16 Days Past Ovulation (DPO) and hCG levels

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So you just happen to know your hCG levels at 16dpo?

We can learn such amazing things about our pregnancies these days.  Our doctors love, love, love to check those hCG levels.  Knowing our levels is not always such a good thing  because doctors will see lower levels and scare women half out of their minds with predictions of miscarriage even when their pregnancy is perfectly viable.

I love to share this particular study with women.  Researchers looked at hCG levels 16 days past ovulation (DPO).  This study can help women understand if there really is truly no hope or if their doctor may be just a little too hasty in dooming the pregnancy.

If you just want to skip down to the nitty-gritty of this page, scroll down to What your hCG numbers may indicate at 16dpo to compare your numbers.

 

I am not a medical professional. The information I share is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.

Our 16dpo Project!

April Update:
We are now collecting our own 16dpo hCG numbers as well as the outcomes. Do you know your own 16dpo levels and the outcome (i.e. later found heartbeat, had miscarriage, etc...)? 16dpo Project

The Study 

Here is the abstract from the study (Scroll down for the explanation!)

Fertil Steril. 2000 Feb;73(2):270-4

Human chorionic gonadotropin as a predictor of outcome in assisted reproductive technology pregnancies.**
Homan G, Brown S, Moran J, Homan S, Kerin J.
Department of Obstetrics and Gynaecology, The University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.

OBJECTIVE: To determine whether serum hCG and progesterone levels obtained 16 days after ovulation are reliable predictors of pregnancy outcome.

DESIGN: A retrospective study. SETTING: The data were obtained from two integrated Adelaide-based clinics: the Queen Elizabeth Hospital and Wakefield Clinic.

PATIENT(S): Women who have achieved a pregnancy through ART treatment.

MAIN OUTCOME MEASURE(S): Analysis of data using logistic regression (STATA v.5.0) to predict a binary outcome: ongoing pregnancy or miscarriage. Ongoing pregnancy was defined as progression to >20 weeks' gestation. Miscarriage included spontaneous abortion, biochemical and ectopic pregnancies, and blighted ovum.

RESULT(S): Human chorionic gonadotropin was found to be the main determinant of ongoing pregnancy. Age and progesterone had minor effects, whereas stimulation, luteal support, and treatment types were nonpredictive. Low hCG levels between 25 and 50 IU/L are associated with a low probability of ongoing pregnancy (<35%), whereas levels of >500 IU/L predict a >95% chance of ongoing pregnancy.

CONCLUSION(S): A single serum hCG level 16 days after ovulation provides a useful predictor of pregnancy outcome.

**my apologies for the html formatting of this PDF document. This was the only link I had with the complete text.

What your hCG numbers may indicate at 16dpo 

Table 2 from this study

Taken from Table 2
Summary of Outcome by hCG levels

What this study found:

25 - 50 hCG at 16dpo -- Four women in this study had hCG levels below 50 at this stage. The researchers concluded that with these levels less than 25% would continue on with their pregnancy with more than 75% miscarrying.

50 - 100 hCG at 16dpo -- Of 16 women, 25% continued on with their pregnancies.

100 - 199 hCG at 16dpo -- Of 27 women with these levels, 73% continued on with their pregnancies.

200 - 299 hCG at 16dpo -- Of 48 women, 96% continued on with their pregnancies

Over 300 hCG -- All 105 women continued on with their pregnancies.

What you may want to take away from this study 

I've e-mailed this table to countless women over the last few years.

Let me share what I believe may be important after seeing this study.

First of all, if your hCG levels at 16dpo are over 300, do not wrongly assume you are safe from miscarriage. Miscarriages still happen but are fewer and farther between. However, this pregnancy does have a much better chance than most of continuing.

Secondly, if your levels are below 50 hCG at 16dpo, don't give up all hope. I've talked to women who have had hCGs do strange things early in pregnancy. They've temporarily slowed, plateaued or even declined and they still go on to have a viable pregnancy. We've had women report they were dehydrated and once they hydrated, their numbers jumped up again. Also, it is possible the loss of a hidden twin may cause numbers to temporarily slow or decline. Many pregnancies start out as twins and end up as singletons in very early pregnancy. Also, women can be off on their dates and have longer cycles. You may just not be as far along as you and your doctor might believe (happens far too frequently).

These researchers did find that age also plays a role. Women over 30 who had lower numbers were more apt to miscarry than women under 30 years of age. Again, some women under 30 with lower numbers can and do miscarry whereas women over 30 with lower numbers continue on with their pregnancies.

If your hCG numbers are on the low side and if you are in your 30's and 40's, you may want to have your progesterone checked. We've seen that a number of women with low hCGs also seem to have low progesterone. Some studies suggest that progesterone supplements can have a positive influence in the direction these pregnancies take. Talk to your doctor.

Conclusion
These numbers simply give you an idea of what may happen. They are not written in stone and they do not mean that you will not miscarry or will miscarry. Mostly these numbers are for women told they may miscarry or be at greater risk of miscarriage. I do know for some they may provide a bit more reassurance especially when their physicians give them little room for hope. And, now, you are a bit more educated on what may be happening with your pregnancy at 16dpo.

Want to Learn More about hCG Numbers? 

Here are some links to help demystify hCG numbers in the first trimester.
Advanced Fertility -- hCG levels in pregnancy
Early Pregnancy -- Including an explanation of hCG levels and ultrasound findings
Conceiving Concepts
Great information on real hCG doubling times (no it's not really every 48 hours for many) and typical ranges of hCG values.
hCG levels and the First Trimester of Pregnancy
My own FAQ about hCG numbers.

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  • Reply
    twink twink Jul 11, 2009 @ 7:52 am | in reply to zee
    Did you end up being pregnant? I had one positive digital and 3 regular test negative. I went and got a blood test and my hcg level was a 4? I am going monday for a second test to see if it went up I guess?
  • Reply
    zee zee Apr 27, 2009 @ 9:22 pm
    i felt prego! and i got a blood test it said i was 11 hcg the dr. said i was prego. i had another test a wk later and it was down to 3 hcg and they said non prego (MC). i went back again after a month becasue i felt prego still. i got my period and didnt call in for the test results asuming i was not prego. i felt prego again so i called for the test results and it said 4 hcg, so that means it went up 1 level after 1 month!?? what does this mean?????
  • Reply
    trish trish Dec 13, 2008 @ 11:39 am
    Ive had several positive hpts within the last few days. My doc appt test yesterday was neg. I came home and had another positive hpt. They called and told me my HCG level was 4. (negitive according to them) Im confused as to why i would have over 5 positive hpts. I would be 4wks.
  • Reply
    avery avery Nov 15, 2008 @ 9:03 pm
    [in reply to Cari_Kay

    5.2 weeks fetal age not gestation :O)
  • Reply
    Avery Avery Nov 15, 2008 @ 9:01 pm | in reply to Cari_Kay
    thank u- ive been so confused they told me that i was 2-31/2 weeks according to my levels ( taken 9-10-08 ).....I wanted an outsiders opinion because when they did a intervaginal ultrasound 12 days ( done 9-22-08 ) after my levels were taken - they measured my baby to 5.2weeks- but they said its not impossible but not likely.... However both the levels and ultrasound are one in the same,,,, Am i going crazy,, or does how im figuring it sound wrong....
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by Cari_Kay

Hello. My name is Kay. I'm not a medical professional but due to life's twists and turns, I've learned a bit about topics like miscarriage (as well... (more)

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