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HCG levels not doubling

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Hello, I am currently maybe 5-6 weeks pregnant (i really dont know how many days I am pregnant). I went to the doctor a little over weeks ago and they took blood and confirmed that I am pregnant. They took more blood samples and he said since they were not going up as fast, he thought I would miscarry or have a etopic pregnancy. The counts at different intervals were from 250, 300, 500, 650 and today 1067 (this is over a two week period). He want to do a D&C now to ensure I dont have any problems and rule out etopic pregnancy. (FYI,his "tech" did an vaginal ultrasound, but did not see anything.) I thought this was wierd that I was rushing into a D&C so I started to get a second opinion. Saw the other doc last Friday, she performed the ultrasound her self and saw a "yoke sak" and said there is no way I have an etopic pregnancy. She wants me to wait a little longer and see what the counts do. She has no desire to do a D&C unless absolutely necessry. She think it is better for the body to naturally miscarry rather than risk any D&C future complications. Now I have the original doc pressuring me to do the D&C ASAP. I am confused, what should I do. FYI, I am having no cramps, etc. Am I at a etopic pregnancy risk even though the doctor saw something in the uterus from Ultrasound. I am so confused and dont know what to do. FYI, I have a cruise also next week and was wondering if I should cancel.

Category: Infertility Specialist

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Category: Infertility Specialist
 22 Doctors Online

Thanks for your consult at

Well, over a two week period, the counts have not risen satisfactorily. Yes, your B HCG values do raise a strong suspicion of an ectopic pregnancy or a miscarriage.

A vaginal ultrasound in expert hands is the only way this differentiation can be seen.

With ectopic pregnancy, rarely a sac like structure is seen intra uterine too. But generally speaking, if a yolk sac was seen, probability of an ectopic is very low.

It all boils down to how good the sonologist was. I would advise an expert transvaginal ultrasound scan before rushing headlong into any procedure, particularly a D and C.

It could be a miscarriage, or a normal pregnancy that is just taking its time to develop , albeit this last option is less likely with low HCG levels. The option for you is get an expert transvaginal scan. Meanwhile, repeat the HCG count if not done lately. Do NOT rush into a D and C without a definitive diagnosis.

Would you be able to enjoy the cruise with all this confusion ? If possible, postpone it till you know the diagnosis for sure.

Take care.
Please feel free to discuss further.

Patient replied :

Thanks for your reply. The other doctor that I went to for a second opinion was the one that performed the ultrasound and she also was the one that wanted to have the wait and see approach.

On the cruise, I think we will be able to enjoy this but I am more concern about my health in case if something happenned. Being on a ship for 7 days does not provide many options if there was a major emergency. From the info I have given, is it safe to go on the cruise. That is really my question.

Till you know for sure whether it is a miscarriage, a normal pregnancy or an ectopic pregnancy, it is not safe to go on a trip.
You might bleed anytime and require emergency medical care anytime.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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