Possible ectopic - what do the HCG and progesterone levels mean??

[Jvx01]

I am mum to an 11 month old son conceived via ICSI. Prior to this (3 years ago) I had an ectopic pregnancy resulting in emergency surgery.

I got a positive pg test two days ago but have been having some abdominal pain and was referred to the EPU for potential ectopic pregnancy. I’n 4w5d today. So the US showed absolutely zip, couldn’t find pregnancy either in my womb or out of it.

The unit just phoned to tell me my HCG level is 252 and progesterone 72. They then told me to come back on Saturday and gave me no more information...

So my question is what do these numbers mean? They said them to me like they should mean something but I have no idea if they should indicate to me whether it’s likely to be ectopic or a viable pregnancy??

I would be delighted if it was viable but with history of ectopic and nothing in scan I don’t feel very optimistic 🙁

Any advice appreciated!!

@Jvx01 It just means you are pregnant, HCG at 4-5 weeks can be anywhere from single digits to thousands.

I had a scan at 4+3 and there was nothing then a week later there was a baby with heart beat x

I’m in a similar position to you at the moment. Your hCG level doesn’t really mean anything as they need to see the difference over 48 hours. When you go back you want to see it doubling.

Your progesterone level is high, most ectopics are 10-20. Mine is 21.

Thank you, that’s helpful. Last time it all happened so quickly I was rushed straight for surgery so haven’t been through this diagnostic stage...

Good to know @HJWT that seeing nothing on the scan at this point doesn’t rule out a viable pregnancy.

@rhayader sorry to hear you’re in a similar position. It’s so horrible.

HCG varies wildly from person to person. I went to EPU for a massive bleed at dead on 5 weeks - they took blood and sent me home as wont routinely scan that early, and mine was 14,500 at which point they called me back because they said at that level something should show on an ultrasound.

I was scanned at 5+3 and there was a yolk sac but no fetal pole. Went back at 7 weeks and there was a baby.

So I had a second lot of blood tests and the HCG had gone up to 540, double what it was before. From what I’ve now read that seems to be a good thing, though I don’t know if this early on it could still be ectopic and growing like a normal pregnancy just in the wrong place???

I’m still having abdominal pain but not bleeding so I’m really hoping it isn’t ectopic. Just have to wait a bit longer to find out I guess....

I had terrible issues with ovarian cysts when I was pregnant with my second, and they thought initially it was ectopic. I had three operations before I was 13 weeks to remove them but she is now 6.5 and running around refusing to go to sleep.

Fingers crossed for everything being okay for you.

Sorry, that was a half explanation. I had unbelievable abdo pain from about five weeks. It burst at 7 weeks, twisted and had to be drained at 8.5 weeks, refilled and had to be dissected by keyhole at 12.5 weeks. Genuinely the pain was worse than actually giving birth to her.

Ouch! That sounds awful. Glad it all worked out for you in the end. Now you mention it they did find a cyst on the U/S. He didn’t say anything about it though so I didn’t think anything of it, he just wrote in notes some measurements and that it’s a ‘corpus luteum.’

Generally speaking you would expect to see a gestation sac in the uterus if HCG was above 1000.

Prior to that serial HCG levels can give some indication of whether this is likely to go on to become a viable intrauterine pregnant. In 48 hours you’d expect levels to double, which yours have so that’s a really good sign. A plateau or an increase of 66% or less would suggest ectopic pregnancy or failing pregnancy

Corpus luteum is normal in early pregnancy- it just shows which ovary you ovulated from before the pregnancy - I have had surgery for cysts in the past so panicked when they said cyst but it’s normal and expected.

Doubling HCG is good. Abdo pain can be normal so don’t rule yourself out. They don’t tend to scan you before 6 weeks (unless they need to medically) because it’s pretty likely you’ll see absolutely nothing and it’ll cause distress and anxiety - it’s absolutely normal to see nothing so early on. It’s hard when you’ve had bad experiences in the past to not assume it’ll happen again. I had 2 MCs so assumed this pregnancy would be the same ... but currently 13 weeks with a wriggly little one. In about 4/5 days you should be able to see something on a scan as levels will be high enough.

Good luck OP xx

How are you doing now @Jvx01

Starting to believe this might have a happy ending! I had another scan yesterday evening and they were able to find something in the womb they described as ‘possibly a very early intrauterine pregnancy’. I’m still being managed as pregnancy of unknown location but feel a lot more optimistic. Had bloods taken again and back for another scan tomorrow.

With both male and female fertility factor issues, high risk of ectopic etc I will be so happy to have conceived spontaneously. Not to mention the £££s saved with not having to do IVF again

Aww that's good news OP!! Fingers crossed that it keeps going in that direction. Sounds like you're getting some really good care.