Q. Does low hCG level indicate ectopic pregnancy or miscarriage?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on May 06, 2019

Hello doctor,

Before a week I went to the hospital and I found out that I was pregnant with a hCG level of 23. The next day, I started getting cramps on my lower right side stomach. Four days later, I got two transvaginal ultrasounds and nothing was found in the uterus, or anywhere else. So I was sent to the hospital again concerning an ectopic pregnancy or possible miscarriage.

I got blood tests done, and they told me that my hCG levels went down. So, they ruled it out as a miscarriage or I was in the process of losing it. So on the next day, I went to my doctor, and she told me that she does not understand why they said to me that my levels went down as they went up from 23 to 100’s, so she said it could be an ectopic pregnancy.

I got more blood test done, and I came to know that my hCG levels are going up but very slowly. I do not know what is going on. First, they said it was a miscarriage and now something else. I need answer. This is my first pregnancy.

Dr. R Balakrishnan Menon

Infertility Obstetrics And Gynaecology


Welcome to icliniq.com.

Let me give you a few basic facts about beta hCG (human chorionic gonadotropin). This hormone is produced from fetal tissue. Once it reaches a level of 25 mIU/mL, it is detectable in the urine test. A normal rate of rising of beta hCG is double in 48 hours. This doubling would mean a healthy pregnancy inside uterus. Rise less than double would mean either an abnormal or ectopic pregnancy. But your level has risen satisfactorily. Many times even a rise just below double also is normal.

Only when the level reaches 1500 mIU/mL, then the fetus will be seen on the scan. So do not decide about the health of the baby until the scan sees the sac or fetal heartbeat. The blood test is not always right. Just wait for 10 to 14 days and have a scan. Hope for the best and pray well. I hope I have clarified your query, do write back if any more questions, for feedback.

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