hCG Levels in Chemical Pregnancy: What You Need to Know

A chemical pregnancy is a term used to describe a very early miscarriage that occurs before the fifth week of pregnancy. Confusing and heartbreaking, chemical pregnancies occur after a positive pregnancy test result but before a pregnancy can be visualized on an ultrasound. Chemical pregnancies are believed to affect up to 75 percent of all pregnancies. Here’s what you need to know.

Positive hCG Test

Six days after our last embryo transfer of two untested “day 3” embryos, I took a pregnancy test and got a clear positive second line. I couldn’t believe it: was this really happening? Three days later, and still more positive pregnancy tests, I shot an email over to Dr. M and asked: “Could we come in for an early blood pregnancy test to confirm?”

A blood pregnancy test checks for the presence of the human chorionic gonadotropin (hCG) hormone. The presence of hCG is an early indicator of pregnancy because the hormone is released into your bloodstream only after the embryo has successfullly implanted into the uterus.

Dr. M. responded to my email with this surprising piece of information: She could actually check my current hCG levels from the luteal blood test that I had given that morning. A luteal blood test is the blood work you have done during the “two week wait” post embryo transfer to check progesterone and estrogen levels. Dr. M. revealed that, for research purposes, the lab tests for hCG levels during your luteal blood test. However, it’s not recorded in your official files and won’t be reported to you.

A few minutes later, Dr. M. called me back. “Your hCG level is 21,” she whispered excitedly. “Congratulations, you are most definitely pregnant!”

Normal hCG Levels in Early Pregnancy

The hCG hormone enters your bloodstream soon after implantation has occurred and can be detected by both a home pregnancy test, referred to as “qualitative hCG test,” and a blood test, referred to as a “quantitative hCG test.” While there is no single “normal” hCG level, there are typical hCG ranges for early pregnancy. See the typical hCG ranges below (source: BabyMed):

• Blood hCG under 5 mIU/ml: Negative. Not pregnant
• Blood hCG between 5-25 mIU/ml: “Equivocal”. Maybe pregnant maybe not. Repeat test in a couple of days
• Blood hCG over 25 mIU/ml: You are pregnant!

Although my level of 21 mIU/ml was technically still “equivocal,” the presence of hCG in my blood stream this early was a really great sign. My mind instantly leapt to the question: Could it be twins? For the first time ever, we had transferred two embryos and early rising hCG levels are typically a sign of a twin pregnancy.

“It’s still way too early to tell if both embryos implanted,” Dr. M. explained. “Your hCG levels should continue to rise and we’d like to see it at or above 50 on the day of your official pregnancy test. But for now, everything looks great!”

In that moment, my entire gray world turned to Technicolor and I basked in its warm glow. I didn’t think about the pregnancy, about due dates, about sonograms, about gender, about even the potential baby (or babies!). I was simply flooded with one emotion: pure relief. It was over! We had made it to the other side, and no matter where this pregnancy landed, we had achieved it. And that changed everything.

I didn’t think about the pregnancy, about due dates, about sonograms, about gender, about even the potential baby (or babies!). I was simply flooded with one emotion: pure relief. It was over! We had made it to the other side, and no matter where this pregnancy landed, we had achieved it. And that changed everything.

Chance of Chemical Pregnancy after Positive Test

With a strong positive home pregnancy test and a confirmed hCG level of 21, my husband and I quietly celebrated our success – but very quietly, as my in-laws were visiting us for the weekend and we weren’t ready to reveal the news yet. Although my official blood pregnancy test was just two-days away, I decided to give myself more peace of mind by taking a Clearblue digital pregnancy test. I had never taken a digital pregnancy test before and I was excited to see the words “Pregnant” flash across its screen.

I excitedly unwrapped the test and felt a surge of positive emotions – we had finally made it this far! A few minutes later, I eagerly peeked at the test’s result window and to my utmost horror, it glaringly read: “Not Pregnant.”

“It’s probably just too early,” my husband assured me. But I knew in my heart that my hCG levels should be high enough to register on a digital pregnancy test. Starting to panic, I quickly took another two-line pregnancy test and, sure enough, the second line appeared slightly fainter than it had the day before. “No, no, no, no, no,” I started screaming internally. I felt like I was watching a car crash and was absolutely powerless to change a thing.

Dropping hCG Levels – Success Stories?

My husband and I huddled in the bathroom (trying to keep things discreet from my visiting in-laws) and tried to calmly assess the situation. “There’s no way we could plummet from possibly having twins to not even being pregnant in just one day,” my husband said confidently. “It’s going to be okay.”

I spent the next few hours Googling the query “dropping hCG levels success stories?” and although I found some that were real beacons of hope, the majority of stories always started and ended the same: a clear positive pregnancy test suddenly turned negative and ended in a disappointing “chemical pregnancy.”

hCG Beta Levels in Chemical Pregnancy

The next morning was my official pregnancy test at the clinic, commonly referred the quantitative hCG test or “beta test.”  After it was over, I spent the next few hours trying to look cheerful over brunch with my in-laws while anxiously awaiting the results. As I stared down at my untouched eggs, I willed myself to believe that the digital pregnancy test was just an error and that today’s call would bring positive news. But as the morning stretched on, I felt period cramps lurking and a horrible pit in the bottom of my stomach.

My phone rang with the results just as the four of us were walking into the National Geographic Ocean Odyssey exhibit in Times Square – a surprise birthday gift that I had purchased for my husband months earlier.

 

“I’m sorry but your hCG levels are only 16 today*,” Dr. M. explained sadly. “Once we see hCG levels start to drop like this, they usually continue to do so. You should prepare yourself for this pregnancy not working out, but please report back to our office in two days to check levels again.”

The news hit so hard that I felt almost dizzy. I looked around to steady myself and realized that I was in, quiet possibly, the worst place ever to process it: an “ocean odyssey” exhibit, with hundreds of other people, virtually “20,000 leagues under the sea.”

The next several hours were spent in my own personal hell and, in hindsight, I almost laugh at the absurdity of it all: there’s me looking at the anatomy of virtual Humboldt squid; finding my way through a constructed “kelp” maze; listening to the cries of humpback whales in the dark – all while trying so hard not to lose my shit over my freshly, unprocessed grief.

They say that this IVF journey makes you stronger, and the strength I had to summon that day to keep my head above water, despite being virtually “20,000 leagues” under it,  still amazes me to this day.

They say that this IVF journey makes you stronger, and the strength I had to summon that day to keep my head above water, despite being virtually “20,000 leagues” under it, still amazes me to this day.

Looking for the Silver Lining after IVF Failures

Two days later, I went for follow-up blood work and my hCG had sunk to a measly 6.5. The outcome of this transfer was officially deemed a “chemical pregnancy” – a term that I was now all too familiar with. As we gathered our emotions off the floor, we tried to see the silver lining of yet another IVF fail:

1. We’ve never seen such dark lines on at-home pregnancy tests.
2. We’ve never registered a positive hCG result on a blood pregnancy test.
3. We’ve never been told “Congratulations, you’re pregnant!” by our doctor.

These are not only new milestones for us, but it further confirms our theory about PGD testing pros and cons: Our untested embryos preform better than the ones we subject to testing and the proof is in the pudding. Although this transfer ultimately failed, the two untested embryos we transferred made it far enough to register a positive pregnancy blood test. Conversely, our three previous transfers of untested embryos never even came close to a positive pregnancy blood test. As painful as it is, we are getting closer and closer to our goal and I’m determined to keep pushing through these deep, murky waters and into the light.

 

*hCG levels vary widely from person-to-person and from pregnancy to pregnancy. Please note that a level of 16 is not indicative of a chemical pregnancy across the board. If you have questions regarding your hCG levels, please consult a medical professional.