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Dr. Andrew Rynne

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Have got HCG report. had miscarriages. Are the reports normal?

Answered by
Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3768 Questions

Posted on Mon, 7 Jan 2013 in Infertility Problem
Question: Need inputs on HCG rise , My HCG did not increase (2404 to 2420 in 4 days), though u/s shows growth. My HCG was (314- Day 28, 1381- Day 32, 2404- Day 34, 2420-Day 39) Scan results ( Day 34- 0.26 gest. sac,nothing else seen Day 39- 0.53 gest sac, foetal pole-0.23 cm, no heartbeat). Missed miscarriage in Aug 12 (HCG rise slowed, no heartbeat in 8th week). Both thru IUI. 3 IUIs and 1 IVF earlier, did not conceive. Aug IUI conceived after HLT + DHEA supplement. (LMP-Nov 6). Investigation after first miscarriage included thrombophilia profile , XXXXXXX antibodies, both of our karyotypes etc. All are normal. Product of conception did not grow in culture, so chromosome analysis of foetus could not be done. All other values-FSH,AMH,LH etc. are done. A diagnostic laproscopy was done last Dec, which also did not find anything. Currently treating at Dr. XXXXXXX XXXXXXX hospital Bangalore. Could there be any immunological causes ( as HLT was needed to conceive). Should we test for NK cells. Also both IUIs produced a large no. of follicles(probably after DHEA?). This time 5 of them ruptured at same time, doctors doubted multiple pregnancy. Only one seen on ultrasound ( could there be a vanishing twin?) Why does HCG levels do not correlate with scan results
Answered by Dr. Mahesh Koregol 38 minutes later

Thanks for your query. I read your query and I understand your concerns.

Following is my reply:
1) First possibility could be a wrong hCG report which happens sometimes. Since your scan results are showing improvement, there is no need to panic.
2) hCG value doubles every 48 hours. Hence I would advise you to repeat hCG after 4 days to be very sure.
3) Mean while make sure your doctor is giving ecosprin tablets & discuss the option of starting low molecular weight heparin which can be of some help in women like you with past history of abortions.
4) I advise you to stay relaxed physically and mentally and take complete rest.
5) There is no question of vanishing twin as twin is not identified on USG.
6) No need to do any other tests like NK cell or other tests.
7) As of now I advise you to stay relaxed and wait for 4 days.

Please get back to me with hCG and Scan reports after 4 days.

All the best

Dr. Mahesh Koregol
IVF and infertility specialist

Above answer was peer-reviewed by : Dr. Mohammed Kappan

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