hCG levels can be difficult to understand during the treatment process. Basically, hCG is the pregnancy hormone. You may have taken a home pregnancy test (HPT) and got a positive result. You may also have had an hCG blood test afterward. If the hormone is pulsating in your body, these tests will confirm the good news.
However, the next process may seem complicated. Are your hCG levels rising properly, does high mean twins, low level means miscarriage? You may have as many question marks. Here is the important information you need to know about your hCG levels.
How should the hCG level be considered good?
After struggling to get pregnant, you’re finally pregnant after IVF and your beta hCG levels are positive. There is no single test that will provide you with a clear answer, however beta hCG levels are helpful indications of fetal development and viability when assessed during the first few weeks of pregnancy.
Beta levels are highly variable and what is “acceptable” depends on a number of other factors. Two criteria are particularly important at this point:
The first is the beta hCG level measured on day 10 after embryo transfer on day 5.
The second is the rate of growth, which is often calculated by doubling the time (DT). The risk of miscarriage or ectopic pregnancy is particularly high in pregnancies with an initial hCG value under 50 IU/L.
Your doctor will likely keep a close eye on you and check your serial beta levels every two days, even though some of these levels will eventually catch up. The overall DT is generally shorter in pregnancies and a range of 1.2 to 3.2 days is considered appropriate. The wide range makes it possible to more accurately estimate viability when a pregnancy is assessed using several beta hCG tests spaced several days apart.
Unfortunately, it’s hard to feel safe until we see a fetal heartbeat around 6.5 weeks. At this stage, the risk of miscarriage is less than 5% in most cases. The 6.5 week mark is approximately 25 days after day 5 ET. Unlike natural pregnancies where progesterone levels >25 are reassuring, IVF pregnancies are routinely supplemented with progesterone supplementation.
If progesterone is administered intramuscularly, measuring these levels will not help because only the adequacy of injections will be measured, not fetal viability. Since vaginal progesterone does not affect serum progesterone levels, this test can be used as additional reassurance in those using this type of progesterone supplement. (2)
What happens if hCG level is low?
Human chorionic gonadotropin is known as hCG. After conception, your placenta produces it. The majority of HPTs will measure the HCG 11–12 days after the embryo enters the womb. However, a blood test can catch this earlier. Every 48 to 72 hours, the normal level of hCG doubles to 6,000 mIU/ml.
A low starting hCG level doesn’t mean it’s all over. Patients with fertility issues are of particular concern since they have the unique ability to pinpoint the exact moment of conception. Early testing will probably result in a low score. What matters, though, is how hCG levels increase.
What hCG level indicates twins after IVF?
Human chorionic gonadotropin (hCG) is a hormone that is produced by the cells that form the placenta after a fertilized egg implants in the uterus. In IVF, hCG levels are closely monitored after embryo transfer to assess the success of the treatment and the potential for multiple pregnancies.
In general, hCG levels tend to be higher in twin pregnancies than in singleton pregnancies. However, there is no specific hCG level that definitively indicates a twin pregnancy after IVF. The hCG level can vary widely between different women and even between different pregnancies in the same woman. Moreover, other factors such as maternal age, and the quality of the embryos can also affect hCG levels.
That being said, some studies have suggested that hCG levels above a certain threshold may be more likely to indicate a twin pregnancy after IVF.
It is important to note that hCG levels should not be used as the sole indicator of a twin pregnancy. Ultrasound scans are the most reliable way to confirm multiple pregnancies and assess the number of fetuses implanted. In addition, hCG levels should be interpreted in the context of other clinical factors and with the guidance of a healthcare professional.
Confirming your pregnancy through ultrasound is the recommended method. At 6.5 weeks, your hCG levels should reach at least 2,000 mIU/ml or possibly higher, allowing for the detection of a fetal heartbeat during the scan. Reliance on hCG scores alone can be misleading, which is why it’s important for your doctor to closely monitor you from the moment a positive result is obtained.
Having consecutive blood tests taken 48 hours apart, along with an early scan, can provide a clearer picture. It’s crucial to trust a medical professional rather than relying on information found on the internet. Remember, there is no standard hCG score and every pregnancy is unique. (3)
De Ziegler, D., Bijaoui, G., & Chapron, C. (2008). Pre-hCG elevation of plasma progesterone: good, bad or otherwise. Human reproduction update, 14(4), 393-393.