A little over two and a half years ago, I went three weeks and through four ultrasounds believing I had a blighted ovum. I was determined to have a natural miscarriage and turned down the D&C twice. Well, long story short, at just about nine weeks (with only one possible date of conception) we saw my baby. My hcg's were over 100,000 and the sac measured 28.5mm. This week, she'll be two years old.
Since that time I've learned alot and I know hcg and ultrasound questions arise here, so let me share what I've learned in the hopes that it will help you. If any of this information is of interest to you during your pregnancy, take what you've learned to your physician and if you feel your physician is not being straight with you or giving you the attention you need, get a second opinion. Most importantly, remember, you have the right to know without a doubt what is happening in your pregnancy. My doctor was wrong about my miscarriage and I read stories weekly of other women who have been scared and misdiagnosed.
(taken from conceivingconcepts.com)
Accordingly, the key to interpreting the true value of HCG measurements is to look at their progression. In general, the HCG level will double every two to three days in early pregnancy. Approximately 85 percent of normal pregnancies will have the HCG level double every 72 hours. However, as you get further along in your pregnancy and the HCG levels get higher, the expected doubling time increases.
* For HCG levels <1200 mIU/ml, the expected doubling time is 48-72 hours.
* For HCG levels 1200 to 6000 mIU/ml, the expected doubling time is 72-96 hours.
* For HCG levels >6000 mIU/ml, the expected doubling time is >96 hours.
HCG levels peak at about eight to 10 weeks of pregnancy and then decline, remaining at lower levels for the rest of the pregnancy. Here is a sample listing of expected HCG levels based on time after conception:
* 0-1 week: 0-50 mIU/ml
* 1-2 weeks: 40-300 mIU/ml
* 3-4 weeks: 500-6,000 mIU/ml
* 1-2 months: 5,000-200,000 mIU/ml
* 2-3 months: 10,000-100,000 mIU/ml
* 2nd trimester: 3,000-50,000 mIU/ml
* 3rd trimester: 1,000-50,000 mIU/ml
* Non-pregnant females: <5.0 mIU/ml
* Postmenopausal females: <9.5 mIU/ml
Just keep in mind that hcg's do not need to double in 48 hours to have a normal pregnancy. After 6000 or so, they can easily take four or more days to double. Also, after 7 or 8 weeks, hcg's are a poor indicator of miscarriage because they do tend to plateau and decline near the end of the first trimester and exactly when they do varies from woman to woman.
Also, just a few things i've learned:
If you have short cycles (under 26 days), are an 'older' mother or highly stressed, you should have your progesterone checked.
Progesterone is key to acheiving and maintaining pregnancy. If hcg's are not rising properly or the baby's heartbeat is slow, you may have progesterone issues. Some studies indicate synthetic progesterone has side effects but prescription natural progesterone has been shown to really benefit a pregnancy. One study I've read examined a group of women with threatened miscarriages who were seven or more weeks along. They were given progesterone supplements and only 8% of the women actually miscarried.
About a missing baby on the ultrasound or being told you are one to two weeks behind
Unfortunately blighted ova are all too common but also commonly misdiagnosed. If you are ten weeks or so and under and are told you may have an anembryonic pregnancy (aka blighted ovum), you need to ask if you have a tilted uterus (aka retroverted or tipped uterus). Women often do not know they have a tilted uterus and doctors rarely mention it because it is so common. If you have a tilted uterus, you have a good chance that your baby will be seen a bit later and you will probably be told you are one to two weeks behind. However, during the second trimester when the uterus is back in a more normal position, your dates will be right on again. This happens alot and is very common. If you do not have a tilted uterus, babies are generally seen by 8 to 9 weeks. With a tilted uterus, women report seeing their babies any time between 7 to 11 weeks with an occasional case after 11 weeks.
Is it safe to wait for a D&C?
The quick answer is YES. Newer research shows that as long as you know the signs of infection (i.e. fever, odor, abnormal pain, etc...) and stay monitored by a physician, you can wait to schedule your D&C. In fact, studies are showing that women having D&C's actually have a very slight increase in numbers of infections over women who have natural miscarriages.
If you are interested in more information:
Saving Babies Online (progesterone and pregnancy stories)
HCG levels in pregnancy
I hope this information helps somebody. I only wish I'd had all this information in one place when I went through my scare.