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Pregnant and low HCG levels

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OK so here is my problem now. I recently found out that I am 5 weeks pregnant. However, my HCG levels were tested today after cramping for 4 days and it was only 420. I was told to follow up on Monday and make sure it has doubled. I just don't feel pregnant anymore. Sore boobs are gone and they could not see anything on the vaginal ultrasound. So I am worried but I have not bled severely so doctor said he thinks i am still pregnant. I was just noticing that other blood work they did was concerning to me. My RBC was low at 3.87 and my MCV was high at 96.8, My BUN was high at 29. They said nothing about this but Im wondering if this signals anemia, or low folic acid therefore my hcg is so low? I'm just so stressed out and trying to put things together. a month or two my b12 was way high because doctor had told me to take b12 as i was low. So I am so confused. Are this tests correlated and tied to my pregnancy? Thank you.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Welcome back to DoctorSpring.

Cramping during pregnancy is a normal phenomenon and can be due to multiple reasons in the first few weeks of pregnancy. Can be due to implantation, increasing uterine size or constipation and gas can cause cramping too.
But cramping or abdominal pain with bleeding are warning signs and you need to take immediate medical care.

Ideally the transvaginal USG detects the gestational sac in 5 weeks of gestation and the hCG levels should be between 1000-2000mIU/ml .
In your case you could have ovulated late in the cycle as a result of which it is not already 5 weeks of gestation, nor are your hCG levels above 1000mIU/ml
The higger the levels of hCG the more you will notice symptoms of pregnancy. The lack of experiencing symptoms as you have mentioned is none specific.

I would advice that you repeat your hCG levels on Monday as mentioned by your doctor to see if your levels have doubled as hCG levels should double in 48-72 hours.

Repeat the transvaginal USG in a weeks time, and you can do an abdominal USG in 12 weeks. ( It will take that much to for the fetus to be visible in the scan)

As for your blood reports, you need not worry about the RBC and MCV levels as its a normal phenomenon to see a slight drop in Hb in pregnancy which has caused your MCV to be on the upper limit.
I would suggest you, test your creatinine levels and repeat your BUN levels. We will correlate the two to see if any futher investigation is required.

If you have any signs of worsening abdominal pain or bleeding contact your doctor immediately.
As of now continue taking your folic acid tablets, avoid consuming alcohol and repeat the tests as I have mentioned above.

Hope this helps
Feel free to ask followups

Patient replied :

Okay and I also devastingly found out I have hsv 1 & 2. I don't recall or think I've ever had an outbreak in the 6 years I've been with my partner. Doc told me it could have been dormant in me till know that i got pregnant. I was tested because I kept peeing frequently and had burning. Plus irritated vagina. Doc said it could be my only out breK I get or that It might be my initial breakout and it could get worse since it was dormant for so long. Is it possible that if I was the carrier, my fiancé could still be negative because I've never had a out break before or his immune system is different? If he breaks out barely could it be that I barely infected him because I had an outbreak?


First of all there is nothing "devastating" about it. Upto 50% of adults have Herpes infection in their body. Yes you are right this was dormant inside you body. You really cannot tell whether you infected your partner or vice versa.

The tricky thing here is that that blood test alone might not confirm that it is HSV. For example a simple bacterial urinary tract infection can cause the same sings and symptoms. You should ask your Doctor whether the tests shows a recent infection. A urine culture to check for a bacterial infection has to done.

Hope this helps
Feel free to ask followup
Thank you

Patient replied :

Hello and thank you. I just have been severely depressed since finding out. Fiancé doesn't really want to touch me now. I didn't have uti or any other infection. Doc said it was for sure hsv1 and 2 after doing blood test. So what
What do you mean by recent infection? As in it was dormant and barely had outbreak or if I didn't have it and barely had it? Is it possible he doesn't have it?

Presence of HSV 1 and 2 in the blood could be due to an old infection. So even if your current infection is not due to HSV, the blood test will always show HSV+.

So this does not mean you have an active disease or outbreak. The IgG and IgM component in certain cases can help your Doctor to tell whether it is recent or not.

It is unfortunate that your partner is taking it in that way. Herpes is as common as humans ! That's what we say . if you both were sexually active for some time then he could also be positive.

Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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