# question about HCG level - chemical or ectopic



## cryjack

I was about 6 weeks pregnant yesterday when I went in for an ultrasound. I'd been experiencing light bleeding off and on for a few days. There was nothing in my uterus - no embryo, no sack - so the doctor told me it was probably a chemical pregnancy.

She had my HCG checked - my level was 856. I go back on Friday to get the level checked again.

My question is - could it possibly be a chemical with HCG levels that high at 6 weeks? And I haven't passed much in the way of blood - certainly not even the level of a normal period. My fear is that this might be ectopic.

Thanks for any input.


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## NullSet

I don't have any real advice for you but I wanted to post anyway. I'm so sorry.














Are you having any pain that makes you think it could be ectopic? I would hope that a doc not finding a baby or sack would have thought to check for an ectopic pregnancy.


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## hippy mum

I'm so sorry.
I agree though, w/ not finding anything, they should have checked for eptopic. Why are you going back so soon to check your numbers? Where they concerned about something?


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## cryjack

Thanks for responding. She did check out my tubes pretty carefully but didn't see anything. Ectopics can hide from an ultrasound, though, so I have been worried. But I'm not having any pains that would suggest ectopic, so I think I may have been worried unnecessarily. I get my HCG level checked again tomorrow, so hopefully that will tell the tale.


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## cryjack

bbrandonsmom - I think they want to make sure the number is going down at the right rate because if it isn't, that's a sign of ectopic. I'm going to talk to the nurse tomorrow when I go to get my blood drawn. I was so scattered after the ultrasound, I wasn't asking the right questions...


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## Jenifer76

Just wondering -- could you not be far enough along to see something?


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## cryjack

Jenifer76 - I wish that were the case, but I was at 6 weeks 1 day. Something should have shown up by that time.


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## Jenifer76

*hug*

Hope my ? didn't upset you.


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## cryjack

Jenifer76 - No, not at all! I appreciate the supportive community on the boards here. It's nice to be able to talk about this stuff with you ladies because I'm not really talking about it with anyone else.


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## hippy mum

Gotcha, they checked my levels before discharge too. It did take almost 2 months for my levels to get back to normal though.
Are you still spotting? Let us know what turns out for your levels. I'm just wondering the same thing as Jen, and if the numbers go up, not down, I'd ask for another u/s-maybe in a week or so?


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## Jenifer76

I hate to offer any possibly false hope but there is a website where alot of women post about being told there was no baby and then a week later there is one. Or no heartbeat and then there is one. I have a very tilted uterus which makes it harder to see what is going on inside.

Regardless, *hug* and *love*!


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## cryjack

Well, this was unexpected. I just heard from the doctor about my HCG level. Went from 856 on Tuesday to 2099 today. So I'm still pregnant - it wasn't a chemical. The doctor doesn't think it is a viable pregnancy, but she does want me to come in for another ultrasound on Monday. I am still worried that it might be ectopic - I'm still spotting but no pain so far. The doc said to watch for "moderate to severe" pain - if that happens, I should call the answering service immediately. Otherwise, it's just hide and watch. I'm hoping that if she couldn't see anything in my tubes on Tuesday that I can make it until Monday (if it is indeed ectopic).

This is really a confusing situation.


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## WaitingForKiddos

Wow, crazy ups and downs!

Not to bring false hope but like Jennifer I've heard of women with empty u/s results turn up pregnant and fine a week or so later.

misdiagnosedmiscarriage.com

I'm curious as to why the DR thinks it's not viable?


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## Jenifer76

I am going to hope against hope for you!


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## cryjack

Hhmmm...I'm assuming the doctor thinks it's not viable because I've been spotting all week and before that experienced some bad cramps and bleeding. And maybe she can't get over not seeing anything on ultrasound when I was supposed to be around 6 weeks.

After the ultrasound earlier this week, I accepted the fact that I had (or was about to have) a miscarriage. At this point, I'm just hoping it's not ectopic. I'll post again after the ultrasound on Monday.


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## Mrs_Lurker

It's a puzzling situation - I wonder if they couldn't see anything on ultrasound before because the levels weren't high enough. To my understanding, as a general rule, levels need to be over 2000 before they can see anything on ultrasound. So maybe it was just too early?


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## purplelilacs

I would be very vigilant about an ectopic now if I were you. I had spotting, but no real pain (just general abdominal discomfort), till about 7.5 weeks for my ectopic.

My ectopic was never picked up by ultrasound - even at almost 9 weeks when my tube was starting to rupture. And I had many u/s (vaginal and abdominal) at 2 different hospitals. When it was removed (along with my tube sadly), it was the size of a golf ball. So you are correct that not seeing it on an ultrasound does not mean it does not exist.

I hope it is a healthy uterine pregnancy. Your doubling time is good, so maybe it was just too early to be picked up.

If it not a uterine pregnancy, I hope that the methotrexate works for you - it did not for me though I was at 8 weeks when they tried. They weren't even sure I had an ectopic when they did my surgery, but they definitely found one.

Don't hesitate to go to the ER if need be!


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## Jenifer76

Yes levels need to be above 2000 for something to be picked up.

I hope its not ectopic but purplelilacs has good advice.

*hugs*


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## Amy&4girls

thinking of you


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## cryjack

Saw the doctor yesterday for an ultrasound. My HCG had only risen to 2167 (from 2100 three days before), and I was starting to pass a little bit of stringy red blood. Once again, she didn't see anything in my uterus or anything in my tubes. She brought in another doctor for a different set of eyes. The second doctor felt pretty sure this isn't ectopic - she found my extra thick lining to be especially indicative of that. I'm going back in a couple of days for another check of my HCG. I appreciate the fact that my doctor isn't pushing treatment on me that I may or may not need.

I just find it odd to have a chemical pregnancy hold on for this long (about 7 weeks). The doc said it is unusual but not unheard of.

So that's my story for now. Fingers crossed things start moving soon.


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## purplelilacs

Quote:


Originally Posted by *cryjack* 
Saw the doctor yesterday for an ultrasound. My HCG had only risen to 2167 (from 2100 three days before), and I was starting to pass a little bit of stringy red blood. Once again, she didn't see anything in my uterus or anything in my tubes. She brought in another doctor for a different set of eyes. The second doctor felt pretty sure this isn't ectopic - she found my extra thick lining to be especially indicative of that. I'm going back in a couple of days for another check of my HCG. I appreciate the fact that my doctor isn't pushing treatment on me that I may or may not need.

I just find it odd to have a chemical pregnancy hold on for this long (about 7 weeks). The doc said it is unusual but not unheard of.

So that's my story for now. Fingers crossed things start moving soon.


Honestly, your story is not that different from mine. The erratic rise of HCG is definitely a symptom of an ectopic. I have no experience with chemical pregnancies, but at this point, I can't imagine there would be any HCG rise with them.

I had an actual radiologist at a hospital look at my tubes and say it was not ectopic at 8 weeks. And she was just one of many who viewed my tubes and said it was not. Ultrasounds are essentially worthless for some ectopics. My uterine lining was also very thick.

I would go to a different doctor. They should also be monitoring your progesterone as that was something my OB used in evaluating an ectopic. You are really starting to get in a danger zone if this is ectopic. I would think they would want to see you every few days for an ultrasound in addition to more bloodwork. If that is not the case, then I think they are being negligent.

I was certain I did not have an ectopic and had just passed the baby in some of the bleeding I had had. I was very resistant to trying the methotrexate at 8 weeks or so when there was nothing in my tubes. But I was just ready to be done with the whole thing so I finally gave in.

It was too late for me as the metho did not work despite my HCG levels being low enough for it to theoretically work. They did not want to waste time with another metho shot and I was passing huge clots for a week after the shot (so much so that I couldn't really leave the house for long in that week), so I didn't care what they did at that point. Since my HCG was still rising after the shot, their sole option was exploratory surgery. That is another factor to consider in waiting to get a second opinion. Getting another opinion soon could be the difference between saving a tube and not.

Sorry you are going through this and I hope it works out that you don't need any intervention; but even if you are start bleeding more, that does not mean that you are out of the woods for an ectopic. And neither is a lack of pain. I had definite discomfort and some sharp pains at certain points, but there was no continuous pain (even at my tube was starting to burst) that required meds or would have indicated to an OB that I was having an ectopic.


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## cryjack

purplelilacs - what does your progesterone do if it is ectopic? My temp is still up (though it's dropped a little) and my breasts are still sore, so I'm assuming my progesterone remains high.

The doc said we'd do another ultrasound on Friday if Thursday's blood test doesn't support what she thinks is happening. I'm going to hold out until Thursday (if I can) to see what my bloodwork tells us. I may see if they'll give me another ultrasound on Thursday rather than waiting another day.

Thanks for the input, ladies. I'm taking it all to heart.


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## purplelilacs

Quote:


Originally Posted by *cryjack* 
purplelilacs - what does your progesterone do if it is ectopic? My temp is still up (though it's dropped a little) and my breasts are still sore, so I'm assuming my progesterone remains high.

The doc said we'd do another ultrasound on Friday if Thursday's blood test doesn't support what she thinks is happening. I'm going to hold out until Thursday (if I can) to see what my bloodwork tells us. I may see if they'll give me another ultrasound on Thursday rather than waiting another day.

Thanks for the input, ladies. I'm taking it all to heart.

I don't recall what the progesterone levels meant, just that they were monitoring them and would keep telling me whether or not the levels pointed to an ectopic (initially they did not.)

Glad they are doing an ultrasound soon. The final push to the emergent surgery (within an hour of my office visit) was that the tech thought he might have seen a little fluid outside my tube.

Hope that you can get an answer one way or another soon.


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## triscuitsmom

It's been a week since you last updated... How are you?


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## cryjack

Here's my update. Thanks to you ladies (and my own intuition), I pushed for another ultrasound last week after my HCG rose to 2667 (500 points in four days). My doc was still trying to tell me it was a chemical pregancy (we were past 7 weeks at this point) and that I should come back in a few days for ANOTHER blood test, but obviously something was making my HCG levels go up. So I told her that I was having strong cramps (which I was, though they felt like regular menstrual cramps) in order to push the issue, and she agreed to another ultrasound. She sent me to an ultrasound specialist, and after much poking and prodding the specialist was able to find a 2.7 cm mass in my right tube. The little bugger just barely made it past my ovary and was very hard to find.

I took the methotrexate shot that day (last Friday). Came down with a chest cold on Saturday (not sure if that's related or not) and am still sick (today is Wednesday). I go in tomorrow for a check of my blood levels. Hoping the one shot did the trick - I don't want to put any more of that stuff in my body (nor do I want surgery, obviously).

I would reiterate what some of you ladies were telling me last week - if things don't feel right, and if your HCG is going up randomly and seemingly for no reason, keep pushing for another ultrasound - with an ultrasound specialist instead of your doctor since they can sometimes see things your doc can't. I'm still not sure how my situation will turn out, but I have a better chance at not losing my tube since we started to address the situation last week instead of waiting for another blood test this week. I'll update after my blood test later this week.


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## purplelilacs

Sorry it turned out this way, but good for you for being an advocate for yourself. I hope the ob's at your practice learned something from this. I can't imagine still thinking it was a chemical pregnancy at that point. It seems an HCG rise from a chem pg at that stage and an ectopic pg would be about the same rates of rarity; so IMO, they should have just treated the worst possible scenario regardless of what an ultrasound showed or did not show.

Anyway, be sure you get the bloodwork back before the weekend. One major mistake my ob made was scheduling my bloodwork for the Friday before Labor Day (a week after my metho shot). I thought that was kind of dumb and moved it up a day so we had it back before the long weekend. That was a very smart move on my part as if we had waited till Tuesday for the results - well we wouldn't have waited, as I would have been in the hospital that weekend probably needing a transfusion as my tube was bursting (my surgery was the same day as I would have had the bloodwork.)

Hope the metho works and that you recover quickly and find some peace. Please do keep us updated.


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## cryjack

On day 7 after the shot of methotrexate a couple of weeks ago, my HCG had gone up to 3077 (from 2667 on the day of the shot). For whatever reason, my doc didn't do a day 4 check of my levels. So I got a second shot of MTX last Friday (day 8). As of today (day 14), my level has dropped down to 936. So it looks like things are going in the right direction. Finally.


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## triscuitsmom

I am sending hugs and positive thoughts your way.


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