hCG levels and the First Trimester of Pregnancy
As a result of my first and second misdiagnosed miscarriages as well as my work on the Misdiagnosed Miscarriage site, I receive messages from women daily asking how they might know if they are misdiagnosed as well.
Many of the questions I receive center around hCG levels and the importance of these levels. I am not a medical professional but have done a bit of research and would like to share with you what I have learned.
I believe every woman deserves to have no doubt before having her pregnancy ended.
I am not a medical professional. The information I share is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.
So, You Want to Know about hCG?
So what is that stuff?
You're newly pregnant and keep hearing people bat around this hCG word. So, what is it? Well, hCG is just a quicker way of saying human chorionic gonadotropin. This hormone produced by the placenta, released into mom's bloodstream, is usually first detected eight to fourteen days after conception. When you get that infamous second line on your HPT (home pregnancy test), yep, that is the hCG doing its thing.
Well, How do I know I'm Pregnant?
Putting that hCG hormone to work?
If your doctor takes blood to test of hCG, you'll know you are pregnant if they say your levels are five or higher. If your levels are below 5, you are not considered to be pregnant.
I Might Be Pregnant!
Which HPT should I use?
If you are possibly pregnant and just cannot wait another day to find out, check out this site: hCG Levels and HPTs You'll find some tests are more sensitive to hCG than others. If you believe you have conceived and you are not due for your period yet, you'll want to take a more sensitive test.
WARNING ON SENSITIVE HPTs: Unfortunately, with the advent of sensitive HPTs, many women are realizing they are having early pregnancies. Prior to these HPTs, women just assumed they were having their period. Now, if a woman gets an early positive and then starts bleeding around the time of her period, she'll know she may be miscarrying.
Are hCG levels REALLY supposed to double every 48 Hours?
The quick answer is a hearty NO!
You are going to hear from so many people that your levels are supposed to double every 48 hours if this is a viable pregnancy.
This is just not true.
Sure, your levels may double in that amount of time but chances are good that they will not and this is okay too.
For more on doubling times, see the FAQ below.
hCG Doubling Poll
"hCG level will double every 48 - 72 hours. As you get further along in pregnancy and the hCG level gets higher, the time it takes to double can increase to about every 96 hours."
— American Pregnancy Association
Some of the most common questions I encounter.
Should HCG levels double every 48 hours during early pregnancy?
Generally, HCG levels double every two to three days in the beginning stages of pregnancy for approximately 80% of viable pregnancies. This means that roughly one out of five women will see levels doubling at a slower rate and their pregnancies are just fine.
What are considered normal doubling times early in pregnancy?
If your hCG levels are below 1,200, they can take 48 to 72 hours.
If your hCG levels are 1,200 to 6,000, they can typically take up to 96 hours to double.
If your hCG levels are above 6,000, your levels may take 96 hours (four days!) or more to double and still be perfectly normal.
When do HCG levels normally start to decline?
HCG levels will generally taper off and start to decline from about week eight and are no longer considered a good indicator of pregnancy outcome.
What HCG levels are normal before they start to decline?
According to HCG charts, at about eight weeks, levels above 10,000 mIU/ML are considered within normal range and may start to decline. A number of 'normal', healthy pregnancies are at the low end of the HCG spectrum.
What do low HCG levels combined with a slow rise in numbers mean?
If you have low HCG levels and your numbers are very slowly rising, you may be facing an impending miscarriage however some pregnancies with low HCG numbers and slow rising do go on to full-term.
At what HCG level should a woman be able to see her baby via ultrasound?
Normally, ultrasound techs expect to see a baby when levels are more than 5000 mIU/ML. Newer guidelines suggest the gestational sac size is more important. Once the sac reaches 25mm, a doctor should wait one week for a follow-up ultrasound to verify. Keep in mind, numerous explanations may explain why the baby cannot yet be seen. I hear from women weekly who did not see their babies before eight or nine weeks.
Because we really do have a lot of questions about hCG
So, why can't my baby be seen if my HCG levels are high enough?
Some women have been unable to see their babies despite the fact that their levels are upwards of 100,000 mIU/ML. Some women who are candidates for 'hidden babies' are women who have a tilted uterus or some uterine abnormality such as a bicornuate uterus.
How do I know if I have a tilted uterus?
According to the MayoClinic*, a tilted or tipped uterus "refers to a uterus that's tipped backward (retroverted) instead of normally forward on the cervix. According to Bioscience.org**, roughly 1 in 2 women will have a tilted uterus if they've had endometriosis and for all other women, your chances of a tilted uterus is about 1 in 5. Other sites say nearly 1 in 3 women have a tilted uterus. Your ob/gyn or ultrasound tech should be able to tell you if your uterus is retroverted.
How do I know if I have a uterine abnormality?
Some women with bicornuate uteruses are able to see their heart-shaped uteruses with an ultrasound. Some bicornuate uteruses and other abnormalities are not detectable without actually being able to look first-hand at the uterus (i.e. during a c-section) and, therefore, many women do not even realize they have this abnormality. If your mother took DES, a common synthetic estrogen medication used for almost 40 years until the early 1970s, you are a strong candidate for uterine abnormalities. If your mother took a medication to combat morning sickness during that time, you may very well have some uterine abnormalities and should let your ob/gyn know.
Have You Been Misdiagnosed?
Misdiagnosed Miscarriages are fairly common. Many women are misdiagnosed simply because their numbers were rising normally and not doubling quickly. Sometimes they are given little hope and even turn down the D&C. Each and every misdiagnosed story provides comfort to women who are going through their own miscarriage scare. Your story will help women. Please consider taking the time to share your story at The Misdiagnosed Miscarriage website. Thank you!
Important New Guidelines for Diagnosing a Miscarriage
The UK is the first to acknowledge that misdiagnosed miscarriages are indeed a problem. The Royal College of Obstetricians and Gynaecologists has revised its guidelines. If your gestational sac is more than 25mm and/or the CRL is 7mm or more, you should wait a week to verify (if there are no complications). If the measurements are less, you are too early to diagnose. For more information (and something to take to your doctor), please, see my new page:
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Lara on October 03, 2019:
I had ectopic 14 years ago miscarried this January
Found out I was pregnant 4 weeks ago
Went for early scan Monday I gave a backward tilting womb
Found sack no baby had blood test Monday HCG just over 5000 blood test last night and similar count
Hospital have said either miscarriage ectopic but still resting positive
No bleeding or pain except for back pain with u had since found out
Kay (author) on September 15, 2017:
(((hugs))) to you. Not sure what is happening. I'm glad to hear you are getting a second opinion.
Linda on September 13, 2017:
I am going though a hard pregnancy .. I have a bicornuate uterus and well sadly i have been told im haveing a miscarriage. At 8 weeks i was told they could not see the heart beet. I still had hope that maybe the baby was hiding its heart beet some how.. Then i started to bleed about as much as i would on a period with some pain.. My hcg started yo drop.. But all this reading im doing is still giveing me hope.. I still feel life in there. But the doc i had would not give me another ultrasound.. I found a new doc nd scheduled for one next week.. Is yhere really any hope.. Has this happend to anyo e befor?
Kmeek on June 30, 2016:
Hello ladies. This is my second pregnancy. .you first daughter is almost 8. After almost a year of trying I finally got a positive results!! But then it took a turn. June 11th-15 I had my normal 5 day period, that next Tuesday I started bleeding red blood but it never got on my underwear. This continued until Saturday night. I scheduled an appointment to see why this weird period was happening. Friday June 24 I go in and they do a blood test -positive and my hcg levels being 80. I cry out of excitement. I go back Monday June 27 and my levels were 65 and now. Miscarriage is being thrown around and pretty much being runless out. Tuesday night I go for an ultrasound and nothing is seen but there is suspicious fluid in the lower part of my uterus. Wednesday is go back and levels are 59. More miscarriage talk is rolled out but I have no more bleeding, cramping or anything. I go back tomorrow morning for more levels. Anyone experience this
sarita from Hisar on February 18, 2014:
I will surely refer this to my friend who is pregnant.
durrob on July 21, 2013:
You have some great information on pregnancy, I will give it a thumbs up.
Melissa Miotke from Arizona on November 18, 2012:
Great lens. I just found out I was pregnant last week 4 days before my missed period. I've been nervous because I know taking early pregnancy tests can end in heartbreak since chemical pregnancies are so common. I've been taking a pregnancy test everyday at the same time after holding my urine for the same amount of time. The line keeps getting a little darker everyday and that's been reassuring me though I may be putting stock into something that doesn't mean anything, I'm not sure... I'm now 2 days late so hopefully things will be okay. I've had two successful pregnancies and no miscarriages but I'm afraid since they're so common that I'm up for one. I always worry a lot with my pregnancies. Blessed!
cherry-milanda on September 29, 2012: