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What are chances for viable pregnancy with high HCG levels and visible intrauterine gestational sac?

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Practicing since : 2001
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I am somewhere between 5 and 6 weeks pregnant, at least for now. This is a spontaneous pregnancy after several failed rounds of IVF and I am 40.5 years old. I am not completely certain of LMP (believe to be December 10, 2013), and my cycles are typically 25 days. I am fairly confident that my conception date was December 26 2013. My first beta HCG test on 1/6 was 217 (I had some bleeding, more than spotting, that occurred for about 3 days following this) followed by 603 on 1/8, followed by 1302 on 1/10. I am on progesterone support based on the bleeding I had. I had an ultrasound due to lower left quadrant pain on XXXXXXX 17th, to rule out ectopic, which indicated the presence of a gestational sac with a diameter consistent with 6 weeks pregnant (the only information I was given), a yolk sac, but no fetal pole. HCG of 14,000. According to various calculations, I could have been anywhere between 5w2d to 6w at the time of that ultrasound. My doctor informed me today that with a gestational sac of that size, and with the high hcg level, most women have a visible fetus if the pregnancy is viable. She scheduled me for an ultrasound in 1 week. What do you suppose my chances for a viable pregnancy are? What might explain all the discrepancies? Just looking for any reason to have hope as opposed to just waiting for Wednesday to be told that I need a D&C.
Posted Tue, 11 Feb 2014 in Pregnancy
Answered by Dr. Rakhi Tayal 1 hour later
Brief Answer: Likely to be a viable pregnancy. Detailed Answer: Hello, Thanks for trusting us with your health concern. With the high HCG levels and a visible intrauterine gestational sac the fetus is usually visible but the presence of a well formed yolk sac also indicates a viable pregnancy. Once the levels of HCG have reached at least 3600, gestational sac is expected to be seen in the uterus using high resolution vaginal ultrasound. Due to the fact that pregnancy dating can be wrong, it would be much too early at this point to lose hope. Blighted ovums dont have yolk sacs. The follow up scan after one week is likely to show a well formed fetus with a cardiac activity. Please do not worry. The chances of having a viable pregnancy are high. Please feel free to discuss further. I will be glad to answer the follow up queries that you have. Wishing you good health. Regards. Dr. Rakhi Tayal. For future query, you can directly approach me through my profile URL
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Follow-up: What are chances for viable pregnancy with high HCG levels and visible intrauterine gestational sac? 5 minutes later
What about the fact that my OB said with that gestational sac size that a fetus should be seen?
Answered by Dr. Rakhi Tayal 4 hours later
Brief Answer: may be due to delayed conception. Detailed Answer: Hello. Thanks for writing again. Usually fetus is visualized when the HCG levels are so high. But non visualization of fetus at such an early gestation with a normal yolk sac does not go in favor of a non viable pregnancy. Your OB has suggested correctly that fetus should have been there but many times late appearance of fetal node is seen due to a delayed conception. Hope my answer is helpful. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health. Regards
Above answer was peer-reviewed by
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