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Q. Is intrauterine pregnancy possible with low hCG levels and brown spotting?

Answered by
Dr. Aishwarya Parthasarathy
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 16, 2017 and last reviewed on: Jul 28, 2021

Hi doctor,

My wife has brown spotting and mild abdominal pain since a few days. We did beta hCG test three times, and the results were 257 mlU/ml, 437 mlU/ml, and 657 mlU/ml respectively. Once in a while, she feels a sharp pain on the left side lower abdomen. So, we checked for ectopic pregnancy by transvaginal ultrasound. But they did not find any pregnancy in the left fallopian tube or the uterus, except a thick endometrium. The doctor said that the hope for a viable pregnancy is very low and there is still a chance for an ectopic pregnancy. Based on the hCG results, the doctor decided to go for Methotrexate injection. I would like a second opinion on this.

We got married three years ago, and have been trying to conceive for the past two years. My wife had an ectopic pregnancy which ended with right side fallopian tube removal and a laparoscopic surgery was done to remove a block on the left fallopian tube. The tube is open as per HSG test. Currently, my wife takes Thyronorm, Folsafe and Naturogest 200 medicines. She also has mild PCOD and hyperthyroidism.

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Hello,

Welcome to icliniq.com.

  • Human chorionic gonadotropin (hCG) is very specific to pregnancy because hCG level when more than 1500 mlU/ml will reveal a pregnancy in a scan.
  • Now you must understand that beta hCG doubles in cases of intrauterine pregnancy once in two days. Since the hCG value is low in your wife's case and it is not doubling, the chances for an intrauterine pregnancy is less.
  • Since there is a history of an ectopic pregnancy and tubal surgery, the chances of an ectopic pregnancy are higher, as your doctor said.
  • It is best to consult your physician and get an hCG test again. Once ectopic pregnancy is confirmed then Methotrexate injection is the best treatment.

For more queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

Thanks for your reply. But, what if a fetus be present in the uterus? Can we go ahead with the pregnancy then?

#

Hello,

Welcome back to icliniq.com.

  • If pregnancy is intrauterine, then it can proceed. But first, you need to confirm that.
  • As your doctor has suggested, kindly do beta hCG and follow-up.

For more queries consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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