hCG

Those of you who have been on the infertility rollercoaster with me for awhile are well-versed about this weird little acronym, but for those who are NOT, pull up a chair and sit tight for a little bit of edumacation!

First, a definition: hCG stands for "human chorionic gonadotropin," and it is a hormone. Its role in pregnancy is critical. CRITICAL, I tell you. I say that because it is produced by the developing embryo after conception, and it prevents the corpus luteum of the ovary from dissolving, thereby ensuring that a woman's progesterone levels stay elevated to support the pregnancy. Without adequate progresterone, a pregnancy cannot be sustained.

When a person is trying to conceive and gets close to or passes the end of their cycle, they often buy a home pregnancy test. PEE STICKS!! FUN STUFF, I tell you! (At least for the first few months. After four-and-a-half years, however... You get the drift.) Anyway, the pee sticks are designed to detect hCG concentration in a woman's urine to determine whether there is a pregnancy. Most home pregnancy tests won't turn positive until hCG is above 20 or 25. Blood hCG tests are more precise, and they are sensitive enough to detect serum hCG levels even lower than 5. For the record, fertility doctors consider pregnancy to be achieved any time hCG is over 5.

Now, when I got pregnant with Super Boy many, MANY moons ago (he was conceived in August 2002 and I tested positive on September 14, 2002, when I was 28 years old), I don't think I was ever told to come in for a blood test right after I'd missed my period. I'd gotten a very strong line on my home pregnancy test with him one day after my period was due, and if memory serves, when I called the ob's office to inform them that I was pregnant, I was just told to come for a check-up at - I think - 10 or 12 weeks. I remember them drawing blood at that time, but I am pretty sure hCG wasn't among the tests they ran. So I honestly have no idea what my hCG levels were at the start of that pregnancy.

When we had IUI #3 in April and my period never showed up when it was due on April 22nd, I peed on a stick on April 23rd; it was negative. I skipped the 24th and tried again on the 25th, since my period still hadn't come; that time, I got a barely-visible SUPER faint positive. I didn't know what to make of it. Like I said, the only other time I'd gotten pregnant, with Super Boy, the line was BOLD and it filled me with confidence that YES - I WAS PREGNANT. To have a super faint line 3 days after missing my period, I was a little apprehensive.

I called the fertility doctor's office on Monday, April 26th to get in for a blood test. They called me later that day to tell me that I was "technically" pregnant, with an hCG of 27.2, but it was unusual for the number to be so low 4 days after missing a period, and they told me not to get my hopes up, that it might not be a keeper. Still, I was told to hope it at least doubled by Wednesday, which is what they hoped to see.

On pins and needles for 48 hours, I went back in on Wednesday, April 28th for a second hCG test. When they called that afternoon, I was informed that I was DEFINITELY pregnant, because the hCG level had tripled in 2 days, to 99.6. I was ecstatic!

Until I went in for a 7-week ultrasound on May 14th to find that the pregnancy had indeed failed.

And then the kicker was that I had to start going back in for labs WEEKLY to make sure my hCG was FALLING, indicating a complete miscarriage. Let me tell you, it's a lot harder emotionally to wait for hCG to fall than it is to pray for it to go UP. After 2 weeks, I was considered no longer pregnant when my hCG was down to 1.1.

I did a lot of research about hCG levels after my first hCG test back in April. I had no idea what WAS considered a "normal" result for someone 4 days after missing their period. As it turns out, I found a wide range of what is considered "normal", all of which left me somewhat uneasy, because it did appear that my levels were low at both tests, despite having tripled from the first to the second. Some sources I found online seemed to indicate that when numbers are that low early on, it's often a sign that the pregnancy WILL end, and often in a blighted ovum, which is what ultimately happened with that pregnancy.

I will most certainly be paying attention to my hCG levels going forward if I should happen to get pregnant again. After what happened last time, I will want to see GOOD, STRONG levels, to put my mind at ease.

I hate being a slave to numbers, I really do. It was so much simpler to pee on a stick, see a line, and just sit back and wait out the rest of the first trimester. Having to wait for numbers - which can ether make your day or break your heart - stinks. Especially if you're an impatient person like me!

Baby dust to all of you,
SW