvaginal US on April 21 showd GS of 5 weeks 3 days but no yolk sac, hcg levels drawn 20 hours after the first was 12000. OB predicts blighted ovum due to abnormal rising hcg and empty sac and suggested I stop taking  prometrium. I am sheduled for a repeat US in 5 days and wondering if there is any chance this could be a normal pregnancy despite findings. I have had no spotting or cramping.

Answer
Since a sonogram between 5-6 weeks gestation (from the first day of your last period) will only show an empty gestational sac and no fetus or fetal heartbeat, I would not repeat the sonogram until you are 6-7 weeks from the first day of your last period. By then, you should see a fetus and a fetal heartbeat. If there is still no fetus, I would agree with your doctor. Sometimes there can be a slow rise in HCG titers and still be a viable pregnancy, but there should be sonographic evidence of a fetus by 6-7 weeks. Don't stop the progesterone suppositories until you have confirmed that there is no fetus.