can you have an ectopic pregnancy with high hcg levels?
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An ectopic pregnancy is likely if there are no signs of an embryo or fetus in the uterus as expected, but hCG levels are elevated or rising. Two or more blood tests of pregnancy hormone (human chorionic gonadotropin, or hCG) levels, taken 48 hours apart.
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Levels of this hormone increase during pregnancy. This blood test may be repeated every few days until ultrasound testing can confirm or rule out an ectopic pregnancy — usually about five to six weeks after conception.
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Serious urinary tract infections (with high levels of WBC, RBC and nitrite) can occasionally cause a false positive pregnancy test result. Ectopic pregnancies typically produce lower levels of hCG than normal preganancies.
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Fallopian tube damage is a common cause of ectopic pregnancy. A fertilized egg can become caught in the damaged area of a tube and begin to grow there. Some ectopic pregnancies occur without any known cause.
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Depending on initial serum hCG level, the time until undetectable hCG levels can be as long as 6 to 8 weeks. The diagnosis of persistent ectopic pregnancy is made if serum hCG levels rise again or stop declining.
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If you don't have any hCG present in your blood, this doesn't necessarily mean you aren't pregnant. You may be too early in your pregnancy for your hCG levels to increase. HCG levels higher than 5 million international units per milliliter (mIU/mL) typically indicate pregnancy.
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Almost all ectopic pregnancies—more than 90%—occur in a fallopian tube. As the pregnancy grows, it can cause the tube to burst (rupture). A rupture can cause major internal bleeding. This can be a life-threatening emergency that needs immediate surgery.
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A slow rate of rise or a drop in HCG levels during the first 8 to 10 weeks of pregnancy represents death of trophoblastic tissue and can indicate ectopic or nonviable intrauterine pregnancy. Serial quantitative HCG values are, therefore, helpful in management of threatened early pregnancies.
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An intra-uterine pregnancy can usually be seen by 5-6 weeks gestation or when the HCG level is >1500 IU/l. If it is not in the uterus, it may be ectopic. In 95% of ectopic pregnancy cases, a good transvaginal ultrasound examination can actually see the ectopic pregnancy in the Fallopian tube.
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An ectopic pregnancy occurs when a fertilized egg grows outside of the uterus. Almost all ectopic pregnancies—more than 90%—occur in a fallopian tube. As the pregnancy grows, it can cause the tube to burst (rupture). A rupture can cause major internal bleeding.
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How HCG works as a pregnancy test. Many women have very low levels of HCG in their blood and urine when they are not pregnant. HCG tests detect elevated levels. Tests may not detect pregnancy until HCG has risen to a certain level.
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Even if a complication associated with low hCG levels occurs, such as a miscarriage or an ectopic pregnancy, this does not mean that someone will be unable to get pregnant again or that their fertility is compromised. A successful pregnancy is still possible with low hCG levels.
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During the early weeks of a normal pregnancy, hCG levels double every 2 days. Low or slowly increasing levels of hCG in the blood suggest an early abnormal pregnancy, such as an ectopic pregnancy or a miscarriage. If hCG levels are abnormally low, further testing is done to find the cause.
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To find out if you have an ectopic pregnancy, your doctor will likely do: A pelvic exam to check the size of your uterus and feel for growths or tenderness in your belly. A blood test that checks the level of the pregnancy hormone (hCG). This test is repeated 2 days later.
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High or low hCG levels could still indicate a normal pregnancy. Doctors can, however, gain information from looking at trends. A normal pregnancy has hCG levels that double every 48 hours, and hCG levels usually peak around 90-100,000 mIU/mL, says Dr.
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Conclusion: Ectopic pregnancy after HSG-confirmed tubal occlusion is a rare event. Necessary measures to prevent this from occurring include not only confirmation of bilateral tubal occlusion, but also recognition of correct location of the micro-insert within the lumen of the fallopian tube.
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IUI probably doesn't increase the risk of ectopic pregnancy, but all women having fertility treatment need to be aware of the possibility of ectopic pregnancy. We can usually detect an ectopic pregnancy by the level of hCG in the pregnancy test and an early ultrasound scan, but not always.