HCG Levels After Miscarriage

 HCG, or Human Chorionic Gonadotrophin, is a hormone the placenta produces to aid fetal growth. In the initial weeks of a viable pregnancy, hCG levels multiply every 48 to 72 hours. These levels can be identified using urine and blood tests. However, in the case of a miscarriage, the hCG levels decrease (clinically known as a non-viable pregnancy), and after miscarriage, hCG levels eventually drop to zero. If the hCG levels fall during pregnancy, it could indicate a miscarriage. However, it is not the only criterion. In the following sections, let us know the connection between pregnancy and hCG in greater detail.

What are HCG Levels?

The HCG hormone is produced by the placental cells to provide nourishment to the fertilized egg after it has attached to the uterine wall. Whenever you are expecting, the doctor suggests you take a blood test and urine test. These two tests also measure the HCG levels. Even the home pregnancy test kits also work on the HCG concept. It can successfully detect pregnancy post 12 to 14 days of conception, while the blood test can do the same in 11 days.

HCG Levels During Pregnancy

If you have visited a gynaecologist thinking you are pregnant, the doctor will do a blood test to confirm it. An expected amount of HCG count must be present in your blood. If no HCG is found in the blood, don’t lose hope! There are chances that you are too early in the pregnancy.

The HCG levels are measured in milli-international units per millilitre (mIU/mL). In most healthy pregnancies, the HCG count doubles every 48 to 72 hours. The hormone reaches its maximum during the 8 to 11 weeks of pregnancy, after which it declines steadily and reaches a stable stage.

HCG levels over 5mIU/mL (million international units per millilitre) usually indicate pregnancy. Your first test creates the baseline level. This level is crucial because it lets the doctor measure the doubling time. Supposedly, if your baseline level is 5mIU/mL, the doctor will ask you to repeat the test after a few days to find out if the number doubles.

In the case of a viable pregnancy, the HCG levels typically double every 2 to 3 days. So, the first two blood tests are enough to confirm a pregnancy. In most cases, the doctor recommends an ultrasound during 8 to 12 weeks of the pregnancy to check the developments.

But these counts may vary from woman to woman. However, we are sharing the values that are considered normal in a tabular form:

Does HCG Levels Go Up After Miscarriage?

Doctors use the doubling mechanism to test pregnancy. First, the doctor calls you for a blood and urine test to measure the HCG count. Then, the doctor asks you to repeat the test after two days. Ideally, the HCG level should be doubled in case of a healthy pregnancy. If not, there are chances that you have miscarried, which can be confirmed using a transvaginal ultrasound.

However, there can be several factors when your HCG levels do not drop after a miscarriage. Instead, they keep rising. This could be possible if the fetus gets attached somewhere else in the female reproductive system instead of the uterus. It is called an ectopic pregnancy.

There could be another scenario of a blighted ovum. The placenta develops but not the fetus, giving you a high HCG value.

The HCG levels can rise after a miscarriage if you suffer from gestational trophoblastic disease. In this disease, there is an abnormal growth inside the uterus from the placenta. The change can be a benign tumour or a dangerous cancer like choriocarcinoma.

In such cases, the HCG will not decrease as expected in a normal miscarriage. If the HCG levels fail to return to normal in due time (4 to 6 weeks), you will need further diagnosis.

Getting HCG Level Back to Normal After Miscarriage

A miscarriage entails unintended pregnancy termination, typically during the initial 20 weeks of gestation. Various factors can lead to a miscarriage, including chromosomal irregularities that hinder proper uterine implantation. The process of hCG levels returning to their usual state takes several weeks. Below is the hCG levels after the miscarriage chart.

Why Do HCG Levels Rise After Miscarriage?

There could be three possibilities if you still show high HCG levels after miscarriage. These are:

1. Heterotropic Pregnancy

A heterotropic pregnancy occurs when one fetus attaches to the uterine wall and another outside the uterus, mainly in the fallopian tube (ectopic pregnancy) or sometimes in the ovary or cervix.

2. Persistent Trophoblastic Disease

This occurs when some molar tissues are still left behind in the woman’s womb, even after surgically removing a molar pregnancy.

3. Blighted Ovum

If the placenta develops but not the fetus.

How Long Until HCG Levels Fall Back to Zero After Miscarriage?

Falling of HCG level during pregnancy could indicate a miscarriage. The time that it reaches zero varies from woman to woman. It depends on what your HCG level was at the time of miscarriage. A level less than 5mIU/mL is considered negative or zero.

If the miscarriage happened in early pregnancy, the HCG test after miscarriage will show a lower count and can easily return to zero. If the count was high during the miscarriage or the miscarriage happened during the later course of pregnancy, it might take many days or even weeks to get back to zero.

When the HCG count goes back to zero, you start ovulating and get your menstrual cycle again.

Can Low HCG Levels Cause Miscarriage?

• The placenta cells produce HCG, or the pregnancy hormone, to nourish the fertilized egg. This count increases after 48 hours of the egg attaching to the uterine wall.
• The doctors use the HCG level to know about the pregnancy developments. If the HCG count is not according to the developmental stage of the fetus, it can be a sign of miscarriage.
• Also, if the doctor sees the fetus in ultrasound and cannot see the expected growth, they can ask you to take an HCG test. If the HCG level is lower than expected, the doctor might predict the fetus as non-viable.
• But the critical point to note here is – HCG levels cannot cause pregnancy loss. It is just used as a parameter to determine the pregnancy’s progress.

Does Boosting HCG Levels Prevent Miscarriage?

No medical evidence proves administering HCG hormone injections or medication can prevent miscarriages. Remember that HCG drop after miscarriage is a symptom of pregnancy loss, not its cause. If it had been the cause, the artificial injection might have prevented the miscarriage.

Can you ovulate with high HCG after Miscarriage?

Ideally, this is not possible. It is because the HCG hormone suppresses the normal ovulation process. Your next ovulation cycle will start only when the HCG hormone levels after miscarriage drop below 5mIU/mL.

FAQs

Let us now take some frequently asked questions regarding miscarriages to clear off a few doubts. Let’s get started!

1. Should you wait to conceive after a miscarriage?

The ideal waiting time to try to conceive again should be until your HCG level drops to either zero or an undetectable level. The hormone count resettlement signifies that your uterine wall is normal and can welcome a newly fertilized egg.

However, it will help to get reassurance from your doctor. The recommendations might differ on factors like your medical history and the reasons for your miscarriage. Usually, your body reaches normal HCG levels after the miscarriage in 4 to 6 weeks, and then your period starts. If it does not fall back to normal levels in this duration, it might suggest that some HCG-producing tissue is still present in your uterine wall. Generally, a procedure called ‘D&C’ removes these leftover tissues.

If you have to go through the D&C procedure to complete the miscarriage, your doctor might recommend you wait for two or three menstrual cycles before trying to conceive again. It is because the D&C procedure can thin down the uterine wall. Since a thicker wall is better for pregnancy and can repair itself in a few months, waiting can lead to better results.

2. Why do you get a false-positive reading after a miscarriage?

There are chances that you might get a false-positive result after a miscarriage. It is because HCG might remain in your bloodstream and stay for weeks even after the miscarriage. Since the pregnancy test relies on your HCG count, you may get a positive on the test strip.

3. Why Won’t my hCG Levels Drop After a Miscarriage?

After experiencing a miscarriage, it generally requires around four to six weeks for hCG levels to normalise. During this time, a positive hCG test result can still be obtained. Additionally, there’s a possibility that some women might conceive shortly after a miscarriage, leading to the presence of hCG in the bloodstream due to the new pregnancy.

4. How Do I Check my HCG Levels at Home?

Home pregnancy test kits identify the presence or absence of hCG levels but cannot measure hCG quantities. As a result, quantitative detection of hCG levels can only be accomplished through blood tests.

5. Does Your HCG Have to Be 0 to Get Period?

For ovulation to take place, hCG levels must be close to zero. Following ovulation, a menstrual period typically follows after approximately two weeks.

Miscarriage is a dreadful scenario in a woman’s life since it affects her physically and mentally. If you see some signs related to miscarriage, please consult your doctor. Do not delay things. There might be chances that the child can be saved in a few scenarios. The doctor might ask you to get your hCG blood test to confirm your doubts.

If you miscarried, do not consider it the end of everything. Do not worry – you can still conceive. Next time when you are pregnant, share your miscarriage history with your doctor.

References/Resources:

1. Seeber. B. E; What serial hCG can tell you, and cannot tell you, about an early pregnancy; Fertility ans Sterility; https://www.fertstert.org/article/S0015-0282(12)02233-9/fulltext; October 2012

2. hCG (Urine); University of Rochester Medical Center; https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=hCG_urine

3. What is hCG?; American Pregnancy Association; https://americanpregnancy.org/getting-pregnant/hCG-levels/

4. Betz. D, Fane. K; Human Chorionic Gonadotropin; NIH; https://www.ncbi.nlm.nih.gov/books/NBK532950/

5. Chemical Pregnancy; Cleveland Clinic; https://my.clevelandclinic.org/health/diseases/22188-chemical-pregnancy

Also Read:

Ovulation After Miscarriage
Signs and Symptoms Of a Miscarriage
Positive Pregnancy Test After Miscarriage