The First Trimester and Non-Doubling hCG Levels

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Non-Doubling hCG Levels in the First Trimester Do Not Mean Inevitable Miscarriage!

Due to my work on the Misdiagnosed Miscarriage site, I've learned a lot about pregnancy and miscarriage topics important to women. I wrote a page on Frequently Asked Questions about hCG Levels. I'd now like to share some of the studies showing that hCG levels do not need to double in 48 hours as some doctors all-too-casually misinform their patients.

Keep in mind, what we know about medicine is all-too-often evolving. Most doctors are overworked and staying on top of the more current research would be exhausting if not nearly impossible. For this reason, I like to encourage women to learn more about their pregnancies and share what they have learned with their physicians. A good doctor will take an interest in what you have learned.

I believe every woman deserves to have no doubt before having her pregnancy ended.

 

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.

Number One: Research regarding hCG Levels 

Redefining [beta]-HCG in viable pregnancies: rose 50% every 2 days

The Study
Redefining [beta]-HCG in viable pregnancies: rose 50% every 2 days

What they found
Researchers examined 293 women with viable first-trimester pregnancies. In this study, they found that in many of the pregnancies, hCG levels only rose 50% in two days.

Why is this important?
Many women are incorrectly told that if their levels do not double in two days or, at the most three, they are probably going to miscarry. In fact, I get e-mails daily from women who have been told this. In some cases they go on to miscarry but many go on to continue their pregnancies.

Number Two: Helpful Article About hCG Levels 

Ultrasound markers useful in determining early pregnancy viability: don't rely on [beta]-HCG levels

The Article
Ultrasound markers useful in determining early pregnancy viability: don't rely on [beta]-HCG levels

What they found
Although this is not specifically a study, there is some useful information to take away:

"Once you confirm [by ultrasound] that the pregnancy is in the uterus, there is no place for [beta]-HCG,

"Many clinicians determine whether [beta]-HCG levels have doubled within 48 hours, a sign of normal pregnancy, but sometimes they rely on this sign too far into the pregnancy"

What NOT to take from this article
This article is correct that far too great an importance in placed on doubling hCG levels. However, they also state when a yolk sac and embryonic pole should be seen. We have collected enough misdiagnosed miscarriage stories now to know this is not necessarily true. We have seen that if you have a tilted uterus, chances are you will see your baby up to three weeks (or even more!) later than most women. So, while we agree with their thoughts on hCG levels, their criteria for diagnosing a miscarriage with ultrasound is not quite as valid.

Number Three: A Doctor's Blog Discussing hCG Levels 

HCG Levels and Ultrasounds in Early Pregnancy

The Blog
HCG Levels and Ultrasounds in Early Pregnancy

About this blog
This blog by Dr. Robert Warnock again reiterates that misinterpretation can cause a lot of needless stress.

What to take from this page:

HCG that does not double every two to three days does not necessarily indicate a problem with the pregnancy

Once the pregnancy is visible on ultrasound, further HCG testing is less reliable than ultrasound for monitoring a pregnancy, as the variations in HCG levels are frequently misleading and cause unnecessary worry.

If you're pain-free and you're not bleeding and you're at low-risk for an ectopic pregnancy, try to avoid the temptation to monitor HCG levels.

Try not to read too much into the absolute numbers and rates of increase of the HCG levels.

Once an intrauterine pregnancy is visible on ultrasound, do not put any faith in HCG measurements.

Number Four: Pregnancy Site's Information on hCGs 

HCG Ranges on Conceiving Concepts

This Page
HCG Ranges

What you'll find here
The information found on this page is found in numerous places on the web. I just like that they've got it all contained on one page. You'll find average range of hCG levels as well as typical doubling time.

Most importantly, remember, typical doubling times increase with higher hCG levels.

- Under 1200 mIU/ml: 48-72 hours.
- Between 1200 to 6000 mIU/ml: 72-96 hours.
- Over 6000 mIU/ml: more than 96 hours

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I'd love to hear from you

Do you have any further pages of interest to women researching hCG levels? Please, feel free to leave links or just comments.

If I don't reply to you here, please feel free to e-mail me directly at bonzobean@gmail.com

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  • Reply
    shawnee shawnee Sep 18, 2009 @ 6:52 pm
    I am 11 weeks and just started bleeding yesterday . i went to the doctor yesterday and the vaginal ultrasound didnt show a sac or a baby, my hcg levels was 6,318, and today they were only 4,995 the doctor said i was probly haveing a miscariage. do you know if they can drop and go back up?just to get a second opinion thanks!
  • Reply
    Lolly Lolly Jun 29, 2009 @ 4:42 pm
    I miscarried in 2007 at 17 weeks and just finished 3 IUI cycles with negatives.

    I happened to be at my gynecologist's office last week for a pap and took a routine urine test which came back positive-which is mind blowing for me. I took an hcg and the first one was 24 and two days later was 27. It's very stressful for me to see such a low rise. I can't be miscarrying AGAIN when it took me two years to get pregnant again can it???
  • Reply
    Penny Penny Jun 27, 2009 @ 3:47 pm | in reply to Amy
    I am having a problem of the same my HCG levels went from 25 to 32 in thirty six hours i have been ttc for 11 months and my AF is due 6/29 so i hope that this is not a real miscarriage and i actually keep the baby
  • Reply
    Amy Amy May 28, 2009 @ 5:00 pm
    My first hcg was 14, and the second, 2 days later, was 19. Since it was not even close to double, would you assume that this is not a viable pregnancy?
  • Reply
    Kristina Kristina May 18, 2009 @ 2:36 pm | in reply to Kristina
    It was actually over 7 days. Sorry.
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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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