HCG levels Post IVF

Is it possible for me to ascertain from the level of hCG in my blood, whether my pregnancy is a healthy one or not? Yes, that is possible, but only to a certain extent. The human chorionic gonadotropins (hCG) hormone is a very remarkable hormone. It’s unusual because only the cells that will eventually become the placenta of the developing embryo (trophoblast cells), produce this hormone. Once the embryo has implanted in the uterine lining, these particular cells begin producing HCG.

It takes only a few days for this hormone to build up in the body to a level, that is high enough to be detected in the urine or blood of pregnant women. Typically you would do your hCG blood test 14 days post embryo transfer. By this time, the embryo implantation will have taken place and your urine pregnancy test will also be positive.

The HCG hormone level in the blood doubles every 48-72 h. If the HCG level doubles well, this is indicative of the fact that the embryo cells are dividing at a good pace; this suggests that the pregnancy is progressing normally and is healthy.

Monitoring the progress of the embryo

It’s also why we monitor the hCG blood levels over the course of the first few weeks. This helps us ascertain whether the pregnancy is progressing well. Any dip in the level of this hormone, in this period indicates that the pregnancy isn’t healthy. It’s important that you get your hCG blood test done at the same lab every time; this avoids discrepancy in the results.

However, it’s important to remember that since the hCG is produced by the embryo’s trophoblastic cells, and because the levels are rising well, it doesn’t necessarily mean the pregnancy is healthy. While a drop in these levels does indicate that the pregnancy won’t be successful, a rising level provides very minimal information.

Also, once the HCG level crosses the 1000 mIU/ml level, you should get a vaginal ultrasound scan done; this provides much more useful information rather than just the HCG levels. This is because it allows us to actually visualize the development of the growing embryo.

What is a chemical pregnancy?

At times, patients might find that the joy of being pregnant is very short lived. Your urine test or blood test may be positive before or after 2 weeks post your embryo transfer. However, the subsequent pregnancy tests you take might reveal a dipping HCG value; or your urine pregnancy test might become negative.

This is an extremely difficult situation to face because you feel very disheartened and cheated. This kind of a pregnancy, that dissolves quickly, is called a chemical pregnancy. It means your embryo did implant in your uterine lining, but it failed to develop further. This is pretty common and occurs because the embryo isn’t competent enough to grow further.

Don’t blame any activities or your lifestyle for this. A chemical pregnancy can’t be prevented by any means what so ever - taking extra progesterone, avoiding certain foods, avoiding intercourse or taking strict bed rest cannot prevent a chemical pregnancy, so please do not be hard on yourself.

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Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.