Measuring and interpreting Blood hCG to Assess Pregnancy Viability Following ART Treatments

I know of no medical announcement associated with the degree of emotional anticipation and anguish as that associated with a pending diagnosis/confirmation of pregnancy following infertility treatment. In fact, hardly a day goes by where I am not confronted by a patient anxiously seeking interpretation of a pregnancy test result.

Testing urine or blood for the presence of human chorionic gonadotropin (hCG) is the most effective and reliable way to confirm conception. The former, is far less expensive than the latter and is the most common method used. It is also more convenient because it can be performed in the convenience of the home setting. However, urine hCG testing for pregnancy is not nearly as reliable or as sensitive e as is blood hCG testing. Blood testing can detect implantation several days earlier than can a urine test. Modern pregnancy urine test kits can detect hCG about 16-18 days following ovulation (or 2-3 days after having missed a menstrual period), while blood tests can detect hCG, 12-13 days post-ovulation (i.e. even prior to menstruation).

The ability to detect hCG in the blood as early as possible and thereupon to track its increase, is particularly valuable in women undergoing controlled ovarian stimulation (COS) with or without intrauterine insemination (IUI) or after IVF. The earlier hCG can be detected in the blood and its concentration measured, the sooner levels can be tracked serially over time and so provide valuable information about the effectiveness of implantation, and the potential viability of the developing conceptus.

There are a few important points that should be considered when it comes to measuring interpreting blood hCG levels. These include the following:

  • All modern day blood (and urine) hCG tests are highly specific in that they measure exclusively for hCG. There is in fact no cross-reactivity with other hormones such as estrogen, progesterone or LH.
  • Post conception hCG levels, measured 10 days post ovulation or egg retrieval can vary widely (ranging from 5mIU/ml to above 400mIU/ml. The level will double every 48–72 hours up to the 6th week of gestation whereupon the doubling rate starts to slow down to about 96 hours. An hCG level of 13,000-290, 0000 mIU/ml is reached by the end of the 1st trimester (12 weeks) whereupon it slowly declines to approximately 26,000– 300,000 mIU/ml by full term. Below are the average hCG levels during the first trimester:
    • 3 weeks LMP: 5 – 50 mIU/ml
    • 4 weeks LMP: 5 – 426 mIU/ml
    • 5 weeks LMP: 18 – 7,340 mIU/ml
    • 6 weeks LMP: 1,080 – 56,500 mIU/ml
    • 7 – 8 weeks LMP: 7, 650 – 229,000 mIU/ml
    • 9 – 12 weeks LMP: 25,700 – 288,000 mIU/ml
    • A single hCG blood level is not sufficient to assess the viability of an implanting embryo. Caution should be used in making too much of an initial hCG level. This is because a normal pregnancy can start with relatively low hCG blood levels. It is the rate of the rise of the blood hCG level that is relevant.
    • In some cases the initially hCG level is within the normal range, but then fails to double in the ensuing 48-72hours. In some cases it might even plateau or decline, only to start doubling appropriately thereafter. When this happens, it could be due to:
      • A recovering implantation, destined to develop into a clinical gestation
      • A failing implantation (a chemical pregnancy)
      • A multiple pregnancy which is spontaneously reducing (i.e., one or more of the concepti is being lost) or,
      • An ectopic pregnancy which will either absorb spontaneously (a chemical-tubal gestation), or evolve into a full blown tubal pregnancy continue and declare itself through characteristic symptoms and signs of an intraperitoneal bleed.
  •  The blood hCG test needs to be repeated at least once after 48h and in some cases it  will need to be repeated one or more times (at 48h intervals) thereafter, to confirm that implantation is progressing normally.
  • Ultimately the diagnosis of a viable pregnancy requires confirmation of the presence of an intrauterine gestational sac by ultrasound examination. The earliest that this can be achieved is when the beta hCG level exceeds 1,000mIU/ml (i.e., around 5-6 weeks).
  • Most physicians prefer to defer the performance of a routine US diagnosis of pregnancy until closer to the 7th week. This is because by that time, cardiac activity should be clearly detectable, allowing for more reliable assessment of pregnancy viability.
  • There are cases where the blood beta hCG level is extraordinarily high or the rate of rise is well above the normal doubling rate. The commonest explanation is that more than one pregnancy has implanted. However in some cases it can point to a molar pregnancy  
  • Finally, there on rare occasions, conditions unrelated to pregnancy can result in detectable hCG levels in blood and urine. They include ovarian tumors that produce hCG, such as certain types of cystic teratomas (dermoid cysts) and some ovarian cancers such as dysgerminomas.

1,377 Comments

Erika B

Hi doctor,

I had an IUI (using letrozole 5 MG and Pregnyl trigger) on March 13th. My first HCG level at 15 days DPO was 347. My second HCG level at 19 days DPO was 3463. And my last HCG level at 21 DPO was 11,385. I also had an ultrasound at 21 DPO and the gestational sac was visible. With the HCG levels doubling every 27 hours and being so high, is it possible that I have twins, or just a rapidly progressing level of HCG?

No history of twins in family. I had one succesful pregnancy and delivery 12 years ago. I am 34 with diagnosis of premature menopause.

Thank you!

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Dr. Geoffrey Sher

This looks promising, and yes, a multiple could be possible.

G-d bless!

Geoff Sher

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Anna

Hi Dr!
I had an IUI on March 23. I had blood drawn yesterday – 9 dp-iui and the result is 1… My doctor is willing to repeat the test again on Saturday at 12 dp-iui if I would like, but I am feeling very defeated… Is it possible I could still be pregnant or would SOMETHING have shown up by 9 days on the labs??

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Dr. Geoffrey Sher

Frankly Anna, you can be surprised. Yes! I would do the schweduled repeat beta.

Miracles do happen!!

Stay safe.

G-d bless!

Geoff Sher

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Juliette

So I’m slightly anxious due to this being a new pregnancy after a recent mc and I got pregnant before I had my period. My levels went from 22, 55, and then 126 (all 48 hour intervals). Is this progressing in a healthy manner?

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Trisha

Hi i had beta hcg on 14dp3dt and it came out as 3373 miu/ml .Is this normal?!? I have a scan scheduled 15 days later

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Dr. Geoffrey Sher

That is high and you should be evaluated for a molar pregnancy!

Good luck!

Geoff Sher

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Katie Joseph

I had an vaginal ultrasound in 3/31 of which showed an 8mm gestational sac but no yolk sac or fetal pole. My doctor said that I should prepare for a miscarriage since my HGC level was at 5900 I go back tomorrow morning (49 hours after my last blood test) for another ultrasound but he was already talking about a D&C. I’m devastated and keep reading that the fetal pole and yolk sac can be visible at hgc level 7200. What are your thoughts?

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Dr. Geoffrey Sher

Unfortunately, only time can tell!

Stay strong and stay safe!

Geoff Sher

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Samantha Brown

Hi! I went on 3/30 for my first ultrasound appt and there was a gestational sac and little tiny yolk sac and I was measuring 5 weeks. My HCG levels on that day were 811. On April 1st I got my blood drawn again but they had fallen to around 622ish. I also had a progesterone level of 6.2 and the OB put me on progesterone pills right away. Could they go back up?

Backstory: In November 2019 I went into preterm labor with my husband and Is first at 21 weeks. They ruled that I had an incompetent cervix and that’s why we lost him. Not sure if that has anything to do with it or not.

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Dr. Geoffrey Sher

I am afraid this does not look very promising!

Please consider the following!

Whenever a patient fails to achieve a viable pregnancy following embryo transfer (ET), the first question asked is why! Was it simply due to, bad luck?, How likely is the failure to recur in future attempts and what can be done differently, to avoid it happening next time?.
It is an indisputable fact that any IVF procedure is at least as likely to fail as it is to succeed. Thus when it comes to outcome, luck is an undeniable factor. Notwithstanding, it is incumbent upon the treating physician to carefully consider and address the causes of IVF failure before proceeding to another attempt:
1. Age: The chance of a woman under 35Y of age having a baby per embryo transfer is about 35-40%. From there it declines progressively to under 5% by the time she reaches her mid-forties. This is largely due to declining chromosomal integrity of the eggs with advancing age…”a wear and tear effect” on eggs that are in the ovaries from birth.
2. Embryo Quality/”competency (capable of propagating a viable pregnancy)”. As stated, the woman’s age plays a big role in determining egg/embryo quality/”competency”. This having been said, aside from age the protocol used for controlled ovarian stimulation (COS) is the next most important factor. It is especially important when it comes to older women, and women with diminished ovarian reserve (DOR) where it becomes essential to be aggressive, and to customize and individualize the ovarian stimulation protocol.
We used to believe that the uterine environment is more beneficial to embryo development than is the incubator/petri dish and that accordingly, the earlier on in development that embryos are transferred to the uterus, the better. To achieve this goal, we used to select embryos for transfer based upon their day two or microscopic appearance (“grade”). But we have since learned that the further an embryo has advanced in its development, the more likely it is to be “competent” and that embryos failing to reach the expanded blastocyst stage within 5-6 days of being fertilized are almost invariably “incompetent” and are unworthy of being transferred. Moreover, the introduction into clinical practice about 15y ago, (by Levent Keskintepe PhD and myself) of Preimplantation Genetic Sampling (PGS), which assesses for the presence of all the embryos chromosomes (complete chromosomal karyotyping), provides another tool by which to select the most “competent” embryos for transfer. This methodology has selective benefit when it comes to older women, women with DOR, cases of unexplained repeated IVF failure and women who experience recurrent pregnancy loss (RPL).
3. The number of the embryos transferred: Most patients believe that the more embryos transferred the greater the chance of success. To some extent this might be true, but if the problem lies with the use of a suboptimal COS protocol, transferring more embryos at a time won’t improve the chance of success. Nor will the transfer of a greater number of embryos solve an underlying embryo implantation dysfunction (anatomical molecular or immunologic).Moreover, the transfer of multiple embryos, should they implant, can and all too often does result in triplets or greater (high order multiples) which increases the incidence of maternal pregnancy-induced complications and of premature delivery with its serious risks to the newborn. It is for this reason that I rarely recommend the transfer of more than 2 embryos at a time and am moving in the direction of advising single embryo transfers …especially when it comes to transferring embryos derived through the fertilization of eggs from young women.

4. Implantation Dysfunction (ID): Implantation dysfunction is a very common (often overlooked) cause of “unexplained” IVF failure. This is especially the case in young ovulating women who have normal ovarian reserve and have fertile partners. Failure to identify, typify, and address such issues is, in my opinion, an unfortunate and relatively common cause of repeated IVF failure in such women. Common sense dictates that if ultrasound guided embryo transfer is performed competently and yet repeated IVF attempts fail to propagate a viable pregnancy, implantation dysfunction must be seriously considered. Yet ID is probably the most overlooked factor. The most common causes of implantation dysfunction are:

a. A“ thin uterine lining”
b. A uterus with surface lesions in the cavity (polyps, fibroids, scar tissue)
c. Immunologic implantation dysfunction (IID)
d. Endocrine/molecular endometrial receptivity issues
e. Ureaplasma Urealyticum (UU) Infection of cervical mucous and the endometrial lining of the uterus, can sometimes present as unexplained early pregnancy loss or unexplained failure following intrauterine insemination or IVF. The infection can also occur in the man, (prostatitis) and thus can go back and forth between partners, with sexual intercourse. This is the reason why both partners must be tested and if positive, should be treated contemporaneously.
Certain causes of infertility are repetitive and thus cannot readily be reversed. Examples include advanced age of the woman; severe male infertility; immunologic infertility associated with alloimmune implantation dysfunction (especially if it is a “complete DQ alpha genetic match between partners plus uterine natural killer cell activation (NKa).

I strongly recommend that you visit http://www.DrGeoffreySherIVF.com. Then go to my Blog and access the “search bar”. Type in the titles of any/all of the articles listed below, one by one. “Click” and you will immediately be taken to those you select. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly.

• The IVF Journey: The importance of “Planning the Trip” Before Taking the Ride”
• Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol
• IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation (COS)
• The Fundamental Requirements for Achieving Optimal IVF Success
• Use of GnRH Antagonists (Ganirelix/Cetrotide/Orgalutron) in IVF-Ovarian Stimulation Protocols.
• Ovarian Stimulation in Women Who have Diminished Ovarian Reserve (DOR): Introducing the Agonist/Antagonist Conversion protocol
• Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
• Human Growth Hormone Administration in IVF: Does it Enhances Egg/Embryo Quality and Outcome?
• The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS). Coming off the BCP Compromise Response?
• Blastocyst Embryo Transfers should be the Standard of Care in IVF
• IVF: How Many Attempts should be considered before Stopping?
• “Unexplained” Infertility: Often a matter of the Diagnosis Being Overlooked!
• IVF Failure and Implantation Dysfunction:
• The Role of Immunologic Implantation Dysfunction (IID) & Infertility (IID): PART 1-Background
• Immunologic Implantation Dysfunction (IID) & Infertility (IID): PART 2- Making a Diagnosis
• Immunologic Dysfunction (IID) & Infertility (IID): PART 3-Treatment
• Thyroid autoantibodies and Immunologic Implantation Dysfunction (IID)
• Immunologic Implantation Dysfunction: Importance of Meticulous Evaluation and Strategic Management 🙁 Case Report)
• Intralipid and IVIG therapy: Understanding the Basis for its use in the Treatment of Immunologic Implantation Dysfunction (IID)
• Intralipid (IL) Administration in IVF: It’s Composition; how it Works; Administration; Side-effects; Reactions and Precautions
• Natural Killer Cell Activation (NKa) and Immunologic Implantation Dysfunction in IVF: The Controversy!
• Endometrial Thickness, Uterine Pathology and Immunologic Factors
• Vaginally Administered Viagra is Often a Highly Effective Treatment to Help Thicken a Thin Uterine Lining
• Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
• A personalized, stepwise approach to IVF
• How Many Embryos should be transferred: A Critical Decision in IVF?
______________________________________________________
ADDENDUM: PLEASE READ!!
INTRODUCING SHER FERTILITY SOLUTIONS (SFS)
Founded in April 2019, Sher Fertility Solutions (SFS) offers online (Skype/FaceTime) consultations to patients from > 40 different countries. All consultations are followed by a detailed written report presenting my personal recommendations for treatment of what often constitute complex Reproductive Issues.

If you wish to schedule an online consultation with me, please contact my assistant (Patti Converse) by phone (800-780-7437/702-533-2691), email (concierge@SherIVF.com) or, enroll online on then home-page of my website (www.SherIVF.com).

PLEASE SPREAD THE WORD ABOUT SFS!

Geoff Sher

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lizett torres

I went in for sono and they said 6 week 2 day but they took a progesterone and hcg I was at 23,600 and it fell 500 points in two days. Is that normal? Ive had 2 miscarriages already

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Dr. Geoffrey Sher

At this stage and with that high an hCG level, it is not really sinister. What matters now is another US in 5 days from today.

Good luck!

Geoff Sher

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mH

Hi Dr. Sher, my betas were tripling nicely but suddenly, they are taking much longer.
At 5w2d (23dpo)- 4100
5w5d (26 dpo) – 7450
Is this an impending problem, do you think? Thank you and bless you

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Mh

I forgot to add – I had an ultrasound on 5w5d and gestational sac and yolk sac were seen, but fetal pole was not.

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Ashleigh

Hi Dr Sher, my first 3 hcg’s taken 2 days apart during my 4th week did not double appropriately (224, 323, 463) but 1 week later they were 4000, which right on track. I saw heartbeat 6weeks and am now 9 weeks but I can’t stop thinking something will go wrong. In your experience, can levels ‘catch up’ and result in healthy pregnancies? Thank you

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Dr. Geoffrey Sher

If US showed a HB and appropriate size of conceptus and sac, my bet is that all is well. However, your OB should be scrutinizing development and growth from here on out and if there are concerns, then further additional prenatal testing might be indicated.

Good luck!

Geoff Sher

Geoff DSher

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Dr. Geoffrey Sher

It is not unusual to see the betas slowing down with regard to increase, once the level reaches 5,oo! This alone is not very concerning to me.

Geoff Sher

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Mangostree

Hello Sir,
I was on just one round of clomid 100 mg last month and I got positive on 18th march.
My hcg level on:
19th march was 225,
24th march was 2972,
and 28th march is 12414.
.
I know hcg levels in itself aren’t definite indicative of twins, multiples, but still just curious to know your expert opinion whether it could be twins/multiples?
My US is not until next two weeks due to lockdown. Just anxious and seeking your opinion. Please oblige.

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mangostree

Also, 19th march was
15th dpo, when I got hcg level as 225.
Thereafter, 20th dpo and 24th dpo respectively.

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Vishu

In my 10 week but no pregnancy symptoms, im on progesterone pills and shot…i had a miscarriage in past so im paranoid that baby is not growing and because of progesterone im not even bleeding, what are the chances that progesterone can mask a miscarriage from happening…my clinic is closed for indefinite period coz of this virus thing so my scan is also cancelled

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Dr. Geoffrey Sher

Hi Vishu,

I previously responded to this post, stating that the the progesterone is unlikely to mask an inevitable miscarriage.

Geoff Sher

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Dr. Geoffrey Sher

So sorry!

Trisomy 9 is an extremely rare chromosomal developmental defect . I have never seen this before. I would wait another 3-4 weeks and do an amniocentesis before acting…but of course that would be up to you to decide.

Geoff Sher

Geoff Sher

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Victoria Tumolo

Hello doc! I had my hcg drawn at 12DPO (March 25, 2020). My level was 77. I’m concerned that is too low. Any opinion? Thank you!

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Dr. Geoffrey Sher

This is still acceptable. I suggest you repeat this in 2 days to see if it will double.

Geoff Sher

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Lauren Andrade

Complete molar pregnancy 8 months ago. Got okay to try again 6months after molar which was Janurary 2020
Positive pregnancy test march 14th
Hcg at 10dpo =10
Hcg at 13dpo =101
Hcg at 19dpo=1545
19dpo progesterone 9.69ng/lm

What do you think do you think based off those numbers my pregnancy is viable?

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Robyn

I am 9 weeks pregnant accordingly to the date of my last period – I had my HCG levels tested on Friday 20th March and again on Monday 23rd March and the level had only risen from 150,000 to the early 160,000 – I am having another blood test tomorrow Thursday 26th March so hopefully it has risen more – are these results normal or something to worry about as I am completely unsure.

I would appreciate a response.

thank you!

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Dr. Geoffrey Sher

That could well still be acceptable. The rise in hCG levels tend to slow down after 5-6 weeks and then tail off. US serial assessments are far more reliable.

Good luck!

Geoff Sher

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Marissa H

Hello Dr Sher! Hope you are well. I somehow got a positive beta doing a natural cycle. I ovulated on cd7, so super early, and didn’t have much hope. My Hcg has been tripling nicely every 48 hours. betas: 156 – 600 – 1500 – 4100. My only problem is my estrogen has been very low. It was 25 with no estrace. Now taking 4 mg of estrace a day, and it’s 125. Do you think this points to an unviable pregnancy given the estrogen? I am on oral and vaginal progesterone and it’s around 45.
Thank you for your time!

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Dr. Geoffrey Sher

I suggest you do a beta hCG test and then repeat in 2 days to see if the levels are increasing appropriately.

Geoff Sher

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Marissa

thank you! My beta hcg is doubling, but estrogen remains low. What is your opinion on the importance of estrogen in regards to viability? Thank you!

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Dr. Geoffrey Sher

In my opinion, as long as the hCG keeps rising appropriately, progesterone is >10ng/ml, you still are in the running for a favorable outcome.

Geoff Sher

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Mel

Hi there. My beta came back today it is 689 and I am 11dp5dt. Can you tell me if that is in the normal range?

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Dr. Geoffrey Sher

It is on the high side…Could be a multiple?

Good luck and G-d bless!

Geoff Sher

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Renee Smokovich

I had a beta test today at 6dpt5dt. Hcg was at 0.5 which went down from my first beta test at 4dpt5dt from 1.5. Is this drop due to The trIgger shot wearing off? Or is it not a good outcome?

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Dr. Geoffrey Sher

Hi Renee,
I regret to have to tell you that this is unfortunately a failed implantation!

So sorry!

Geoff Sher

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Chels

Hi Dr Sher,
I live in a small rural town and do not have my first obs/gyn appt until end of April,2020. I am 10 weeks 3 days today (23/3) have had some brown discharge with pelvic pain for the past 5 days, my HCG on 20/3 was 92,000 and dropped to 75,000 on 21/3. I had an ultrasound on 20/3 and bubs was right size with heartbeat of 160bpm. My GP has said that dropping HCG is a sign for impending miscarriage. Are they correct in this diagnosis?

Thank you so much for your time and expertise.

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Dr. Geoffrey Sher

At this stage of pregnancy, hCG levels can fluctuate. You cannot go by the hCG alone. Ultrasound will be more reliable at this stage….in my opinion.

Geoff Sher

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Chels

This has given me a glimmer of hope and fingers crossed all is still well, as it was at last scan 3 days ago. My GP is organising another ultrasound for this week and i’m pending a 3rd HCG BT results from today. We’ll take every day as it comes. Thanks Dr Sher, really appreciate your time.

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Mabel

Hi Dr. Sher,

I had a 5 day blastocyst transfer on 10 March, and the hcg test only showed a level of 10 on March 20. Will do another test in 48 hours. Can i ask if the hcg level is the only criteria? Shall i request for a progesterone test as well? When shall i make decision to give up? Can i start a new IVF cycle immediately?

Many thanks,
Mabel

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Dr. Geoffrey Sher

I do not personally believe that measuring progesterone will matter. I would however, not give up until repeated hCG tests and/or subsequent US done 2-3 weeks from now, discounts a pregnancy. Thereafter, my advice is to take a break for one full cycle before re-engaging.

Good luck and G-d bless!

Geoff Sher

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Sreeja Pradeep

Hi Doctor,
I am Sreeja, since 2 days i am waiting for your valuable answer. 2012 underwent open ovarian cystectomy, 2016 got married and after 2month ectopic salphinjectomy left done because there is adhesion of the open surgery. Tried 2 years ovulation induction and IUI, but failed, HSG done, and my doctor told that tube filled with dye but only some spillage is present to the peritoneum, there may be a distal block and he adviced 2 options, HLS to assess tube or IVF. Which is suitable for me. Will HLS help to remove distal block? I am eagerly waiting for your reply.

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Dr. Geoffrey Sher

You need IVF but if you have a hydrosalpinx, this should be addressed beforehand. Talk to your RE.

Geoff Sher

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Janelle

My hcg was 256 on March 5th. On March 17th at 3pm it was 2566 and on March 20th at 11 am it was 2839. Is there something wrong? Can I still have a healthy pregnancy. My last period was feb 5th

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Dr. Geoffrey Sher

This is a slow rise. Only time and ongoing testing can determine if this is a viable or non-viabl3e implantation.

Good luck!

Geoff Sher

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Destiny L.

Hi!. My IUI was 2/29/20.
3/16 was 212
3/18 was 590
Are those good numbers? What’s the likelyhood of twins with the numbers almost tripling in right at 48-49 hours.

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Jenny

Hello!

I had a single, 5 day transfer on 3/11/20. Beta HCG on 3/20 was 131, and repeat done on 3/24 was >1000. Im wondering your thoughts on this rise, is it a fast rise in your opinion?

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Dr. Geoffrey Sher

I suspect this is a healthy pregnancy on the make!

Good luck!~

Geoff Sher

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Priya

Hi Dr. Sher,
This is my first IVF cycle. 2 embryos were transferred at 5th day on Feb 26. I am now at 5 weeks and 5 days after LMP.
I had my first beta 7 days later. Progesterone was 29 on March 16. HCG levels were:
March 4 – 45
March 12 – 744
March 16 – 1300
March 18 – 1669

My RE initially said she was happy with the numbers and now says she is concerned that the number from March 18th isn’t higher and that I need to have an US to check. What are the chances this is still a viable pregnancy? What do you think is happening?

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Shara

Hi Dr,
My IUI was done on 02/29/2020. My hCG:
03/13 — 27
03/16 — 31
03/18 — 88
Do you think it is a viable pregnancy?

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Dr. Geoffrey Sher

It is too early. Repeat the hCG in 4 days , it should quadruple if OK. Then do an US in 2.5 weeks from now for a definitive answer.

Geoff Sher

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Shara

Thanks for your reply. I was curious to know even if this ends up as a viable pregnancy, does the low hCG mean that the fetus may have disabilities? Or there is no such connection?

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Dr. Geoffrey Sher

There is not necessarily a connection. However, a lot will depend on measurable, progressive developmental parameters. Discuss with your RE and Perinatologist..
Geoff Sher

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Christe Anastopoulos

Hi Dr. Sher,
I am officially freaking out! Any success stories with HCG not fully doubling? Or similar numbers?

10dpo (3 weeks 3 days)
Beta HCG: 37

13dpo (3 weeks 6 days)
Beta HCG: 140

17dpo (4 weeks 3 days)
Beta: 292

My last beta reflected HCG doubling every 3 days & 18 hours
(2 days increase 44%)

Going in for another beta tomorrow…
I have gone off the deep end reading studies….I have found 3 different opinions. Some studies say 60% increase in 48 hours, some say 50% and I saw another that said the threshold should be lowered to 35% increase in 48 hours. What are your thoughts on this being a viable pregnancy with the numbers above?

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Dr. Geoffrey Sher

I wish I could assure you that all is well Christe, but that is not possible. You will have to wait another 2 weeks and do an ultrasound. In the meanwhile ask your doctor to keep an eye out for a tubal (ectopic) pregnancy. I am not suggesting that this is what is happening but rather be safe than sorry. Report any pain, light headedness or bleeding to your doctor.

My thoughts and prayers are with you.

Geoff Sher

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Christe

Thanks! I’ll keep you posted. Just so anxious and sad regarding the last beta…. I had a MC in Sept and a second MC on Thanksgiving 2019. This is now my third pregnancy and no baby yet. I really hope the Beta’s make a turn for the positive.

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Christe

Got my results back. It went from 292 on 3/16 to 526 on 3/18
2 Day change = 80.1 % increase.
Doubling time =2.4 days or 56.53 hours

Hopeful?

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Zee

My betas have started slowing down. I’m 6w2d today and they’ve gone like this:
25dpo: 4689
27dpo: 7024
30dpo: 11732
The last two readings have a doubling time of 97hours. Does this look like it’s failing? A sac was seen in uterus at 5w5d
Thanks

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Dr. Geoffrey Sher

Not at all! At this stage of pregnancy the rise in beta hCG level slows down.

I think all is well!

Good luck and G-d bless!

Geoff Sher

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Lily

Hi,

I had two miscarriages before, now had a positive pregnancy test with 66 hcg 13dpo. I haven’t done a second test but just concerned that 66 is low. What do you think?

Thanks!

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Dr. Geoffrey Sher

Do a second test in 2 days to see if it doubles.

Good luck!

Geoff Sher

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Ali

Hello Dr Sher

Transferred two Embryos on 2/23/20

My Betas are

3/2/20 370 8DPT
3/6/20 2205 12DPT
3/9/20 6478 15DPT (Two weeks)

Is this a normal progression? Could it be multiples ?

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Heather

Hello Dr. Sher,
I’m pretty sure I ovulated around March 14th. Had a very faint positive at home pregnancy test on March 26th. Went for beta on March 30th was at 57. Went in again today April 1st and it was 99. Doctor said to do an US in 3 weeks but didnt say to repeat beta. I’m feeling uneasy about these numbers.

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Dr. Geoffrey Sher

I am afraid that only time will tell!

My hunch is that all will be fine!

Geoff Sher

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