HCG changes in expectant management

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1

Hi,

I’m Looking for people experiences or understanding of expectant management of ectopic pregnancy, especially in terms of understanding HCG levels.

My ectopic was diagnosed 2 weeks ago. HCG started at roughly 200 and was about the same 1 week later. Today, which is 1 week later again, they’ve done a big drop down to 15.

When the pregnancy was diagnosed as ectopic I was bleeding a small amount. Then toward the end of last week I had strong period like cramps and a big bleed with very bright red blood and passing bits of tissue. Since then the bleeding has stopped completely (it’s stopped for about 3 days now).

I read that the Fallopian tube can expel the pregnancy and it can be miscarried from the womb from that point. Could this be what has happened to me perhaps? Or am I thinking too hopefully (hopefully in the sense that I want this over and done with now!).

The nurse said that even from very low levels after a big drop HCG can climb back up again. Has anyone experienced this?

I know only time is going to tell with this but waiting another whole week just seems so long :pensive:

Thanks everyone.

2

Dear Autumn,

I am so sorry to hear of your ectopic pregnancy and loss. There is no set pattern for bleeding or how quickly our hCG levels fall following ectopic pregnancy. It all depends on our unique physiology, and how high the blood levels had reached. Even then some ladies will bleed very heavily, some ladies will only have slight spotting, and some ladies will continue to have bleeding or spotting for up to 6 weeks.

Although not common hCG levels can rise even when they have reached very low levels such as yours. This is why it is important to rest and not to do any heavy lifting or housework.

It seems that your hCG levels are heading in the right direction and as your levels are quite low now it may mean that your bleeding has stopped. If you do start to experience any new very heavy Or pain please seek medical advice.

Sending much love,

Karen x

3

I hope you are doing ok.

I am also going through expectant management. My levels started at 190 back on 11th April….2 scans and 6 blood tests later my levels are now at 42 today (23rd April).

I haven’t experienced pain in the ectopic side. However 2 eggs fertilised at the same time in my case - I miscarried one of them on 12th April, and the other is ectopic.

It’s a long process but I’m keeping everything crossed my body can deal with it on its own without intervention, but the longer this is lasting the less hopeful I am becoming.

4

Hello, I am going through this right now although the end is FINALLY in sight.

I ovulated and caught the egg on 9th March.

I started bleeding on almost my expected AF date so didn’t realise at first that I was pregnant (it was off from the get go).

Realised I was pregnant and it turned out to be ectopic and I’m now going through Expectant Management. Mu HCG numbers have been:

04/04 - 78

06/04 - 128

08/04 - 168 (this was my highest)

13/04 - 122

19/04 - 64

22/04 - 23

27/04 - 23

28/04 - 16

05/05 - ?

When it plateaued at 23, even though that is very low, the hospital wanted me to go to Methotrexate treatment. I only avoided it as my levels then dropped by 1 third overnight. The hospital have asked me to come back on 05/05 for what will HOPEFULLY be a final blood test and will hopefully be 0 or at least under 5.

So it has been about a month for me. I think the fact that yours is dropping slowly could be a worry, as tubes can still rupture even with quite low HCG. Make sure you’ve stopped taking your prenatal vitamin as I feel like maybe that is part of why mine stagnated.

In terms of bleeding, with the exception of March 31 - April 1, and April 4 - 5, I have bled or been spotting constantly. I had one bleed with tissue passing on 18th April but never super heavy.

Bleeding is now browner so hoping it’s alll the oldest blood and I’m finally near done.

5

edit - sorry, I just reread where you said it has now dropped way down to 15, so it looks good for you too!

6

Hi,

I am going through this at the moment too and have found the lack of answers, ideas as to timeframes etc, really stressful.

My levels were 319 on Tuesday at what should have been 6 weeks 4 days pregnant. Then 250 on Thursday and 162 today, so going in the right direction but have been told I’ll have to go in every 48 hours until the zero point. I’m assuming this could take quite a bit of time, reading everyone else’s stories, but really really hoping not. I’m 37 and this is my second loss this year, I’m desperate for this baby but worried time is running out.

Sian x

7

Hi sian,

I hope you are doing ok. I think it can just take time - a nurse told me last week that it can take up to 9 weeks for everything to settle down.

I’ve recently went to weekly blood tests (16 last week and 15 this week).

We’ll get there Sian…and we’ve still got time for it to happen again for us x

8

GogoZ:
Hello, I am going through this right now although the end is FINALLY in sight.

I ovulated and caught the egg on 9th March.

I started bleeding on almost my expected AF date so didn’t realise at first that I was pregnant (it was off from the get go).

Realised I was pregnant and it turned out to be ectopic and I’m now going through Expectant Management. Mu HCG numbers have been:

04/04 - 78

06/04 - 128

08/04 - 168 (this was my highest)

13/04 - 122

19/04 - 64

22/04 - 23

27/04 - 23

28/04 - 16

05/05 - ?

When it plateaued at 23, even though that is very low, the hospital wanted me to go to Methotrexate treatment. I only avoided it as my levels then dropped by 1 third overnight. The hospital have asked me to come back on 05/05 for what will HOPEFULLY be a final blood test and will hopefully be 0 or at least under 5.

So it has been about a month for me. I think the fact that yours is dropping slowly could be a worry, as tubes can still rupture even with quite low HCG. Make sure you’ve stopped taking your prenatal vitamin as I feel like maybe that is part of why mine stagnated.

In terms of bleeding, with the exception of March 31 - April 1, and April 4 - 5, I have bled or been spotting constantly. I had one bleed with tissue passing on 18th April but never super heavy.

Bleeding is now browner so hoping it’s alll the oldest blood and I’m finally near done.

Did you have positive news with your HCG today?x

9

Dear all,

My wife has been diagnosed with an ectopic pregnancy (6 weeks) for just over a week now (8 days have passed). It has been an emotional rollercoaster and nothing truly prepares you for this kind of situation: the loss of a pregnancy and dealing with possibility of risk to your partner

We are down the expected management path but in all honesty we don’t know what to expect next. I have been trying to find out more information about HCG levels, but there is minimal data out there. We have had various blood tests and her HCG values are as follows:

HCG = 64

HCG = 49

HCG = 66

HCG = 81.9

With an interval or 2 days

I am sitting currently awaiting her next blood test result.

I am trying to find out more information about how levels vary, I am surprised there isn’t more out there. From what I have read either people experience:

  1. Slow decline from an initial value of approx 300

  2. From a small initial value, a decline followed by a rise and then another decline.

Obviously this is completely unverified and I may be just cherry picking data.

Obviously we are worried that her levels will simply start to increase and just want to find out as much as we can.

Any advice would be most helpful

Jason

10

Her result just came back, it has decreased by 5%

HCG = 64 21st May

HCG = 49 23rd May (23% decrease)

HCG = 66 25th May (26% increase)

HCG = 81.9 27th May (24% increase)

HCG = 78 29th May (5% decrease)

Thanks

11

Dear user1234,

I am so sorry to hear of your ectopic pregnancy loss,

There is no set time for how quickly hCG levels reduce as it all depends upon how high they reach and our physical makeup. They can sometimes plateau and it can be very frustrating, but expectant management doesn’t have the same side effects as methotrexate and is less invasive than surgery.

It is good to see that your wife’s levels have dropped today and I hope it will keep this downward trend for you both.

Experiencing an ectopic pregnancy can be completely overwhelming for you both. It can also be quite isolating but these boards are a safe place for you to share experiences, ask question or just vent.

We also have a dedicated Mens Board which has some really personal experiences from the partners point of view and you may find it helpful even just to read these. I know when I first approached the trust, I read lots of posts and as well as gaining information and support, it also made me feel less alone.

We have more information on our website about expectant management which I have added here.

https://ectopic.org.uk/treating-an-ectopic-pregnancy

We will be here for you both for as long as you need,

Sending much love,

Karen x

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