Beta hCG Pregnancy Test Results after IVF: Interpreting the Numbers
Dr. Geoffrey Sher Recommends- IVF Failure With “Good Quality” Embryos: What Went Wrong?
- IVF/Egg Freezing for Cancer Patients – A Presentation
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Note: 4/13/11 – Those of you that have had disappointments in your IVF treatment – as most have – are usually looking for answers as to why your treatment failed. Because in the best case scenario, only about half of IVF cycles result in a birth, IVF failure touches most patients at one time or another. For this reason, I am addressing my next series of blog posts to the questions that my patients most frequently ask after a failed cycle. Follow the link to view the first post on Questions After Failed IVF
Geoff Sher
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Beta hCG Pregnancy Test Results After IVF
Each and every patient/couple undergoing IVF, makes a huge emotional, physical and financial investment. The fact that receiving the result of the beta hCG (human chorionic gonadotropin) pregnancy test represents the first decisive hurdle that must be confronted, makes this a very big deal!! The few days after the embryo transfer, waiting for this first outcome report from your fertility clinic is usually anxiety ridden and highly stressful. It is thus imperative that the Fertility Specialist and his/her staff deal delicately with the transfer of this critical information. Dropping the ball at this time would be unconscionable. The physician and staff must make themselves accessible to the patient/couple and communicate the results promptly, professionally and with sensitivity.
At least two quantitative beta hCG blood tests are done (2-4 days apart). The reporting of “beta” pregnancy test results is best deferred until after the 2nd blood test results are in. This is because a successful IVF outcome will (in younger women) result at best in 50-55% of cycles (with the notable exceptions of IVF using an egg donor and the transfer of genetically [CGH] tested “competent” embryos). Thus, it is important to counsel patients in advance of them undergoing beta hCG testing to have rational expectations. It is equally important to inform patients exactly how, when, and from whom they will receive the report of their beta hCG results, because they are about as likely to get “bad news” as they are likely to hear “good news”. Thus I usually advise my patients to “prepare for the worst while hoping for the best” and that in the event of a “negative” result they will have prompt access to me (or a designee) for counseling.
As soon as an embryo begins to implant and its root system (trophoblast) begins to invade the uterine lining (endometrium/decidua), it starts to release the “pregnancy hormone” human chorionic gonadotropin (hCG) into the recipient’s blood stream. About 12 days after egg retrieval, 9 days after a day-3 embryo transfer and 7 days after a blastocyst transfer, the woman should have a quantitative beta hCG blood pregnancy test performed. By that time almost all hCG injected to prepare the developing eggs for egg retrieval should have left the woman’s bloodstream. Thus the detection of >5 IU of hCG per ml of blood tested is an indication that the embryo has attempted/begun to implant. Since with third-party IVF (i.e. Ovum donation, gestational surrogacy, embryo adoption) or frozen embryo transfers, no hCG “trigger shot” is administered, the detection of any amount of hCG in the blood is regarded as significant.
Often times, an initial rise in hCG (between the 1st and 2nd test) will be slow (failure to double every 48 hours). When this happens, a 3rd and sometimes even a 4th hCG test should be done at 2-day intervals. A failure to double on the 3rd and/or 4th test is a poor prognostic sign. It usually indicates a failed or “dysfunctional” implantation but in some cases a progressively slow rising hCG level might point to a tubal (ectopic) pregnancy. Diagnosis requires additional serial blood hCG testing, ultrasound examinations and clinical follow-up to detect any symptoms or signs of an ectopic pregnancy.
In some cases the 1st beta hCG level starts high and then drops with the 2nd test, only to re-start doubling every 2 days thereafter. This sometimes suggests that there were initially more than one embryo implanting and that one of these subsequently succumbed and one survived to continue a healthy singleton pregnancy. It is customary for the IVF clinic staff to call the patient/couple (and when applicable, notify the referring physician) with the results of the hCG pregnancy test. Often times, the IVF doctor or nurse‑coordinator will work through the office of the referring physician to arrange for the all pregnancy tests to be done. If the patient/ couple prefers to make his/her/their own arrangements, the IVF program should provide them with detailed instructions as to how/when and where these tests should be done.
In the event that serial blood quantitative beta hCG pregnancy tests indicate that one or more embryos are likely to be implanting, some IVF physicians advocate daily injections of progesterone or the use of vaginal hormone suppositories for several weeks to support the implanting embryo(s). Others, including several SIRM physicians prefer to prescribe hCG injections three times a week for several weeks until the pregnancy can be defined by ultrasound. Some IVF centers do not prescribe any hormones at all, after the transfer.
At SIRM, patients undergoing frozen embryo transfer, egg donor, or surrogate cycles and who have blood hCG levels that show the appropriate 2-day doubling, will receive estradiol and progesterone injections and/or vaginally administered hormone suppositories, for 10 weeks following the diagnosis of implantation by blood pregnancy testing. A “clinical pregnancy” is defined as one where there is clear ultrasound evidence of an intrauterine gestation. Such confirmation is usually sought two to three weeks after the first “positive” beta hCG test.
A “chemical pregnancy” is one where in spite of the beta hCG test being “positive” it fails to progress to the point of ultrasound confirmation. Chemical pregnancies occur quite frequently following IVF. While they usually result from a chromosomally abnormal (aneuploid) embryo trying to implant, they can also be due to the uterine lining (for anatomical, immunologic or other reasons)being insufficiently receptive to allow healthy embryo implantation. Clearly, to the IVF patient, the diagnosis of a “chemical pregnancy” represents a severe disapointment. However its occurence provides clear evidence that at least one embryo reached the advanced preimplantation phase of development(the blastocyst stage), went on to “hatch” and attempted to implant. As such a “chemical pregnacy” can often be regarded as being a “dark cloud that has a silver lining”…. because it offers the hope of a successful clinical pregnancy in the future.
The chance of miscarriage progressively decreases from the point of diagnosing a viable clinical pregnancy (a conceptus that has a regular heartbeat of between 110 and 180 beats per minute). From this point on, the risk of miscarriage is usually less than 15% in women under 39 years of age and less than 35% in women in their early forties.
Conveying news of a “positive” beta hCG result is easy…. Everyone feels elated and vindicated. It is dealing with the unsuccessful case that offers the real challenge. In this regard, nothing is more important than establishing rational expectations from the get-go. In some cases (fortunately rarely), the patient/couple will crack under the emotional pressure and will require referral for counseling and in some cases psychiatric therapy.
I always counsel my patients that optimal care does not necessarily equate with an optimal outcome. There are too many variables that are outside of our control…especially the “divine” one. Having been involved in this field for about 30 years, it is my fervent belief that when it comes to IVF, the adage…”man proposes while G-d disposes” is always applicable!
More BetaHCG blogs here:
My IVF Cycle Failed – What Went Wrong? Question #3 – Who Is To Blame For My IVF Failure?
My IVF Cycle Failed – What Went Wrong? Question #16: Why Did My HCG Levels Stop Rising Properly?
Dr. Sher,
I am 39 and done frozen embryo transfer of 3day old embryos (no fresh cycle due to hyperstimulation). My hcg level after 14 days of transfer was 14. After 16 days was 37 and tomorrow I am going for the next blood test.
The nurses said its chemical so far. However in your article you indicated that any hcg read is good for frozen embryo. What do you think?
Thanks,
Koko
Looks very promising to me!
Good luck!
Geoff Sher
Hi Doc,
I had an FET on June on 25, 2012 and my beta hcg yesterday i e July2 is less than 2. They had 8 8 8 cell grade1 frozen embryos inserted. Do i have a chance…
It is a little early to completely discount a pregnancy. Repeat the test in 2 days and then you will know!
Good luck!
Geoff Sher
Hi Dr. Sher,
I had my transfer on 7/16/12. I had two blastocysts transferred. Grades 4AB both.. I had a beta done today and it was less than 5. Is there a chance I could still be pregnant? When is the earliest possible day for a positive beta?
Thanks
Unfortunately this does not look good. However, you could simply be having a delayed implantation. Repeat the beta in 2 days and if it still has not risen, then I am afraid that the cycle failed.
Good luck and G-d bless!
Geoff Sher
Hellos Dr.
I had a two embrio transfer on february 12 and on the 19 I went for my first HCG levels count was 6 I had it done again on the 21 it was 43 today feb 25 had another one and the HCG levels are 113 Dr said they need to go upo at least 180 I am concern is this a bad sign?
Thank You,
Hi Ana,
I can understand your concern. Repeat in 2 days…It should double.
Geoff Sher
Hi Dr Sher,
I am currently 8 days post transfer. Nurse just called me with Friday’s result which was 6 dpt. Numbers were as follows: Prog:38.5 Estr:312. What do these numbers mean? We transferred 1 grade A 8cell & 2 grade B 6 cell embryos.
I appreciate your response and feel so lucky to have found this site.
Thank you!
Dr Sher–
I had my FET on December 14th and just got my results from the first blood work. The number is 32. They told me it should at least be 50. Should I be concerned?
Dr. Sher,
Thank you so much for this post and for responding to the questions of so many.
I got the results from my first hcg blood draw today. The level was 26. This is 7 days post a 6 day transfer of two fair quality blastocysts. I know this number is low, but because of the six day transfer I am hopeful that if the number doubles in a few days I may still have a viable pregnancy. Am I fooling myself?
Thanks so much,
Amy
That is not a low hCG. You might well have a viable pregnancy here.
Good luck!
Geoff Sher
June 6, 2012 at 3:31 pm
hi there I did write a post about a week ago I can’t find it never mind, right the problems I’m having is I had 2 embryo transfers over 2 half weeks ago my dr did blood test on 11 day results was at 6 I re did bloods 48 hours after there went up to 9.56 4 days after re did bloods there went up to 18.29. Over pasted 4 days or so I’ve been having a brown loss it seems to be getting worse as days go on and slight cramping, my dr said it could be the second twin I’m loosing?? He said to do bloods in a weeks time, how long would it take for my hcg levels to decrease after miscarriage? no at this stage there’s not much any one can do if it’s early miscarriage but I really don’t have any hope for the other embryo as I’ve had children before the natural way!!! Never had this problem I hope you could maybe shine some light on this for me thank you
This does not look good to me..and I know you know this! Unfortunately the dye is already cast and there is not much you can do at this stage, I am afraid…That is except to wait and see what transpires.
Perhaps you might consider calling 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case.
Geoff Sher
Thank you for your quick reply.. Do you think it’s to early to have my bloods done again in next 48 hours so I just can confirm for my self? Would my hcg had come down in the last couple days if this is a possible miscarriage
hi, please advise me i had ivf and had blood done it was 4 i have had bleeding for 4 days which has stopped now do u think i have any hope im very desperate for some advice thank you
Anything is possible, but frankly it does not sound very hopeful.
Sorry!
Geoff Sher
Dr. Sher
I am in the same boat as Schlaura above. My initial beta was 66 and then went to 579 less than 4 days later which was an increase of 777% in 4 days (rather than two). However, my third beta (44 hours later) was only 960.3 which was an increase of 66% rather than 100%. Am I paranoid or is that not a great result? Sac has been confirmed in ultrasound but very small.
Dr. Sher I am at my wits end I had my 2nd beta today and they did not see the gains they would have liked, I got this from my voicemail and was not able to call back in time to talk to anyone with my questions. My first beta was a 14 at day 9 with 2 embryos inserted at 6 days old. My beta today (day 11) was 21.6. I dont know if I should even be hopeful at this point. Can you comment?
HI Dr Sher
Thank you so much for your insight and medical opinions.
I just had blood taken – 4 days post Day 6 transfer. My Beta was 10.5. I had 3 embryos placed (graded A,B and C) and all tested via alpha CGH. Is this number good. I see above a 26 is good for 7 days – so I think so but wanted to confirm. I am extremely nervous, anxious (I have had 7 miscarriages previously).
I go back on June 10 for my second HCG test. This will be 10 days post transfer – will that give a definite answer? and what should the number be around?
Thanks so much
Beth Ann
My transfer was on 5 th April , two embryos were placed.
11 day pt hcg 46
15 day pt hcg 171
My doc said they r are on the lower side , what do think about he out come?
It is still an acceptable rise to me.
Good luck!
Geoff Sher
Dr. Sher,
I wish I'd found this site sooner.
I went trough my 2nd IVF cycle in March.
3 embryos were transfered on March 17, 2010.
My RE sent me for a beta on March 29, 2010, nurse called me later that day and told me that my results were negitive and to stop taking all meds and that I should recieve my period. Well a month later I still had not recieved a period and called REs office to see if this was normal and to question why I was having pregnancy symptoms(nausea, headaches, sore breast,ect.) (I have an 18yr. and 17yr. old natrally concieved, but had tubes tied after youngest.) The RE told me that there was no chance I was pregnant(but he only did the one beta on March 29, no other testing). I trusted him and went on thinking I was just stressing myself out and that's why my period was late. To make a long story short on May 14, 2010, I started having really bad cramping, it became so painful I could not even walk. My husband took me to the ER and they did another beta and my levels came back at 1611.4.The MD ordered a ultrasound and it was confirmed that I was pregnant,but was miscarring. I know that there's no way I got pregnant on my own, because I had my tubes removed two years ago. So the only way this could of happened was the IVF cycle. So is it possible that the emybros just implanted late? When I called my REs office to let him know that the ER said I was having a miscarrage, he told me it was impossible and would no longer except my calls. But I also know that without tubes it's impossible that I concieved on my own. I can't help to wonder if the RE had kept me on the meds and done a followup beta, if the pregnancy could of maybe had a chance at being fiable?
is hcg levels 367 then 1811 in 3 days good as i had chemical pregnancy 3 month ago and this month i was to have my period on the 1st of june so i took hcg on the 3rd then on the 6th my last period was 2nd of may i am so scared please advise me
The fact that more than quadrupled in 3 days is a good sign.
Good luck!
Geoff Sher
RENE: I would still be optimistic (guardedly so). Repeat the beta in 2 days. My guess is it will double. Then if so, wait 2 weeks and do an ultrasound. I am praying for you.
Geoff Sher
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LIBBY: It is posible thjast you started off with >1 embryo implanting and there has been a natural reduction that happened. Wait 1 week and repeat the US. It should be definitive.
Good Luck!
Geoff Sher
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BETH ANN: That is 2- 3 days early for doing a first beta and it might well an indication of a pregnancy on the make. I do not know what you mean by an "alpha CGH". Could it be an "array CGH". Also. why were 3 embryos transferred after CGH?.
Good luck! Get anoter beta done 2 days after the lst then an US 2 weeks later.
Geoff Sher
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JEN: I agree with you. This was likely a late implantation.It just goes to underscore how important it is never to rely on a single beta hCG result. As to the miscarriage, I strongly recommend that you get the products tested for chromosomal make-up (karyotyping). This will show if the embryo was viable and would give a hint as to whether or not hormonal support might have reduced the risk of miscarriage.
Geoff Sher
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NERMINE: That is a healthy rise in betas. Hang in there and get an Ultrasouund in a week for a definitive answer.
Geoff Sher
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Please post any further questions on the SIRM discussion boards at http://forums.haveababy.com.
I monitor the boards daily and will be happy to answer your questions there.
Thanks,
Geoff Sher
Dr. Sher
Im so confussed. My lmp was june 26th-2010. I had sex on July 4,8th,15th,21st 2010. On the july 22-2010 light pink when i wipped and it stopped so then on the july23-2010 light pinkish,light red brownish spotting only when i wipped. This was for 2 days. I`ve never missed a period and there alway heavy cycle 26-30. I waited then went to the doctors did urine test it was negative. July 7-2010 mild cramps and it stopped on the 24th and all signs of pregnancy. The doctor requested I do a BHCG Quanatitive. Im confussed cause I still havent had actually period and the doc said could be imbalance of hormones or low hormones. The doc didnt mention anything about maybe possible pregnancy. The doc told me I can just take a pill and put my cycle back to regular. Im confussed cause I went in for pregnancy test. Still havent received any results. Can u help me understand whats going on here.today is Aug 3-2010 and still no period.
Thank u so much for ur time
Ann
Regretably thisa must have been a chemical pregnancy because by now thw urine pregnancy test should have been +ve. I would however insist on getting the results of the blood test to confirm.
It could take time for you to have a period…even a week or two. An ultrasound should be done to exclude an ovarian cyst.
G-d bless!
Geoff Sher
Dr. Sher, you recommend doing first beta 7 days after blastocyst transfer. My doc insists on waiting 2 weeks.
Today is 11 days since we transfered a thawed blastocyst (day 5), and my home pregnancy test (sensitivity 20!!) was negative.
So I went to get a blood test, expecting it to be negative, so I could stop taking daily IM shots 1cc progesterone and .2cc delestrogen… but the result was positive – 30.
Is serum beta level 30 at day 11 after blastocyst transfer a sign of a viable pregnancy per your opinion? Shouldn't it be higher, if it's detectable at 7 days after transfer?
Another question – I searched all over the internet… have there been any studies showing how the serum beta levels corelate to urine beta levels?
If my home pregnancy tests have sensitivity of 20, what is the lowest blood serul beta level that thy could detect?
Dr Sher, I am 42 years old and had a 5 day blastocyst transfer on 16th August, late afternoon. Yesterday, the 25th I had a blood test in the afternoon for hcg and it showed <1. Also on 19th I had a blood test which showed progesterone of 59nmol, by 23rd it had dropped to 44. Does this mean that I am certainly not pregnant?
I am using my husbands email address, that explains why his name is showing!
Lisa
Hi
I'm on my first IVF cycle. I had a pgd done and they transferred two grade 5AA embryos that were perfectly normal. My first beta was 9 days after the transfer, because I started to bleed. It was at 67…two days later my level was only at 76. The nurse stated that one of the embryos may have not taken and that caused the low rise. I go back in two days for another test. Does what the RN said sound hopeful? Thank-you!
A single beta is not helpful no matter the level. It needs to be repeated in 48 nhour and should double. Usually the urine pregnancy test will become positive when the blood hCG level is >20.
Indeed sometimes when 2 pregnancies are in the works, an initially high beta won't double in 2 days as it should. This can be because one is absorbing. But the 3rd beta should then double thereafter. Also a beta that does not rise appropriately should uld be regarded nwith some suspicion of an ectopic pregnancy.
Geoff Sher
Hi Dr. Geoffrey,
3 Grade 1 embryos were transferred and my first beta has a value of 1,428.34, 14th day after the transfer. I'm a bit bothered because they did not tell me about the 2nd beta test. Do I need to undergo another one to determine if I have good chance with the pregnancy or to check the possibility of more than 1 baby?
Thank you very much because you're very accommodating in answering our questions.
Unfortunately, this precludes a viable pregnancy.
Geoff Sher
The last response I made was to Mark's post.
i.e; "Unfortunately, this precludes a viable pregnancy."
This response is to Alex…..
This is a very high beta and needs to be followed muploosely. Of course a high multiple is a very strong possibility. Also you need to be checked for a developing hydatidiform mole. An ultrasound exam in a week or so should provide the answer.
Good luck!
Geoff Sher
Geoff Sher
This
Hi There
I had my first HCG blood test today and my level was 20 which they have said is slightly low. Today is 9 days post a 5 day embryo transfer which was done on 25th August. How low is this?
Thanks
I forgot to mention, I had 2 embryos transferred, 1 was blastocyst of AB quality and 1 was BC quality not fully hatched. I am in my 20s , this was a Pgd for balanced translocations which i went abroad for. Out of 28 embryos, only 2 were balanced and good quality and were transferred. Since my HCG levels have behaved erratically, I am concerned. you mentioned that having pgd done may indicate a slowly growing rate of HCG? Fresh embryo transfers of my own eggs.
Gloria, As I stated below, only time will provide the answer.
Geoff Sher
It is on the low side, but more important would be to know what the level was 2 days later. It should double .
Good luck!
Geoff Sher
Hello doc,
I was confirmed pregnant by my general physician. she said i might be 4weeks 5 days. After couple of days i had severe left abdominal pain (for just 4 hours) and pink spotting (lasted for 3 days). I thought the pain might be because, i ate so many gas producing substances that day (pulses, Black Grams, cabbage). I rushed to ER after i saw spotting, they took hcg test, and my first results were 387, i went after 48 hours, my hcg results were 392. Now i have given another test as requested by my gyno, i have to give the 4th one after 48 hours, is there any chances of the hcg to rise up in the 3rd and 4th test?
There is a chance…but be sure to have your RE be on the look-out for an ectopic pregnancy too.
Good luck!
Geoff Sher
It is possible but not probable that it will rise.
Good luck!
Geoff Sher
hello,
i had ivf on 06/Aug/2010 after that in my first and 2nd test of HCG my dr said there is no pregnancy but i do again my HCG test the value is 1027 MIU/ml after almost 35 days.what will you say about this.but there is nothing in the ultrasound.
thanks
I would be concerned re the possibility of a tubal (ectopic) pregnancy. Visit with your GYN to have this addressed.
Geoff Sher
Hi I had embryo transfer 11 days ago had my bloods today and the level was 6 now I’ve read the net and it says any thing after 5 could be a positive my dr told me to stop my meds but I’ve refused and said I want another test in 48. Hours hope u can help
Yes, I agree…repeat in 2 days.
Geoff Sher
Dr. Sher, I just took my first blood test 14 days after a day 3 transfer of 2 embryos, and my HCG was only 51. I go back in 3 days for my second test. With numbers that low, what are the chances for a clinical pregnancy? Thank you.
Hi Dr. Sher. I had the pleasure of having you do my transfer in 08 but I was not successful. I recently received Intralipid therapy and for the first time after 5 fresh and 2 frozen cycles I have a positive beta of 158 and 2 days after 324. My facility does only 2 betas is that ok? Do my numbers seem ok? Thank you…
Looking good Maria, There could even be a multiple.
Congratulations.
Geoff Sher
Hi Candice!
I guess only time will tell. If the number doubles in 2 days…that is a good sign.
Good luck!
Geoff Sher
I had a 5 day blast (1 fresh high quality) transfer on sept 4 with first beta today sept 14 HCG was 3. Nurse said negative and to stop progesterone sup. I questioned not doing 2nd beta and she said I could if I wanted. Am I just delaying bad news?
Personally I would recommend doing another beta. Sometimes you can be surprised although in this case I think it is not likely.
Geoff Sher
Hi Dr Sher. Some questions for help here.
I'm on day 12th after my embryo transfer on 4th sept '10. 2 grade A embryo were transferred and 6 freeze. On the same day i got my prescription of progesterone 100mg capsule utrogeston for vagina use 2 tablet at 3 times daily. it was mention as to strengten my uterus lining.
A week later on 11sept '10, i went back to hospital for blood test hcg and was found at level 26 which is low as mention by the medical officer. They gave me a prescription of dydrogesterone 10mg tablet twice daily to increase hcg to 30 and above which they would want to see. Im still continuing my pregesterone via vagina and dydrogesterone pills.
im so anxious now and afraid the chances of conceiving is low. what do you think Dr Sher? can i check my urine via test kit now? or should i wait till 21st for my last appointment(pregnancy check up).
Yes…If your Urine test is strongly +ve, you are probably OK. However, it would be better to do 2 X blood hCG teswts 2 days apart and if the level at least doubles in that time frame, that would be a promising sign of a developing pregnancy.
Geoff Sher
5 days after 5day transfer of 2 embryos my progesterone was 38, estradiol 84. THe doctor increased estradiol. 10 days after transfer progesterone was 25.32, estradiol 173 and hcg 10. Now 48 hours later hcg is 24 (did not run estradiol and progesterone)Nurse said does not look good stop medicine. I do not understand, if my hcg level doubled over 48 hours why is this not good?
Frankly, I would agree with you. Repeat the hCG 2 days after the last one and if it at least doubles, that would be a good sign.
Geoff Sher
Hi Dr Sher
You kindly responded to me on 3 September about my low HCG level of 20 at 9 days post 5 day embryo transfer which was 3 Sept. My HCG levels since then have been:
3 Sept: 20
7 Sept: 41
10 Sept: 90
13 Sept: 243
15 Sept: 435
Although the numbers are doubling they are low. Do you think it could be late implantation?
Thanks
Nikki
Looks good Niki!
Now wait 8-12 days then do an ultrasound exam.
Good luck!
Geoff Sher
dear Dr Sher:
I'm on day 17th after my embryo transfer on 1th sept '10. here is the my HCG Level
please give me a words.
day 15: 125
day 17: 250
doubling, but low
thank you so much!
jennifer
Jennifer…No doubt this is a slow rise in beta hCG …but it is doubling so there is hope. I would wait 10-14 days and then get an ultrasound done. That would be more definitive.
Geoff Sher
My wife(Age 37 yrs) is due for hCG Trigger om D-10 of Inj Endogen 150 IU
D-9 status is as follows:
-8 follicles of 14 mm & 5 of 10-12
-E2 level 1980
TSH 4 ,T3/T4 at normal range on L Thyroxine 100 mcg for last 12 days
Are this paramters ok?
Regards/Kadam
I wish I could help, but it is not possible to comment properly without being directly involved in her management.
Sorry,
Geoff Sher
Hello Dr. Sher,
I had two blastocysts transferred on day 5 and I had my first beta 13 days later and it was 1,150 and then I had my second beta exactly 48 hours later and it was 1,898 so it only rose by 65%. My RE said it's fine since my first beta was so high and that he won't be doing any more beta tests, should I be concerned?
Hi Dr. Sher,
This is my second IVF the first one ended in a miscarriage at 10 weeks, I had a 4 day transfer on september 20th this time as opposed to a 5 day transfer last time, when should I expect to see a positive HPT if the IVF worked? Thank you!
Hello Dr. Sher,
I've transfered 12 blastocyst over the course of my ivf treatment (2 ivfs, 5 Fets). We did our first ivf when I was 36 and our second when I was 38. Our third from last Fet produced our healthy baby boy. I am 40 now and we would like a sibling for our son. I'm wondering if you think this is realistic? We would have to do another full ivf cycle. I produce a lot of eggs that go to blast but they don't implant. So I'm concerned that I will forever be doing transfers for no real chance of a pregnancy.Why do you think our stats are so low for implantation? What are the normal implantation rates for blasts. We've always gone to blast and on our second cycle had 10 to freeze. If we did go ahead what do you think would be a reasonable amount of embryos to transfer at one time? The most I have done is three but to speed up the process I would hope to transfer more this potential go around.
Hi Dr Sher,
Thanks for all your insight. Im 30 and did ivf for the first time last month. My first beta at 9dpet was 11, 2 days later it went up to 33. I was told this was great news. Then 3 days later it went up to 81. Then 2 days later it came back at 116. I was told this could potentially mean a chemical pregnancy. Im so terrified at the thought.
Im going back in 2 days for another test but realistically what are my chances? I still have all the pregnancy symptoms I had in the past 2 weeks. I am now exaactly 4 weeks since my last period.
Thanks for your time.
Rasha
Hello, dr. Sher!
My name is Diana,I am 23 of age and had a Donor-IVF this month. Actually, on Wednesday(29th, Sept) I transferred 2 day 5 balstocysts.The donor is healthy, my husband the same, my progesterone the day of the ET was 113….So today, 6th, October(7 days after ET) I had a HCG and it showed <0.1 mUI/ml. Do you think it was done too soon? Can it change in the next couple of days?
I also have pains in my abdomen…tender breasts and back aches…So I really don't know what to believe. I wish this was just a bad dream.
Thank you for reading!
Yes it could change and go up in a day or two, but frankly, I doubt it. This I am afraid does not look very encopuraging.
Geoff Sher
First of all, thank you for answering in such a short time. This is truly important for me, because many tests contradict reality in me, and maybe this is one of these cases. For example, I ended up being a subject of study in the University of Medicine because my tests show I should look more like a man….but I actually am a model(and not a very skinny one).The only explanation I got for what is happening to me at such an early age is that the Cernobil explosion is the cause.The cariotyp is normal, the inhibin is ok..but the FSH is 110 and the AMH is very low.
Anyway, thank you for giving me hope. You know what they say…"prepare for the worst…but hope for the best".
Dear Dr. Sher – thank you for taking our questions in this forum. I am a frequent reader of your fantastic blog.
I received a very upsetting phone message from my clinic today. I am just past 5 weeks now after a FET, and it appears that despite perfect betas so far, my 5th beta test did not should doubling – in fact, the increase rate was 50% to 6200. The message indicated I should come in Tuesday "anyway" for my 6-week ultrasound but if I start bleeding and cramping before then, come in right away.
Of course, I'm totally devastated. With 3 excellent embryos transferred and perfect betas so far, I thought we had a chance. Is there any hope left for this pregnancy?
Thank you in advance for your guidance,
Jane
Thank you for your kind words. I wish I could give you some comfort, but the failure to double is somewhat concerning. I am afraid only time will tell!
Geoff Sher
Dr Sher – How important is it for the Beta's to double in 48 hours? A lot of places say that the beta's should double in 48-72 hours (or a 60% rise in 48 hours) to be considered 'normal'. Is there a different standard for ART?
For my FET, my betas were 230 on 12dp5dt and 411 on 14dp5dt. Taking into account the time the tests were drawn this is a 58 hour doubling time. My clinic said they were good numbers and did not do any more tests until the ultrasound.
What are your thoughts?
HELLO AGAIN, DR SHER!
UNFORTULATELY FOR ME, YOU WERE RIGHT….My beta today(12dpt) is <0.1. What I don't understand is why. Shouldn't it be a little over 0? Shouldn't it prove that a faint attempt of implantation existed?Whose fault is it?Mine?The clinic's?I'm devastated.And I want to understand something. I am afraid not to make the same mistake twice.
I think we should talk. Consider calling 800-780-7437 to set up a free telephgone consultation.
Geoff Sher
The betas should double but a few points higher or lower wont matter. Just repeat it 2 days later again ..that must double again.
Geoff Sher
I tried calling that number, but it is not complete….You know…I am from Romania..I think I also need the State's prefix(e.g. for Romania, it is 0040).And I also have to syncronise…..the time zone difference is like 10-13hours…I wouldn't want to wake you in the middle of the night….
Please email our new patient coordinator Laurie to set up a consultation: EvansL@sherinstitute.com.
I had a 5 day transfer on 10/1. My beta on 10/11 was 518 and the second one on 10/13 was 1330. The doctor wants to repeat beta on 10/17. Should I be concerned or do the beta levels seem okay?
Thanks!
I had a 5 day transfer on 10/1. My beta on 10/11 was 518 and the second one on 10/13 was 1330. The doctor wants to repeat beta on 10/17. Should I be concerned or do the beta levels seem okay?
Thanks!
Hi Dr Sher,
I had 2 5day embryos (they hadnt quite reached blastocyst) transferred on the 10/10/10 I test tomorrow.
I have just strated having very light brown spotting and my cervix is low and pouting open that means I'm not pregnant doesnt it? Is there any point in doing the test?
My clinic in the UK doesnt do a blood test I have to do a shop bought urine test.
Thank you so much for your time
From Imogen
I did a three day transfer on October 4th with 3 embryos (two 8 cell and one 7 cell). I did my first blood test yesterday and was told it is positive but the numbers are low, only 56. What does this mean?
Hello i had 3dtr of 2 embryos, today 9dpt i did hcg and it came back <2 Do you think 9dp3dt was too early? Im going to have another test in 2 days but just wanted to know what my chances are?
Thank you in advance.
I also forgot to mention that it was 2 embryos that were transferred.
I had a 5 day transfer with 2 embryos on 10/3. Beta 1- 10/14 was 22, Beta 2- 10/18 was 275, Beta 3- 10/22 was 1141 and Beta 4- 10/26 was only 3115. Do I need to be concerned that it didn't double? What could the reason be that it didn't double?
It is time to do an ultrasound for definitive evidence of a growing gestation.
Geoff Sher
I had a 3 day transfer ICSI and am 8 days post transfer (2 embryos)on 10/30. My first IVF-ICSI cycle 9 months ago was a biochem pregnancy which I was able to detect via HPT as well as physically at this time 8 dpt. This time, with a neg HPT than is sensitive >12.5-20 units, I'm getting concerned. I've got my first beta in 4 days, but want realistic expections so I can mentally prep myself. I'll be facing a bunch of curious coworkers when I get the news. Pregnancy still in the realm of possibility?
Hi Geoff
On the 18 Oct i had egg pick up and had 2 eggs put back in on the 20 Oct. On the 1st Nov, 14 days later my hg was 53 on Day 18 the hcg was 101. Some homepregnancy tests are showing im pregnant and others are not. Is this a chemial prenancy? What can i do?
If indeed your beta just doubled in 4 days, that is too slow. It ideally should double every 2 days.I would repeat it again at 2 day intervals to see.
Good luck and please keep us in the loop.
Geoff Sher
Dr Sher,
I recently had a chemical pregnancy after ivf #2. Beta was at 47 and then dropped to 42..etc
I am 41 years old, have had low fsh #'s between 5.8-7.6. I had 8 eggs retrieved last cycle, 4 fertilized and put back… I am wondering if the cause of the chemical pregnancy is my age. Is it still possible considering my stats? Or is it really just a numbers game?
I am also waiting for my menstrual cycle to start this month. I had one right after I stopped progesterone on last cycle, now I am late by nearly a week. Is this common? I am typically very regular/ every 28 days.. Hoping it's not early menopause. Any feedback would be greatly appreciated.
thanks
hello dr.sher
this is the first time i m writing to u ,and i wud b extremely grateful if u reply,dr sher i had my 2nd ivf in oct and was transferred 3 embryos on the 7th of oct,supportd by a selection of medicines.i had my first hcg test on the 26 of oct which came out to b 1640.33..i was so happy for hve been trying for a baby for the last 6 yrs nw,i am 33,bt in the ultrasound nothing was visible..so my doc called me again n a week.i went bk on the 3rd of nov still nothing in the u/s hence the doc asked me to repeat my hcg and this time it was 232!!! ..no sign of an m/c though bt i m baffled wats happening?my doc has asked me to repeat the hcg …plz advise
Hi Geoff
I repeated the test 3 days later and it has risen from 101 (18th day) to 295 (21st day)
What do you think?
Thanks Megan
That is na normal rise.
Geoff Sher
So Sorry!
This pregnancy is absorbing. It was probably an abnormal embryo trying in vain to attach.
Geoff Sher
Dear Sir,
My wife has undergone IVF with embryo transfer on 25th Oct 2010. Blood HCG level as on 9th Nov 2010 is 4.18. Doctor has suggested to go for another Blood HCG on 14th Nov 2010
What are the chances of pregnancy in our case?
Chirag Shah
This is not good news . It is a very low hCG level for so long after the ET. The prognosis therefore is not good.Nevertheless please get the 2nd beta hCG and klets just keep our fingers crossed.
Good luck!
Geoff Sher
Dear Dr Sher, thank you so much for your time . I am 42 (from Australia)and have never tried to fall pregnant before, had gone thru 4 fresh cycles this 2010, two very good embryos transferred 25th Oct, blood on 9th show Hcg 5, my Dr said it is not an on-going pregnancy again but I am almost 5 days passed expected period, what should I do ? is there anything wrong ???? my breast are still very sore, nausea and headache as well. how long should I wait for my period before seeking for advice? thank you again for your precious time.
While I agree that it is very unlikely, I would still repeat the beta hCG. These do sound like symptoms that aree often associatedc with pregnancy. Also, if the beta level turns out to be high, it would also be important to exclude an ectopic pregnacy.
Geoff Sher
Dear Sir,
My wife has undergone IVF with embryo transfer on 25th Oct 2010. Blood HCG level as on 9th Nov 2010 is 4.18. Doctor has suggested to go for another Blood HCG on 14th Nov 2010
The second beta hcg as on 15 Nov 2010 has come to 32. (doubling every 2 days). But still my doctor is telling that the chances are negligible.
Kindly Guide
Chirag Shah
This is still doubling every 2 days so you are definitely still in the running. I would wait 4 days and retest. It should quadruple. Then when the level rises above 2000 do an ultrasound to see.
Good luck!
Geoff Sher
The periods started yesterday… Bad luck.
3 cycles of IVF and 5 cycles of IUI failed. We both have a prominent satellite on chromosome 22. (as per our genetic report). Doctor says that this may be one of the reason for the failures of such cycles and have suggested either Sperm Donation or Ovum Donation.
Please give your opinion
Thanking you in Advance
Chirag Shah
Dear Dr Sher, I had 2 ectopics pregnancies in the past after had a normal deliver.
I am 40 and i had 3 embryos transfered on Nov 11th,grade 8A, my beta is schedule for Nov 25th… i did a HPT today and was positive… could be a false positive at this point? thank you… Renata
Dr. Sher, I did FET with a transfer of two embryos on 11/7. They were graded 2ab and 2ba. They were six day old embryos and the embryologist said they were beautiful and already hatching. I got my first (very light) postitive home preg test on 11/13. My first beta on 11/17 was 162, P4 was 125. My second beta (exactly 24 hours later) on 11/19 was 272 and P4 was 135. The numbers didn't double and I am very concerned. I do have a lot of pulling and tugging in around my uterus and ovaries. They want me to have another beta tomarrow on 11/22. Are these numbers really concerning????? Should I be worried???? I had a successful FET in 2007 with the same graded embryos. And I am on 400 mg of prometrium daily. Thanks for all your help. Brandi
Dear Dr,
My wife had done hcg testing on day 16th post transfer and the value has come to 14. Are there any hopes in this case?
Regards,
Jitendra
Dear Rprins,
This would only be signifiicant if you had a frozen transfer (and thus no hCG was given prior). Otherwise if it was a fresh cycle it could be residual hCG from the trigger shot.
Time will tell!
Geoff Sher
Dear Branch79,
I agree with your doctor.
Geoff Sher
Hi Jitendra,
It would depend if the beta hCG keeps doubling every 48 hours. If so it could still be good news…
Good luck!
Geoff Sher
how long does a hgc trigger shot remain in the bloodstream?
The periods started yesterday… Bad luck.
3 cycles of IVF and 5 cycles of IUI failed. We both have a prominent satellite on chromosome 22. (as per our genetic report). Doctor says that this may be one of the reason for the failures of such cycles and have suggested either Sperm Donation or Ovum Donation.
Please give your opinion
Thanking you in Advance
Chirag Shah
Dear Dr,
Our doctor said that the cycle failed as my wife's AMA,AOA is positive. Is there any treatment available to rectify this?
Thanks in advance for your time.
Regards,
Jitendra
Shah!
I think we should talk! If you are interested, call 800-780-7437 for a free telephone consultation.
Geoff Sher
Hi Jitendra,
This needs some discussion. I invite you to call and set up a free telephone consultation with me.
Geoff Sher
800-780-7437
Dear Dr Sher
I had my 1st beta today 11 days post Embryo transfer. I started spotting 9d post Et and it progressed to red blood 10d post transfer and today 11 d post ET it looked loke a period. The beta result today was a positive but it was 10 and the progesterone level was 11. On day 9 I called RE and asked if I should increase progesterone pess and he said no. Would it have made a difference. Does the 10 mean there is no chance?
VJ
Hi Vijay,
Sadly, this does not look good. Nevertheless, I suggest you keep an eye on 48 hourly betas which I expect will drop. I hope I am wrong.
G-d bless!
Geoff Sher
Hi Dr Sher..
I had my first beta on 11/30 which was 252 and my second on 12/2 at 454. It did not double and I am extremly concerned. I go in again on the 12/6. What are your thoughts?
Dear Dr. Sher,
I have recently completed my third round of ICSI IVF. I started getting positive hpts on 5dp3dt. I did my first beta on 12dp3dt and it was 175. We got our second beta 14dp3dt was 226, It was not double so we took a third beta on 16dp3dt and it is 309. We've been told that it could be indicative of a problem. I've been scouring the sites to see if a slowly doubling hcg ever turns out to be a normal pregnancy, and there some cases where it does and many where it doesn't. We transferred 4 embryos, do you think it is possible we had two implant (because of the initial high hcg) and then are having a vanishing twin syndrome?
Thank you so much
Although anything is possible, frankly this does not look very hopeful.
I will hold thumbs for you.
G-d bless!
Geoff Sher
hello,
myname is Anca: i had 1 st IVF treatment on septmeber last year and i got 7 embryos from which 4 good quality and 3 not so good . I made on 27 th nobember my last transfer with 3 embryos from which 1 good quality. On 7th december my hcg were <1.2 , as previous transfers. I didn t repeat hcg. Do u think that is necessary to repeat hcg? Also i m on progesterone ovules 200 mg/ 3 tiimes per day. Should i stop taking progesterone? Unfortunately i don t know what happened. All 3 transfer, 2 on natural cycle with good endometrum lining, were with negative results. I m 39 year old.
Hi Anca!
This does not sound good. Talk to your RE first but it sounds as if a second beta might be redundant. Your RE must advise but I would probably recommend stopping the progesterone cold turkey.
I suggest we talk because something does not sound right here. If you are interested in a (free) telephone consultation with me call 800-780-7437 to set it up.
Sincerely,
Geoff Sher
Dr. I had a donor embryo transfer on 11/24. HCG was 120 on 12/6. Today (12/8) it went down to 92. Should I have the 3rd HCG level test on Friday?
I would…in case it was a vanishing twin and the other one remains viable.
Geoff Sher
Thank you Dr. Sher. Based on having a 3rd HCG on Friday, would the HCG have to double from 92 to be considered worth pursuing after that? Thanks for your support and providing much needed information.
Hi Dr. Sher,
Well we had a bit of good news today. I had another beta today and it was 2824, so the doubling rate increased significantly (to 1.87 days) vs. last week where our initial betas had a doubling rate of 4 days our beta last Friday was only 303. While we are thrilled that our betas are now doubling faster than every 2 days, what do you make of the initial funny numbers – see my post on December 5th…. Do you think we might have had a vanishing twin? We put 4 embryos back – first beta was high – but betas didn't double a few days after – although now they are more than doubling! We're remaining hopeful but it does make me wonder what may have happened.
Hi,
Had transfer 25nov, had some on & off spotting on days 11,12,13.
I had my first hcg on tuesday it was 31, nurses told me to repeat test on Friday. Fridays hcg level 51. Have to repeat test on Wednesday…
Very concerned.
I have sort of lost hope.
Please help!
Mariyah10
Dr. Sher. Here are my blood test results. 12 day post 5 day frozen embryo transfer HSG 120, 14 day HSG 99, 16 day HSG 74. My fertility center is considering this a total loss. Do you concur? Thanks . . . Chris
Hi "Christengroves" The answer to your question is yes!
Geoff Sher
Hi "Waiting for #2".
Yes this could well have been a vanishing twin situiation. It is time for ultrasound confirmation (on Monday).
Geoff Sher
Hi "Christengroves"
Based upon your most recent post, I would agree with your RE. Sadly, I think the pregnancy is lost!
Geoff Sher
Hi "Mariyahio",
I am afraid this does not look good.
I hope I am proven wrong.
Geoff Sher
Hi Dr. Sher,
I had 2 8 celled embryo's implanted. The first beta was done 14dpo and came back with 106. The second, done exactly 2 days later was only 142. Doctor said maybe vanishing twin and retested 2 days later to get 257. I was told to come back a week later for blood work and a sono. Any thoughts you can share? I miscarried in May and am very worried that this one isn't progressing as it should. I am 37 and very healthy. No endo issues at all. Thanks!
Update, had some very light spotting and went to Dr. Hcg was 848 after 72 hours. Spotting seems to have stopped. Doctor is still worried. Sono and blood work again on Thursday.
This could well have been a vanishing 2nd twin. It looks good to me.
Good luck!
Geoff Sher
Dr. Sher, when doing a frozen donor embryo cycle, how much of a impact on the embryos' failure to thrive are: 1) recipient advanced maternal age and 2) recipient being overweight? Is there a point when one should no longer attempt additional cycles? Please advise. Thank you!
Of course age and BMI can affectthe safety of a subsequent pregnancy and this needs to be discussed indepth with the treating RE. However, in my opinion, provided that appropriate adjustments are made to preparation for cycle and to treatment protocols, this should not greatly affect the ability to conceive with embryo donation.
Geoff Sher
Hi Dr Sher,
My FET was done on 24/11/2010
My Blood works are as follows:
8/12/2010 Beta HCG 54 mIU/ml
Day 14 Progesterone 18.90 ng/ml
10/12/2010 Beta HCG 129 mIU/ml
12/12/2010 Beta HCG 266 mIU/ml
Progesteron 18.70 ng/ml
I am on Inj Gestone Alternate Day
Are this reports ok? Is there anything to bother
Please Advice.
mr Pravida
Looking quite good…and promising.
Good luck!
Geoff Sher
Dr Sher,
Friday bloods were 51,had another blood test today levels 162, progesteron 26.
Still having on & off spotting.
Now need to wait till wednesday next week for another blood test.
This waiting game is killing me
Mariah10
Dear Dr Sher,
Today USG done showing Intra Uterine g sac 4W but my RE says HCG & Progesteron are to the lower side & advised
Inj Gestone 100 mg daily & to do USG after 10 days.
1)Can I expect this pregnancy will be normal to full term
2)Do I need any further medication support as
RE says my HCG & progesteron are low
3)I dont want to miss this opportunity as I am coceiving after 10 yrs so you can understand my feelings.
My age is 37 yrs
I am waiting for your precious feedback
HCG again for your refrence:
8/12/2010 Beta HCG 54 mIU/ml
Day 14 Progesterone 18.90 ng/ml
10/12/2010 Beta HCG 129 mIU/ml
12/12/2010 Beta HCG 266 mIU/ml
Progesteron 18.70 ng/ml
Mrs Pravida
hi Dr. Sher,
I had a 5-day transfer done on 12/5 (2 high quality embryos). My RE has me on Estrace as well as Crinone. Six days after the transfer I started having red bleeding (not spotting) so assumed it was either my period or I was losing the pregnancy.
However, my nurse told me to come in this past Monday for a beta (2 days early) and my beta came back as 62. She said it is very common for Crinone to make women bleed but as long as I'm not having any cramps or pain, they don't believe I am miscarrying. Three HPT's come up positive.
Thoughts?? I got a 2nd beta today and will know for sure tomorrow.
Things still look optimistic as far as Ian concerned.
Good luck!
Geoff Sher
Jenifer please let me know the next beta result…then I will comment.
GS
Well, today's beta came back at 292, which is quadruple what the first one was! The bleeding has stopped, and I'm having no paid or cramping.
Gret news!
Good luck!
Geoff Sher
Hi Dr. Sher,
My wife had a D6 FET done on Dec. 1st on Dec 13th the RE clinic stated she is 4 wks and 3 days- First HCG 89- Second two days later 133 and then two day later again (today) HCG 163, what do you think?
Antonio
My first beta 14 days past 3dt was 72. 4 days later only increased to 136. 3 days later 234. Nurse said to stop progesterone shots and I will miscarry soon. Would this be your advice? It is do hard to feel pregnant and give up. I have 2 kids. No previous miscarriage.
Dr.Sher,
Yesterday, 11 days post 3 days transfer, I started bleeding. Today, 12 days post, early this morning at 5am, I passed out a big clot-tissue cum blood. after bleeding for 24 hours, I think the bleeding has stopped. I didn't insert my Cyclogest this morning as I thought it was all over. But now that the bleeding has stopped, do you think there is still hope? should I continue my cyclogest tonight and go for the hcg blood test? thanks so much.
AJ
Dr Sher,
Recent HCG level done on 20/12/2010 is 1150
& Progesteron in 12.
Please comment
Pravida
Great site. I had 2 embryos transferred and HCG was 45 on day 10 and only 58 today which was day 14. My doc said it could be that both started taking and one failed to survive. I'm going back in 3 days. At least it went up but wanted to hear your thoughts.
Hello Dr. Sher
Can you give me a possible thoughts on this? On my 4th of FET i got a cold i was afraid of taking any medicine though my doctor gave me a non chemical medicine, so my cough gets worst but my sneezing went gone. Plus my hubby and i fought so i cried and cried. Isnt it bad for me now to feel emotional stress? And though my doctor told me that my eggs are grade A is any possibilities that i can get a postive hcg result? Or should i consider already negative results?
Thank you and hoping for your reponse just to ease the anxiety in me.
I had an ER 12/9 and ET 12/15 …1 perfect embryo (PGD IVF)
I had spotting 2 days after transfer which was a pinkish brown vaginal mucous when I wiped. I had a negative HPT that day and tested every other day, all negative…tested today 12/27 negative again. My blood test is 1/3. Doctor told me PGD is different and I should test at 2 or 2 and a half weeks. Is there any hope? The Dr is probably just trying to keep me positive, I want the honest truth of my chances. I am taking prometrium morning and evenings…vaginal Suppository 3 times a day and vivelle patches.
Dr. Sher, I hope you had a nice holiday!
When you return online and have a minute, would you please share your thoughts on the use of Crinone gel versus Progesterone IM injections post frozen embryo transfer.
Thank you, Chris
Dr. Sher,
I am hoping you can give me your insight- I appreciate the advice you've given so many in need of answers or understanding.
First ivf cycle- embryo retrieval was done on dec 2nd and transfer of two perfect embryos 3 days later. First beta was done on the 16th and came back postive at 47. Second beta 3 days later=97. Third beta 5 days later=115. Doctor said to stop progesterone and estrogen, not a viable pregnancy (this was December 23rd). They said hcg should drop unless ectopic. Tested hcg 3 days later = 149. Went to Er for fever another 3 days later, worrying about infection…which it wasnt- its the flu- but hcg was tested in ER and came back as 167. Nothing was seen in ultrasound done at ER (no signs of pregnancy in uterus or out of uterus) but I understand it would be too early with such a low hcg anyway.
What is most likely causing the slow rise? Any chance this is a viable pregnancy, just slow developing?
Thanks for your reply Dr. Sher. You suggested me to call you personally. Thats fine with me. I m staying in India. So kindly let me know which time will be comfortable for you?
Chirag Shah
Dear Dr. Sher,
first of all – Happy 2011!!!
Please comment my beta hcg levels:
11dp3dt 122
15dp3dt 962
18dp3dt 3820
Thank you.
Best regards,
Dear Dr. Sher – thank you for the dedication and concern you obviously must have for those of us going through this journey. I am so thankful to have found this post.
I am 40, unexplained infertility. I had a chem preg in Oct of 2010 after fresh IVF. I recently transferred 2 good blast via FET, one of which was hatching at transfer. I started to get a faint positive on HPT 5 days after transfer and it only strengthed.
- first beta, 13 days post transfer =435
- second beta 18 days after transfer =1107
- third beta 20 days afer transfer = 1400, followed by us and we could see a nice gestational sac (I'm 5w2d but sac measured 2 days behind but in uterus)
- next us scheduled for monday (I'll be 6w)
- my progesterone is between 15 and 20
Can you please advise whether this is viable. I was thinking perhaps I had a 2nd that was absorbed.
I would not be overly concerned about the US being 2 dayss behind….that is not significant. As for the beta not having doubled over the last 2 day, it is possible that you started with. A multiple that spontaneously reduced to a singleton.An US a week from now will be definitive in all likelihood.
G-d bless!!
Geoff Sher
….
Thank you Dr. Sher for responding. As I write I'm cramping and had some spotting(dark, but not bright red). Will an ultrasound now tell anything or should I just let my body do what it is going to do and wait until Monday afternoon? I'm scared.
hello,
anca here. Please i would like to find out ur oppinion abt amh : i m wold like to know if i have some , and what chances for pregnancy wih amh level at 7.63 pmol/l. My first ivf cycle failed, after 3 transfers events with 2 embryos/ trasnfer from which 1 good quality in every transfer. I had endometriosis cyst on right ovary removed through surgery n no sign of endometriosis since then. I m 40 years old. Fsh always was eleveted 'liike 12,14 .
Thank you
Dr Sher:
Thank you for your generosity of your time in providing us your opinion.
I am seeking yours regarding my situation.
16dpo – HCG 194
18dpo – HCG 299; Progesterone of 25
20 dpo – HCG 438.
I will go in again for HCG testing tomorrow and we can then determine when to do an ultrasound.
My first question is: My RE's office says this pregnancy is borderline. To me from the research that I have done, it seems very likely to fail. Do you agree? What is your opinion?
As to my second question, I'm 41 still trying for our first, and I have had 4 miscarriages in the last 2 years. I have had all of the RPL testing and we believe that I just have old eggs. I have insurance coverage for IVF. But, these losses have been hard on me. I'm trying to decide whether to do IVF with my own eggs or donor eggs. In my last cycle, I was on 150 of Follistim for numerous days and Clomid. I still only had one mature egg and it matured about a week later than normal. My RE is suggesting an antagonist protocal. She believes that I have a 25% of pregnancy and a 10% of coming to term.
With that background in mind, my second question is: do you think from a medical standpoint that I should do at least one cycle IVF to (a) determine how I respond, and (b) get to look at my eggs to determine quality? I've come to accept donor eggs as a solution, but am still trying to decide whether to try at least one cycle of IVF with my own eggs first. To date, I have gotten pregnant: naturally(1), with Clomid (1), with Clomid and Injectables (2x) – all with intercourse.
Thank you for your thoughts.
Dr Sher:
Thank you for your generosity of your time in providing us your opinion.
I am seeking yours regarding my situation.
16dpo – HCG 194
18dpo – HCG 299; Progesterone of 25
20 dpo – HCG 438.
My first question is: My RE's office says this pregnancy is borderline. To me, it seems very likely to fail. Do you agree?
As to my second question, I'm 41 still trying for our first, and I have had 4 miscarriages in the last 2 years. I have had all of the RPL testing and we believe that I just have old eggs. I have insurance coverage for IVF. But, these losses have been hard on me. I'm trying to decide whether to do IVF with my own eggs or donor eggs. In my last cycle, I was on 150 of Follistim for numerous days and Clomid. I still only had one mature egg and it matured about a week later than normal. My RE is suggesting an antagonist protocal. She believes that I have a 25% of pregnancy and a 10% of coming to term.
With that background in mind, my second question is: do you think from a medical standpoint that I should do at least one cycle IVF to (a) determine how I respond, and (b) get to look at my eggs to determine quality? I've come to accept donor eggs as a solution, but am still trying to decide whether to try at least one cycle of IVF with my own eggs first. To date, I have gotten pregnant: naturally(1), with Clomid (1), with Clomid and Injectables (2x) – all with intercourse.
Thank you for your thoughts.
Dear Dr. Sher,
History of NAIT, slowing hCG levels, is there any hope?
DPO hCG Doubling time
15 104
16 141 54.66 hrs
17 229 34.30 hrs
18 337 43.06 hrs
20 554 66.93 hrs
22 912 66.75 hrs
24 1748 51.14 hrs
28 3536 94.45 hrs
We live in London and have been undergoing IVF at ARGC, the only clinic here that does immunology testing. We have a 2.9 year-old-son (first time IVF success at Hammersmith, Prof. Robert Winston's program) followed by three failed rounds at Hammersmith over the last year. When there was no change in protocol, just dosage tweaks, we switched to ARGC. I did a full immune panel in August that showed high cytokines. These were lowered by two cycles of Humira. I have been taking Clexane, dexamethasone (then prednisolone), baby aspirin and Gestone and had repeat immune testing after my positive hCG that showed NK levels within normal range. I did an intralipids infusion on 21/01 when my hCG numbers started slowing. I have not had a scan yet. Also, our son was born with NAIT (neonatal alloimmune thrombocytopenia) and my husband and I have a complete mismatch of our platelet proteins (I'm homozygous HPA-1a negative, he's homozygous positive). We've been told by our fetal medicine specialist that while a future baby has a 100% chance of having NAIT that this should not affect our ability to get pregnant. Do you think there is a need for additional genetic testing? I also read your article on DQa and think that if this round fails we should be tested for DQa matching. I am curious to hear any thoughts you have!
Many thanks for your time,
Mary
Dear Dr. Sher,
Thanks for your helps for so many couples who are eager to have a baby.
I had the 3-day transfer on 2011-01-27. Today is the 9th day. I just did urine test at home. It is negative. Normally, when will the pregnancy test will show positive signs, for urine test and for blood test, respectively? Is it too early to give up?
Dear Dr Sher:
I am very glad I found your website. I recently had my 5th time IVF and did a three-day transfer with 6 embryos on 1/24/11. The first beta result on Feb 3rd is 24 and second one on Feb 5 is 33. Am I on the right track? My Dr. asked me to go back for the 3rd blood test on Feb 10. Should I be concerned?
Thank you so very much!!
Lulu
Dear Dr Sher:
I am very glad I found your website. I recently had my 5th time IVF and did a three-day transfer with 6 embryos on 1/24/11. The first beta result on Feb 3rd is 24 and second one on Feb 5 is 33. Am I on the right track? My Dr. asked me to go back for the 3rd blood test on Feb 10. Should I be concerned?
Thank you so very much!!
Lulu
Hi Dr. Sher,
I'm nervous about the fact that my second beta didn't double. I had three embryos transferred on 1/28. This past Tuesday (11dp3dt), my first beta came back at 253. Today it was 394. This is my third IVF, first successful one. I'm 33 years old and had a (natural) ectopic pregnancy about a year and a half ago.
Any insight you can provide would be so helpful.
Thank you,
Kelly Baskin
Krbaskin@yahoo.com
Hello. We just did our first round of IVF and got our results from Luteal day 18 Beta HCG results. We had two embyros implanted. The fertility clinic called and said that there is a pregnancy but to be very guarded because the level was 85 and considered low. We were told it should be around 200.
Is 85 considered low and what are the odds of it going up? We are having another blood test done in 6 days.
What are your feelings about these results?
Great forum.
Hi Dr. Sher,
My wife has undergone IVF with 3 embryo blastocyst transfer 0n February 12th 2011
on 9th day after the transfer on February 21 2011, Beta HCG test result is 8 is there any chance even with this low level
Thank You
Rupesh
Did my 1st Beta 10DPT(15DPO as it is 5day blastocyst) and result came back as 26, Clinic ordered a second beat on 13DPT(18DPO) and it came back as 67. Now they want to do another one 3 days later.
I know the HCG value is really low but it is doubling. The last time I had a low HCG and with correct doubling , it ended up without any heartbeat at 6w. (DOnor eggs are used)
HI Dr. Sher,
I'm 30 yrs old and have unexplained infertility. I had my 1st ivf in sept and it was ectopic and I lost my left fallopian tube. Then my 2nd ivf I didn't get pregnant. My dr changed my protocal and I got 2 great emrbyos , did icsi and assisted hatching. I have had 3 beta tests all 48 hours apart.
My 1st was 358 ( 12 days post transfer)
2nd 665 (14days)
3rd 1181 (16days).
I'm nervous that they are not quiet doubling and my dr is too. What do you think?
HI Dr Sher
I'm 30 yrs old with unexplained infertility. Here's my story.
1st ivf ectopic- left tube removed
2nd ivf negative (best emrbyos were 6 cells)
3rd ivf changed protocal and got an 8 and 9 cell embryos, did icsi and assisted hatching.
first beta 358 12 days past transfer
2nd beta 665 14 days past transfer
3rd beta 1181 16 days past transfer
My dr is concerned my numbers are not quite doubling. I am too, what do you think???
Hi Dr Sher,
I'm 40 years old and just had my first ivf. I'm panicked about my first betas. I had a beta at 10dp3dt that was 33.5 and a beta at 12dp3dt that was 60.4. That isn't exactly doubling. I've read many women who started with low hcg and eventually lost the pregnancy in the first trimester. There are some women who have carried to term but it is still a cause for concern. Thank you in advance for your professional input.
Hi Dr. Sher,
I had FET last Feb 23 (one 12-cell Grade 2). Here's my HCG result
March 2 (7 days after FET) = 0.1
Today (11 days after) = 4.2.
My doctor told me to stop estrogen patch and progesterone suppositories. Should I still hope that there's a chance to this? Please advise. This is my first time for IVF treatment.
Thanks,
Allie
Hi Dr. Sher,
I had FET last Feb 23 (one 12-cell Grade 2). Here's my HCG result
March 2 (7 days after FET) = 0.1
Today (11 days after) = 4.2.
My doctor told me to stop estrogen patch and progesterone suppositories. Should I still hope that there's a chance to this? Please advise. This is my first time for IVF treatment.
Thanks,
Allie
Hi Dr Shar,
I did a FET two weeks ago tomorrow (with a blast). 10 days after transfer, my beta was 57, two days later (today), it increased to 84. I'm supposed to go back on Monday. I don't know whether to remain cautiously optimistic or if the numbers are pointing out a failed pregnancy. I would greatly appreciate your take.
rebecca
Dr Sher,
Hi – I did a FET (blastocyst) two weeks ago tomorrow. At 10 days, my beta level was 57 – two days later is rose but only to 84. They're suggesting I wait until Monday for another beta. Is this sounding like a failed pregnancy…and I should resign myself to that eventuality…or is there still hope?
I greatly appreciate your thoughts.
Thanks,
Rebecca
I am afraid it does not sound encouragine.
i would hope for the best but prepare for the worst!
G-d bless!
Geoff Sher
Dr. Sher,
So glad I found this sight. I had my 1st IVF this month and we transferred 2 good embryos. 1st beta on Monday (9days post 5 day transfer) was 121. Today (Wed) it only went up 56% to 189. Nurse said 60%+ is fine. The scheduled me for another beta Fri. Do I have any hope or should I prepare myself for a m/c?
Thanks,
Jodi
Dr. Sher:
I had my first beta today after a transfer of 2 frozen embryos (one 'good' quality and the other 'outstanding' with the possibility of looking like it might seperate into two) on March 10th (12 days ago). My hcg level was at 46, and I can't tell if home pregnancy tests are getting darker or lighter. Is 46 low and does it represent the possibility of only 1 possibly baby or more? With my first IVF transfer with a fresh cycle, my beta was at 76 at 8dpt and I made it to 9 weeks of pregnancy prior to miscarrying. Could I just be a low producer of hcg??
Thanks,
Elizabeth
Dr Sher,
I love your website! It's not often you find a doctor willing to answer questions on a website! Iwas wondering about betas… I just did my 4th and finak round of ivf. Last july we did a fresh cycle that took with 5 day blasts of good quality 1st beta was 113 2nd was 1300 but we lost them right before the ultra sound. 3fet later we finally had a positive bet1 this time we did 4 blasts(think they were 2bb?). Anyway our 14dpt beta was 1106. Could this mean we're more likely to have a successful pregnancy this time? And could it be more than 1?
Any answer would be greatly appreciated!
Thank you
Michele
Dr. Sher,
This is a wonderful resource, like no other I have seen. Thank you!
I just went through my first IVF cycle (after getting pregnant naturally at 40 two times last year the two months we tried and miscarrying both times — the second of which was due to trisomy 15 based on testing).
For the IVF cycle, my retrieval was on March 11, 2011, transfer of two four-cell grade one embryos was March 13, 2011, and at my beta today, I was told it was negative and to stop progesterone. When I looked at the lab results it read HCG was 3 Miu/ml. I had some brown spotting yesterday, which has stopped. I have had a number of prenancy symptoms over the last week (which I am now assuming were the result of the prometrium suppositories and the estrogen patch). In light of the reading showing the number 3 (as opposed to 0), I just want to be sure there is no chance I am pregnant before I go off the progesterone, have a glass of wine, and try to figure out next steps etc.
Any answer would be very much appreciated. Thanks again for providing such a terrific resource for those of us on this challenging path.
Elizabeth
Dr. Sher,
I had my IVF egg retrieval on March 8. We transfered 2 embryos (10 & 11 celled) on March 11. My first beta reading on 3/22/11 was 48, my second on 3/24/11 was 74, finally on 3/26/11 my beta was 153.
What are your thoughts. They have me scheduled for my first Ultrasound on April 12. I have not had any spotting etc.
Thanks,
Rachel
What a kind man you are. Both in your compassionate way of informing patients of negative results and the time you take in answering the questions of these young women. The fact that they are even asking you rather than their own doctor/staff is telling. God bless you for what you do.
Hi Dr Sher, I did a single Fet my first beta# was 169 72 hrs later a second Beta # 282. Is their any hope that this is a viable pregnancy? Thanks for your input!
Unfortunately only time will tell. There is still the possibility that a spontaneous reduction of one of a multiple could explain this drop. Do the next beta and if it does not double in 48h this would be more ominous.
Geoff Sher
Dr. Sher,
Thank you so much for your expertise. I am 9 days post transfer of 3 frozen embryos (2 were really strong) that were frozen after 5 days (the last time I did this and got pregnant with my son who is 18 months old). My first HCG level was 56 at 8 days post transfer and I go in tomorrow for another HCG level check. However, my doctor told me this is a good level for a frozen transfer and is very favorable. I didn't know there was a difference between the two (fresh and frozen) in the HCG level post transfer. Why is this?
Wow wow wow…never seen any site like this before. Thank you so much Doctor. Truly only God will reward you. I am writing from Nigeria. Unfortunately I traveled to another state for my procedure so I am left to do only hpt and won't be able to give you the hcg levels.
I had my FET on march 24. I. Was placed on cyclogest, progynova, multisite and aspirin. I have been having cramps off and on like my period was coming. It was due for last Tuesday which is 5 days ago. I haven't seen my period. I did 3 hpt…peeing on a stick but they all came back negative. My breasts are full and quite heavy. I still feel the period like cramps off and on. Head aches off and on. What could be happening? Kindly advice Doctor.
Linda
Either the HPT is wrong and you are indeed pregnant or you might have a cortpus luteum cyst. Do a blood pregnancy test and if negative go in for an ultrasound examination.
Geoff Sher
Do you really answer all of these questions?? wow! Could you please help me? I was pregnant following a successful IVF, and though my beta numbers started out high, they stopped doubling. Though we saw the heart beat at 6 weeks, by 8.5 weeks, there was no heart beat and my beta level was only 14,000. I had a D&C; on March 31st. I spotted for exactly 7 days following the D&C.; Three days later (April 10th) I started bleeding heavy enough to need a tampon. Is this my period?? My beta was drawn today and it is 76. Thank you so much for any insight you can provide!
Hello Doctor – My wife had ICSI done with 2 embryos transferred on March 30th and on
April 11th the BCG = 54
April 13th the BCG = 64
Is the progress too slow even for a viable singleton pregnancy ?
Hi Beth,
Yes indeed, I alone service this site!
You would not have had a period so soon after the D&C.; Your beta of 76, needs to come down to zero before you would start ovulating functionally again.
Make sure that it is tracked until it reaches zero.
Good luck!
Geoff Sher
Dear Beth,
Alas, I am afraid that this is not a good sign. It looks like a "chemical pr4egnancy".
Geoff Sher
Dear Dr. Sher,
On March 28th I had 2 3-day embryo transfered. On the 5th day post transfer I started bleeding for about 4 days and thought it was over for us…
On day 11 (April 8th), first HCG came at 33 (pretty low), then on April 11th it came at 120 and today, April 14th it was 312. Any idea what might be going on here? I am now being cautiously optimistic:)
I thank you so much for your time!!
Your 1st beta was done too early. I think you have very good reason to be optimistic.
Good luck!
Geoff Sher
Hi Dr. Sher,
I had 2 3 day embryos transferred on March 31st. One was 5 cells and the other was 7 cells. Both deemed great quality.
I had my first beta on April 11th. The result was 16. A nurse called to tell me it was a low positive result and I should not get my hopes up. It was likely a chemical pregnancy. The next day I started spotting…then I really started bleeding, but didn't have typical cramps but everything else was like a menstrual period. Heavy bleeding which stopped after 4-5 days. On April 14th, I had a second test and it came back at 108. I was surprised…so was my doctor. I just assumed it would be going back down to zero and there was no way I could be pregnant with all the bleeding. Well, I went in today, April 19th for a 3rd test and it's at 1372 now. I don't get it. I'm afraid to get my hopes up because I can't imagine I could have a normal pregnancy with the bleeding, but maybe I just lost one of the two embryos?? Any insight would be greatly appreciated. I follow your blog and find it tremendously helpful.
Thank you!
I think you have good reason to be optimistic. Go in and do an ultrasound for confirmation…later this week!
Good luck!
Geoff Sher
Hi Dr. Sher,
My sister has undergone second ivf, hcg result on day 14 came as positive and the count was pretty gud. On day 20 (20.04.2011) she undergone second hcg test doctor told to wait for again 5 days to get the result and also to undergo ultrasound scan on 27.04.2011. What does this actually mean is pregnancy confirmed or any negative result is gng to come. Awaiting your earliest reply
Hi Dr. sher
I had undergone second ivf. on 14th day of my hcg test result came as positive with 164. Again 2day 20.04.2011 second hcg result came as 84. Doctor advised me to do ultrasound scan on 10th day.
Was it normal or something negative is gng to happen. Awaiting your earliest reply.
Thanking you.
Anitha Dhanasekar
Dear Dr. Sher,
Thank you for such a great site. I just had my 5-day embryo transfer on 4/19 and two 4AB quality embryos were transferred (I am 32 years old). What are the chances that I might get pregnant. The doctors had retrieved 29 eggs, 19 fertilized and 7 embryos survived post-transfer and have since been frozen. I am optimistic about my chances of getting pregnant, but wanted your opinion about the percentage of success. My doctor told me 50/50, but because of my egg quality and my age, I was hoping for a better expected outcome. Can you opine?
Thanks, Ema
Hello Dr Sher.
Thanks for all the good information you providing.. I am going to have my 13 days HCG test at the 28 of April/2011.. I would like to share you my results, my 6days post transfere Progesteron is 63.1..
Thank you
Ammira
Dear Geoff Sher,
We Had Embryo Transfer on 30th March 2011 i.e. 3rd day of ooctyle…we got Beta HCG which is 0.15 and negative Urine test on 17 April 2011… Last LMP was 13 March 2011, still not have periods (Menses) till today that is on 24 April 2011, all injections stopped already… feeling pain in righ side of Stomach, mild headache and swelling all over body, No menses , itching on body… should we repeat Beta HCG … are these signs of pregnancy or something very dangerous going on…. please help.
Good luck!
Geoff Sher
I wish I could tell you with confidence but I am afraid only time will tell!
Good luck!
Geoff Sher
Those are good odds…not poor!
Good luck,
Geoff Sher
Hi Vanitha,
A beta hCG test dooes nopt confirm pregnancy. It is only a biochemical measure. You need an ultrasound 6-7 weeks post positive hCG to confirm.
Good luck!
Geoff Sher
Dear Vanitha,
The beta hCG blood test provides evidence of an attempted attachment to the uterine lining, by the embryo. Only an US exam done about 2-3 weeks later can confirm the presence of a pregnancy.
Good luck!
Geoff Sher
Hi Samar,
It is not likely that you are pregnant or that this is dangerous to you, but please go and discuss this with your OB/GYN.
Good luck!
Geoff Sher
Dear Dr Sher,
Thanks for yor help
jst wondering about the cramp and a period like pain at day 11 post transferm, I wake this morning with these painfull cramp wondering if it normal? my 6 dpt progesteron level was 63.1 and I am going in 2 days to have my first blood HCG test…my breast was very tender and painful, no bleeding at all even what they call it implantation bleeding,, bit worrry and stressed,, please help with some information…
Kind Regards
AMMIRA
Dear Dr. Sher,
Thanks for providing all the insights which i have been looking for quite sometime.
We had our beta hcg done after the ivf cycle first reading was 12.59 and second reading was 18.75.
Today(26th apr11) we had given blood sample for third Bhcg (gap was 72hrs between 2nd & 3rd test).
What can i expect my count to be. I'm really worried. This is our 3rd ivf cycle.
Best Regards
Kumar
You are very welcome Amira!
Geoff Sher
Hi Ranjeet,
I would expect thew beta to be >50 by now.
Good luck!
Geoff Sher
Hi Ema,
a 50:50 chance is pretty good. I think that unless there are other confounding factors, that is a realistic expectation.
Geoff Sher
Hi Anitha,
A drop in hCG from 164 to 84 in 2 days is unfortunately not a good sign.
I wish you well!
Geoff Sher
Dear Dr. Sher,
Thanks for providing all the insights which i have been looking for quite sometime.
We had our beta hcg done after the ivf cycle first reading was 12.59 and second reading was 18.75,now the 3rd reading came as 24.91.
Our doctor has suggested for fourth bhcg test on 29th apr'11.
What can i expect my count to be. I'm really worried. This is our 3rd ivf cycle.
Regards
Preeti
This does not sound good. I hope I am wrong.
Good luck.
Geoff sher
Hi Dr Sher,
I am very concerned and I hope you can give me some insight into my situation. I am day 17 after IVF, my first hcg on day 15 was 66. My second hcg on day 18 was 147. I have been spotting blood since day 11 until today. What are the possible reasons for this? I am very concerned. I am afraid of possible early miscarriage. TY in advance for your help.
Understandable that you are concerned. However your numbers are good and spotting with no escalation in flow and no cramping is not seriious and quite common.
Good luck!
Geoff Sher
Dear Dr Sher,
My first beta is 248 at day 13 post transfer (28 March 2011), my next test will be at 5th of May…do you think its too high? also my progesteron is 110 at the same day..
please answer if that consider normal pregnancy..
Many thanks
AMMIRA
Dear Dr Sher,
I am writing you for the first time. I had my three days embryo transfer on April 18th. The two of them were very good and one was good – as my biologist said to me. But after exactly 9 days (April 27th) I notice a little bit of blood and I thought it was my period, although the last started on March 30d (it was too soon because my periods come from 30-45 days). Because my periods are very, very painful, I went to a lab and did the beta hCG test, to see if I can use my ibuprofen 600mg (only medicament that helps me). My beta result was <1, so I went to my gynecologist and he told me to continue with therapy (progesterone 250 every other day intramuscular) and then come again with new beta results on May 5th. Of course, I didn’t use ibuprofen after all cause period didn’t start. The same thig happened the next day, but after that nothing. Please tell me, is there any chance for me and my pregnancy? Can beta “jump” anyway?
Best regards Biljana
Hello,
Thank you for writing such informative articles – I have been very confused about the importance of beta numbers.
my first beta was done 11 days past 3day transfer -
14 dpo beta was 158
17 dpo beta was 704
21 dpo beta was only 1537
So they starting off doubling but then slowed considerably. Is there still a chance for a viable pregnancy? I am now very nervous as I thought they had to double every 48 hours until 6 weeks. I so want to be hopeful but also realistic about what to expect next.
Thank you for your consideration and advice.
~ Cara
Hi Cara
I agree they are slowing down, however, get an ultrasound. It should be definitive at this stage.
Keepe in the loop please.
Geoff Sher
Hi Amira,
No I do not believe the beta of 248 is too high. I think this is normal.
Good luck!
Geoff Sher
Hi Biljana ,
This does not look good, I am afraid.
Dont give up…hang in there.
Feel free to call 800-780-7437 if you would like to discuss your case with me.
Geoff Sher
Geoff Sher
Dear Dr. Sher,
I am 39. I had 3 good day-six blastocysts transferred in my first IVF.
9 days post-transfer, my beta hcg was 99.5.
13 days post-transfer, 308.
15 days post-transfer, 474.
19 days post-transfer, 2159.
So my doubling times were 58 hours, 78 hours, 43 hours. The nurse at my practice said they are very happy with this–they were a bit concerned with the 78 hours but as it was above the clinical "floor" of 53% they did not want to give up. Now they are quite happy and want me to wait 2 weeks for an ultrasound.
They are very happy, but I am a worrier! Does this kind of slow down/speed up indicate potential future problems? Vanishing twin? Ectopic pregnancy? I have had no bleeding at all, and no cramping beyond the "normal" low-grade menstrual-type cramps.
Yes it is slowing down. You could go in and have an confirming US anytime now. I suggest you do so!
Geoff Sher
Dear Dr Sher
thanks for your kind response
I am just reporting for you my second beta HCG leve. my first one 14 days after transfer was 248 and the second one (6 days after the first beta) is 5617.. my US will be at 18th of may.
my question: is there is any chance for a misscarry after such high level of beta? i want just to stop thinking for any bad things could be happen…
Thank u
AMMIRA
Hello
I'm grateful to find a website where a professional takes the time to answer questions of worried women! Thank you for that.
I am a gestational surrogate. I had a FET on 15 April, one 5d blastocyst was transferred.
My betas following the transfer have been all over the place, starting quite well, than slowing down, picking up again, then slowing down – I am not sure what to think about this.
The betas were:
10dpo – 30.5
13dpo – 117
18dpo – 287
23dpo – 1295
25dpo – 2450
30dpo – 5958
I am scheduled for another beta and u/s on 18 May. Judging by the advice provide by my clinic, they probably think everything is okay. Yet, everything that I find on the Internet suggests that my numbers are not as high as normal and are not rising quite as fast as they should either.
Could you provide any insight?
Thank you in advance.
Veronika
Hello Dr. Sher,
I have one healthy 6 year old and after that I have had 4 miscarriages and one molar pregnancy last year.
This is my second ivf, first one didn't take. I am due for my Beta tomorrow, but took a HPT today and it showed nothing… Could the test be wrong? I had a 3day transfer of 3 embryos on april 30th… Please advise, should i prepare myself for bad news tomorrow?
Hi Ammira,
The Beta's are rising nlormally and this is encouraging but it does not completely exclude the risk of miscarriage.
I have a good feeling in your case though!
Good luck!
Geoff Sher
Hi Veronika,
I am optimistic all will turn out OK!
Please keep us udated.
Geoff Sher
Hi fatima,
the HPT is not sensitive enough to pick up an early pregnancy consistently.
You need to do the blood tests 2 days apart to look for a positive test and thben a doubling over 2 days.
Good luck!
Geoff Sher
Dr. Sher, thank you for posting your articles. They are very helpful.
I had a fresh donor embryo cycle. Egg donor is 22 years old, my husband is 41, and I'm 46. My husband didn't correctly follow directions, so he had to produce another sample. Second sample was delivered to the clinic at 4pm. (Normally they expect samples between 7-11am)
7 embryos fertilized. On Day 2, we had 5 embryos: 3 vere very good, 2 were OK. By the 5th day we had 2 good blastocysts, 1 "not so good" blastocyst and 2 that didn't reach that stage yet.
2 best blastocysts were transfered, and remaining embrios didn't survive to be freezed.
12 days after day-5 transfer: beta=22
14 days after day-5 transfer: beta=75
It is growing, but it's sooo low! Could this be ectopic?
Is it possible that there was something wrong with embryos we transfered, caused my my husband's mistake and late delivery of his sample?
Dear Dr. Sher,
I wonder if you could comment on my case?
I did my FET on 4/29 with two 6AA grade day 6 embryos:
1st beta 10 post transfer on 5/9, hCG 308
2nd beta on 5/11, hCG 227
3rd beta on 5/13, hCG 77
So far (today is 5/16) my period has not started yet, and I still have some cramping occasionally.
Do I still have hope?
Any insights you could share, I would greatly appreciate!
- JK
I am afraid this does not look hopeful. We would call this a chemical pregnancy.
Geoff Sher
Thank you for your reply, Dr. Sher! – JK
Dear DR Geoffrey i was very happy i found your website and even happier you really reply to everyone's concern,please reply to me as i am very disappointed i am 26 i have gone through ICSI cycle 6 eggs were collected on 30/4 ,3 grade A embryos were transferred back on 2/May i did a blood test yesterday (14 days post ET) was told HCG<1 i got very disappointed when i called clinic nurse said i should not stop progesterone shots and try the test after 3 more days,could there still be any hope? i am really disappointed when can i try again?i have been told my chances are high which really caused this disappointment please let me know what you think .
Hi DR Geoffrey i was very happy to find your website along with your helpful replies,i am 26 and i have gone through ICSI cycle lateley where i got 6 eggs successfuly collected on april/30 and then 3 Grade A embryos were transferred back on may/2 yesterday i took blood test (14 days post ET) that came back negative HCG<1 i called the clinic nurse recommended not to stop progestrone and repeat the test after 3 more days,could there still be any hope?? i am totally disappointed should i try another cycle if still negative and when can i do it??it has been a major disappointment for me,please reply to me
Hi Hala,
I would need to know so much more about your case to deduce what went wrong. WE really should talk. call 800-780-7437 and set up a telephone consultation.
Geoff Sher
You are most welcome Juliet.
Geoff Sher
Hello,
We are using a surrogate and her 12 day level was 17 after a 3-day-old ET. Should I hold out any hope that this will be a viable pregnancy? Or is that level too low to remain optimistic?
It will depend on whether the 2nd beta (2 days later)at least doubles.
Geoff Sher
I am 33 years old.I got my First IVF and failed.Not sure why this happened.Before i started the cycle they said everything is looking fine.What could lead that it failed.What would be my next step.Is there any hope in getting success.Is progesterone levels effect the Pregnancy result.I am unsure really what went wrong.Is it abnormal that IVF failed in my case.What would my option.I really don't understand what to do and so confused and don't have hope any more.I took an appointment with the Doctor to see what went wrong.Taking any accupuncture helps to know if my body has any fault.One of my friend had it and in first Cycle , she is successful.
That is a complex issue requiring much more information to address constructively. isuggedt that you call 800-780-7437 and set up agree telephone consultation so we can discuss constructively.
Geoff SHER
Hi Dr Sher,
I guess I'm hoping for good news, despite knowing in my heart it's not going to be.
My first beta was today – only 20 at 11 days after a 5 day hatching grade A blastocyst transfer.
Although I'll do another beta in 2 days, I suspect it's not going to go well, as I picked up a faint positive at 8 and 9 day post transfer on a First response Early response test – which I know are very sensitive, but probably not sensitive enough to detect the 5 or so that it would have needed to be to get a level of 20 today. Am I over thinking this?
Thanks
No! I think you are on target!
Good luck!
Geoff Sher
Thanks for your rapid response, you've given me a bit of hope – whether that's a good or bad thing only time will tell!
My clinic has statistics for a healthy pregnancy based on the beta level at 11 day's post transfer. They show that my chances are only around 10% – and as I said, the early detection by HPT and failure to increase dramatically makes me feel my chances are even lower.
If it's not increased in two days – should I expect my period soon afterwards (I presume after I stop taking progesterone suppositories?)
Thanks so much for listening at this hard time
I'm a surrogate and 1st beta was 94, second was 290, third was 904, last, todays, was 97. Is it possible for it to drop 800 in 3 days? Everything I'm reading is showing minor drops after 3 days. Could it be a lab error?
It should double every 48 hours at this stage. If it does not, talk to your RE about stopping hormonal supplementation.
Geoff Sher
It is not unheard of for a negative beta to become positive 2 days later. If it does not, then of course it is bad news.
Good luck!
Geoff Sher
Hi Rachel,
Alas it is possible to drop in 24 hours . Repeat in 2 days.
Geoff Sher
Dear dr Sher
I have undergone first ivf et cycle , ET was done on 19 April with a 3day embryo and on 31st may I.e12day later my hcg is less than1. Is there any hope doc for this cycle
Pls guide
Unfortunately probably not much hope!
Sorry!
Geoff Sher
Hello dr. Sher
I took courage from your kind replies eventhough I am extremely disappointed right now. I had my 5day embryo transfer 13days ago. It was my 3rd try and a fresh cycle. I had the results of my beta 2hours ago and its 6,23…my doctor told me that it is a bit early and there could still be a chance…
Anyway, I am going back on Tuesday(Monday is a holiday here) for another beta, but I am just trying to find something to hold on to till then….
thank you in advance for your time
claire
6.5 is a very low beta for 13 days post- a day 5v transfer. It does not look good, I am afraid!
Sorry!
Geoff Sher
Hi Dr. Sher,
It is so awesome that you are taking time to answer questions for us. Thank you!
I'm 35 and have gone through 6 failed cycles of iui.We've just finished our first cycle of Ivf. We had a 3 day transfer, in which 2 great looking embryos were put back in (5/29). Our first beta was only 4 (6/9),so the RE had me do another the very next day, and it was 5. I then had to do another a few days later (6/14)and it was 10.. I'm scheduled to go in for another
Beta tomorrow(6/16). I started spotting early this morning. I know the numbers aren't good but should I hold on to any hope?
Thank you
Dr. Sher,
Thank you for providing such an informative website for all of us! I am 39 year old, and was diagnosed with premature ovarian failure at the age of 14. I just finished my first IVF cycle with donor egg, and found out my beta results on 6/13/11 (11 days post ET). My hcg levek was 1.2, hence, negative according to my nurse coordinator. She suggested I cease my meds, but has scheduled me for a repeat test on 6/30. I have been a little confused as my ER has not contacted me directly, and feel that these are conflicting directions. Also, since I am a donor egg recipient, could any level of hcg be a good thing? I am not at all hopeful, but just confused. Please feel free to share any insight you may have. Thank you!
It could still be a successful pregnancy and the slow recent rise in beta hCG could be due to the absorption of a 2nd tw3in!
Let's hope!
Good luck!
Geoff Sher
Dear Dr Sher,
I had my 5 day embryo transfer on 17 June, today my beta was 0.16.. As you understand i am not ok after hearing the news. We have a male factor, i am a healthy 30yrs old. The doctor said everything was perfect, the embryos were of a very good quality.. Could you please indicate what could be the problem?
Hi Dr. Sher,
I recently underwent IVF, and we transferred 2 embryos at 5 day transfer. I had a positive urine Hcg test at about 6 days past transfer. My beta numbers have been crazy however:
8dp5dt- 85
12dp5dt- 195
15dp5dt- 130
17dp5dt- 257
So now I have to wait 4 days for an ultrasound/repeat Hcg. My doctor believes it is either ectopic, or a vanishing twin syndrome but says my numbers might be too low for the latter. Do you have any insight on beta levels like this and the outcome? Thank you
It could be that you started with twins and one is now absorbing. Only time will tell!
Good luck!
Geoff Sher
Dear Dr. Sher,
I'm heartbroken after having a "perfect" FET cycle.
We put back 2 top-grade blastocysts. The lining looked "perfect"….
Everything seemed so positive. My beta was done
9 days after transfer (late day transfer), and
was told the hcg was 1.00 & to stop all meds.
Is there truly no hope that the beta was premature?
Thank you for your guidance!
Alexis
Hi Alexis,
There is always a chance but I am afraid, the prognosis is not good here!
so sorry!
Geoff Sher
Hi Dr. Sher,
I am so happy to have found this blog. Like many others here, I have too been to hell and back
IUIs, IVFs one mine one using my sister as a donor. From this last one I got pregnant and lost it at about 9 Weeks. We are not sure what happened. Gave up on all of this and started with adoption process…3 years into the adoption process with no results decided to get back on the horse. Well, with donor eggs, I was able to do a 2 good quality blastocyte transfer on day 6. Today, day 10 after the transfer, could not wait any longer for the beta test and are I am happy to say that I got a faint but positive result on a home pregnacy test. Should I read into the line being faint? I would think that is faint because there is not enough Hcg at this point. If so, should I start forgetting about the idea of having twins? 
or is it a bit early still? Any chance that there could be a false positive with urine tests? I thank you in adavnce for any information you can provide. You know how horrible this wait can be….. Tessie (BTW using my husbands account)
Hi "Carlos",
This is indeed encouraging but remember, urine pregnancy tests are subject to variations. You should have a blood quantitative beta hCG test ASAP and then repeat 2 days later. If the levels double (or better) you should be OK!
Good luck and please keep us in the picture.
G-d bless!
Geoff Sher
Yes certainly.. Thank you for your promt response. I have my first beta quantitative scheduled for Monday (day 13th of the transfer) then Wed then Friday. Will keep you posted. Thanks again
Hi Dr. Me again !!! Results came out positive with an HCG of 1242.3 (transfer was done on July 5 – day 6 blastocytes – eggs retreived on June 29). Scheduled for another test on Wed (48 hrs). The nurse said I was 2 weeks pregnant but the ivf calendars i see in the internet say i should be 4 weeks and some. Which one is the correct one? How does this number look to you ? Thanks
Good luck! The results look good!
Geoff Sher
Hi, I just found this site. I'm frustrated and sad because today we were told the embryo was not developing right. They said I was considered 6 wks 3 days. They didn't see the yolk sack or a heartbeat on the u/s, and my bloodwork levels was at 2010. Everything seemed normal until today. 12 days after 5dt, it was 212. 2 days later it was 520. the next week the first u/s showed 4mm. Then a week later (today) only showed it to have grown to 6mm.
They told me to stop the crinone.
I'm only 31, my husband is older, 57, we paid everything out of pocket, we even did genetic testing, took the two best ones.
I mean, what's the chance of success if we do this again with the 3 frozen ones we have left? Should I look for a new doctor? Should I stick with her, hope that an appeal to the insurance company will cover it now that w eproved it didn't work. I have no problems physically, none. I don't know what to think.
This could be a random occurrence. It does not suggest that problems with the other embryos frozen. I am a little concerned that with that high of a beta hCG level, no sac was seen in the uterus. An ectopic (tubal) pregnancy needs to be ruled out stat!
Geoff Sher
I just noticed that I am wrong…they did see a sac!That probably rules out an ectopic. I would suggest that the products of conception be collected and tested chromosomally.
Geoff Sher
Hello Dr. Sher
I had my 3day frozen embryo transfer at July 2. It was my 8th try. I had 3 missed abortus previously.Pre-implantation genetic screening was done. My HCG results were as follows; 7/13 53, 7/15 138, 7/18 634, 7/20 1275, 7/22 2191. They began to slow down. At vaginal US there was a sac today. My doctor scheduled another US 10 days later. I was on progesterone, ASA, enoxaparin. Is there any hope?
thank you in advance
tanya
Still looks OK to me.
The ultrasound should be definitive.
Good luck!
Geoff Sher
Hi Dr. I am a bit concerned. I was reading through the post you have made in this site where it says that numbers should double every 2 days. In my case the numbers are going up but not doubling. The nurse at the clinic says that this looks good and that it has met the expectations but I am still worried after reading your post. I had a day 6 blastocyte transfer. HCG 13 days after the transfer 1242.3, 15 days after 2227.9 (79% increase), 17 days after the transfer 3368 (51% increase). Should I be concerned? Please let us know your thoughts. Thanks
I suggest an ultrasound examination at this stage.
That will be definitive.
Good luck!
Geoff Sher
My name is Kristina. I transfered 1 blast and 1 murola on 7/19/11. I'm 10 days past 5 day transfer. I had my beta this morning on 7/29/11 my beta is 87.3. She said it was a good number and they are happy with it.. is this a good number ??? others are in 100s to 200s so I'm getting worried. Should I be worried, do u thing this pregnancy will be successful
This is a good number.
Good luck!
Geoff Sher
Dear Doctor,
My wife has undergone IVF with embryo transfer on 22th JULU 2011. Blood HCG level as on 30th JULY 2011 is 26. Doctor has suggested to go for another Blood HCG on 01st aug 2011 the result is 100
is it good result
Kindly advice
Navas.k
Dr,
We had our egg retrieval July 22nd, with our embryo transfer July 25th @ 11:00 AM. We transferd three fresh embryos, one was grade A and two grade B. I had my first blood test this AM. My progesterone was 19.9 (they said this was good) but my Hcg was >1. My nurse said that the "real test is Friday?
We are wondering if we could still have a positive result this coming Friday August 5th?
Thanks
Yes! possible but might not be very likely, I am afraid!
Good luck!
Geoff Sher
Dear Dr Sher,
I am wondering if you can offer me any advice.
I have suffered a previous partial molar pregnancy and when my hcg was monitored during that pregnancy it was only showing a rise of 1.4 -1.5 every 48 hours. I am now pregnant again and have been having my hcg recorded, I have had the following readings –
4+2 days pregnant – 711
4+6 days pregnant – 2611
5+1 days pregnant – 4074
So what started as doubling every 50 hours is now doubling every 74. . . be honest, this is not good?
My doctor seems to think this is ok but everything I read along with what I was told at EPU last time suggests otherwise. They will not scan me for another 5 days and I am driving myself crazy with this wait. Do you think there's still any chance that this could be a viable pregnancy?
Hi Doctor,
I was very happy to find your website along with your helpful replies,i am 29 and i have gone through ICSI cycle lately where i got 15 eggs successfully collected on July/18 and seven was frozen for later use and then 3 embryos were transferred back on July/22. I tested first blood test on July 30, 2011 and the result was 26. And took second test on August 1, 2011 the result was 100. I called clinic they told me that it is good result and give date for ultrasound scan on August 22.
Seeking doctor advice also …….
Thank very much doctor
Thanks for your question. Dr. Sher is out of the country until Aug. 23rd and will have very limited access to his blog. Because of this, he may not be able to respond promptly to your question. Thanks for your patience.
Admin
Mr. Sher.
I read about all your responses in this post. I see you are very experienced with the HCG values! Amazing!
We are concerned, my wife HCG values start to drop but the embrio is still getting bigger. no signs of blod at all. Gestational Saq is looking god, with yolk saq and embrio getting bigger and bigger (3mm last saturday, 3.6mm 2 days after). Any ideas why the drop of HCG?
Progesterone level is ok : 53
Here HCG values
02 july – 29
04 july – 59
30 july – 35340
3 august – 43042
8 august – 41250
11 august – 39200
This is very weird and values are dropping but high. Any ideas?
In a case of misscarriage, the values drop slow like we are looking here or the drop is dramatically fast?
We will search the Heart Beat this saturday but I would love to know about this HCG values.
pd: we had a blasto transfer (day 5) in miniFIV. we believe we perhaps had 2 gestational saq at certain point and this is why the values are so high (and now dropping).
is progesterone values ok?
Dear Dr Sher,
My sister had an IVF procedure recently. Her egg retrieval was on 07/23 and her embryo transfer was on 07/26.
Her first beta hcg (13dp3dt)was on 8/8 and it was 19.1 (was told it was very low).
Her second beta (15dp3dt) was on 8/10 and it was 65.4.
Her third beta (19dp3dt) was on 8/14 and it was 241.
The clinic is concerned that this could be an ectopic pregnancy. Do you think there is a possibility of a viable pregnancy here. Can you please advice.
Thanks
C
Dr. Sher,
I had FET – transferred two 6 day old blasts.
The first hcg came at 27, the second 2 days later at 47 – not quite doubled. Is there any hope?
Indeed there is… Follow thew betas every 2 days. They should double. Then an US in about 10 days will be definitive.
Good luck!
Geoff Sher
It seems quite promising!
Good luck!
Geoff Sher
It does not suggest an ectopic to me. The numbers look good!
Good luck!
Geoff Sher
Thank you so much. You need to have an NK cell activity test (K-562 test). Unfortunately you cannot test the blastocyst for DQa nor will co-culture improve implantation potential in such cases. Please read the 2 articles i wrote and posted on this site on May 10th and May 16th.
Good luck!
Geoff Sher
The beta hCG is rising but slowly. However, the ultrasound should be definitive. These values are somewhat concerning though.
Geoff Sher
Just had my HCG test – Nurse called and said it was 4 and to stop meds.
Transferred 2 grade A FET= Transfer was August 5th (one was hatching already)
Progesterone test August 9th = 14
HCG 4 – August 15th.
I have felt all the pregnancy symptoms, but nurse said the meds can do that. I mentioned going ahead and taking the 2-day HCG and she said she did not expect the results to change. Have not yet spoken with the Dr.
What harm is there in taking the 2-day HCG? Or just delaying the final bad news.
Thank you in advance for your valued thoughts.
Geneva
Hello – I am confused – above you say "About 12 days after egg retrieval, 9 days after a day-3 embryo transfer and 7 days after a blastocyst transfer, the woman should have a quantitative beta hCG blood pregnancy test performed."
But in another blog (sorry I didn't write down which one) but you said "In the case of embryo transfer (as with frozen transfers, egg donor cycles or gestational surrogacy) the tests are done at 12 and 14 days after initiating progesterone therapy".
Can you clarify that? I started progesterone therapy on the 31st of July – 5days before the transfer on the 5th of August. So then my HCG test should have been on 11th and the 12th? Not the 15th and the 17th?
I guess then going in for a day 2 HCG test is a mute point then since on the 15th my HCG came back as 4. I wish you could answer me sooner…but I assume you are super busy and not able to. So….guessing I should just accept that the 1st HCG shows definitively that I am not pregnant.
Thanks. Please do still reply as this will be of help to me and perhaps someone else.
I agree with you. I would still do the the 2nd beta since sometimes (although rarely) the rise can be delayed.
Geoff Sher
Remember…in embryo recipient cycles (FET/OD/Gestational surrogacy)we start the progesterone shots, 3-4 days before cleaved embryo transfer or 5-6 days prior to blastocyst transfer.
Geoff Sher
Dear Dr Sher,
Thanks for your previous reply for my question regarding a possible ectopic pregnancy for my sister. The roller coaster ride is actually continuing.
My previous post was
"
My sister had an IVF procedure recently. Her egg retrieval was on 07/23 and her embryo transfer was on 07/26.
Her first beta hcg (13dp3dt)was on 8/8 and it was 19.1 (was told it was very low).
Her second beta (15dp3dt) was on 8/10 and it was 65.4.
Her third beta (19dp3dt) was on 8/14 and it was 241.
The clinic is concerned that this could be an ectopic pregnancy. Do you think there is a possibility of a viable pregnancy here. Can you please advice.
"
You had said that this doesn't look like ectopic to you.
She had blood work again on 8/17 (22dp3dt) and beta had actually fallen to 205. She resigned to the fact that she was having a miscarriage.
She had spotting and light bleeding for abt 1.5 days.
Her blood work today, 8/19 (24dp3dt) came back with a hcg level of 330.
Is this falling and rising expected during a miscarriage ? Her bleeding has also stopped. Please advise. Is there any hope at all ?
Thanks for taking the time to answer.
C
It could indeed be an intrauterine pregnancy on its way out. However I might have been wrong and this could still turn out to be an ectopic pregnancy. Unfortunately, with such low beta's an ultrasound examination might not be helpful in differentiating between a miscarriage and ectopic. Either way, yor MD will have to keep close tabs.
Good luck!
Geoff Sher
I had two embryos transferred (August 17) after 2days of embryo transfer(Aug 14) and then blood pregnancy test was done after 12 days(on August 29). Nurse told me to stop taking progesterone injections and I should have period soon. On August 30 I had just a little (two three drops may be) spotting of dark red sticky blood. I am wondering is there any chance that it can be implantation bleeding. Should I repeat my blood pregnancy test after 1/2 days? should I continue taking injections?
Hello, I live in Los Angeles, Ca and I would like to tell my story. We have been trying for 5 years and finally got pregnant with the help of the IVF and Egg Donor, without any positive results and now I don't want to loose hope or give up despite the Dr. is saying there is none. On July 28, 2011, I had 3 embryos transferred or very good blastocysts. On August 8, (11 days post ET) I received my FIRST POSITIVE! With HCG level of 83, from there I started my nightmare, so far I've had 6 HCG labs, every 2 or 3 days: My HCG levels were: 83-103-333-1308-1865-and 2148. HCG didn’t double all the time but has continued to rise slowly. On August 23, I had my first vaginal ultrasound and the doctor saw a very tiny empty sac, that day the doctor said that the sac was very small (only 6 mm) and with six weeks I can not had a viable pregnancy. Four days later on Sunday 28, exactly one month since my embryos was transferred I had another ultrasound where the doctor after trying to find the sac, showed the same empty sac it showed last Tuesday, he said that it is a very small sac and I was diagnosed with a blighted ovum, he told me my sac was measuring shorter than it should have been for 7 weeks pregnant, and that the fetus never made it, and assured me to schedule a D&C; ASAP and that I must suspend the medicines (progesterone and Vivelle-estradiol patches) I almost begged him to leave me a little longer with the medicines because If I suspend the medicines, this will cause a imminent bleeding. The doc is putting me at 7 weeks. According to the date I had my embryos transfer I should be about 4 weeks. My question is why my doctor says that I have 7 weeks pregnant, if I just turned on Sunday 28, one month since they put the embryos in my body? I ask him and he just answered that is the protocol?? What should I do: to continue with my meds and wait longer or not? I have some symptoms of pregnancy but my doctor says are caused by the medications I'm using. Please help me, what I need to do?
Sadly, this pregnancy is almost certainly lost. If you have a D&C; (and I suggest you do so, if only for for diagnostic reasons) make certain that they do a chromosome analysis of the products to see if this loss was due to an embryo issue. It could be that you have an implantation problem.
I would be happy to discuss your case with you. Call 800-780-7437 if you wish to talk.
Geoff Sher
Dear Dr. Sher,
After a five day transfer I have had three beta's 12 days post transfer 61, 16 days 221, and the latest 19 days 787. I went for a sonogram and my Dr. was unable to find anything on the screen? Do you think there is still a chance for a viable pregnancy? I am going to a radiologist with more high tech equipment to see if they can pick anything up. Any thoughts?
Thank you in advance for the response.
Annie
Dear Sir,
My wife has undergone IVF with embryo transfer on 22nd Aug 2011. Her first blood test was done on 5th and HCG level was 35.5.Blood test was again done on 7th and HCG level dropped to 32.4. We have again done blood test on 10th of Sept and HCG level was found to be 65.1.What are the chances of pregnancy in our case?
Raj
It is possible that she started off with 2 embryos implanting and then one was lost ..hence the drop in beta hCG. Since it is again rising you should repeat the beta in 2 days. If it doubles, there is hope. If not then there is likely a problem.
Good luck!
Geoff Sher
This might be too early to see anything in the uterus. I would wait till the end of the week and repeat the ultrasound examination. If still nothing by ultrasound while the beta's continue to rise , then an ectopic pregnancy must be considered.
Good luck!
Geoff Sher
Hi, last Tue my HCG came back at 98 two days later, Thur, it came back at 116. My doctor said it could be due to a chemical pregnancy or that two eggs implanted and one fell off. Today, Mon, I went in and my levels were at 847. Is this to high? Should I be worried about a molar or ectopic pregnancy? Any input would be much appreciated. Thank you!
Elena
It could be that you started off with more than one embryo implanted and one has reduced.
Hopefully all will be good!
Geoff Sher
Dr. Sher –
We were scheduled for a FET on 9/8/11 of 2 blasts. Having not received a call from a nurse on the 6th giving us our transfer time, I called on the 7th to find out. I received a return call 5 1/2 hours later, telling me my paperwork had not been transferred to the lab and our blasts had not been thawed. They rescheduled it for the 9th, one day later and reassured me one day would not make a difference. Now, right on my flow sheet it is stated that this protocol should only be extended during the twice a day estrace phase and not once PIO is started. I only had one US before the transfer and have no idea what my lining looked like. Would you have gone ahead with the transfer or stopped meds and restarted at a later date?
Ideally the FET should not be performed later than 6 days after the progesterone administration commences.
Geoff Sher
Dr. Sher, I had ovum donation on 2nd september of this month. On 16th september by urine test came positive and beta was 425, on 18th september beta was 449 and my Dr. has called me up with sorry. I was taking crinone gel 8% and then changed it to Susten(prometrium 400mg), can that change might have ruined something, also taking estradiol. Please reply. I'll ask for a repeate beta tommorrow.
Do I have hope?
US
This is very sad!
Were you on Crinone or prometrium once or twice daily. I am not sure but I doubt the switch over was the cause.
If you want to talk please call 800-780-7437.
Geoff Sher
Hi,
I am running in 7th week of pregnancy, But i did the scanning and Serum Beta HCG Test, In Scanning report it showing the YOLK is Found but No Fetal Pole seen, But My HCG Level at first time was 3300 (i.e 4th week) after 2 days again we did, that time it was 3200. My Doctor told us to do the test one more time after 2 weeks, Last two days back we did the HCG test that time it was 7300 and again after 48 hours we did one more time, that time it was 5250. My Question is, Is this HCG test will give a correct result during the first 12 weeks? i mean first 3 months. Is that heart beat levels can be identified during first 3 months? Please respond what could be the problem? Appreciate your hlep.
I was on crinone gel once in the morning and then switched to susten(progestrone 400mg). My progestrone level also came very low 1.2. I've had blood drawn this morning, will give you a call as soon as I hear the beta values.
Thank you so much for prompt reply, highly appreciate it.
You need serial follow-up ultrasounds to see how this progresses but the prognosis does not look good, I am afraid.
please keep me in the loop!
Geoff Sher.
Good luck!
Geoff Sher
Dear Dr. Sher,
I had a 5days FET of 2 average grade blasts on 8/29/11. My hcg levels are as follows:
9/10/11 = 13.76
9/12/11 = 28.41
9/14/11 = 63.14
9/16/11 = 79.47
9/19/11 = 173.07
9/21/11 = 241.86
What do you think of the progress? it does not always doubling but it still increases. Do you think there's still a chance that this will turn out to be a viable pregnancy? Thank you so much!
There is a lag in the middle, but yes, it could still be fine. Get an ultrasound in a week or so. That will be definitive.
In the meanwhile please be on the lookout for any sudden pain in the lower abdomen or right shoulder and/or light headedness which could signify an ectopic pregnancy—see elsewhere on this site for details about ectopic pregnancies (which by the way I do not necessarily believe you have) and if these develop go directly to your doc or to the emergency room for evaluation.
Geoff Sher.
Thank you for your fast reply. My OB is concern because there's only a 40% increase from 9/19/11 to 9/21/11. Do you think it is something that we should worry about? I'm going to have another beta hcg on 9/23/11. Thank you.
Dr. Sher,
This is shana from last posts. As I mentioned that I had 3 fresh embryo transfer(2 good quality) on 2nd september. Here are my beta.
16th sep – 425
18th sep- 449
20th sep – 845
so it did double but after 4 days. I insisted D. to do this last one after getting idea from your blog that what if initialy 2 embryo implanted and one didn't take up. I'm not raising hope, but do you think there is chance?
I'm taking progestrone and estradiol. my progestrone was low 1.2, should I ask my Dr. for intramuscular injections? Please advice. I tried calling but its after hours, will try tommorrow.
dear dr.sher,
i done my first beta hcg test after 13 days transfer of ETon 18 sep 2011 and the no. is <1.20 and yesterday i do my second beta hcg test but i dont know the report of my second test. dr.please tell me is my pragnancy is may be positive or not. is my beta no. is increase or no.
rekha
Dear Mr. Sher ,
14th day after ET , the hcg was 3680 and on 16th day it is 8749
Is this a good , healthy pregnancy . Is this can result in multiple pregnancy .
Best Regards
While this is not promising and likely points to a negative outcome, in some cases the beta delays in rising. The second test should be definitive.
Geoff Sher
Very promising indeed!
Good luck.
Geoff Sher
Hi Dr. Sher,
My sister has done 3 separate IVF treatments and she has had 2 unsuccessful attempts, her third try has been 2 weeks ago, (the embryo transfer has been done on Saturday Sep 10th) she has done a HPT today (Sep 22) and has gotten a negative results, she is 24, should she loose all hope and not test again? or should she do a blood work? is a blood test necessary for confirming a pregnancy after IVF, or should one leave faith to the home pregnancy test?
thank you in advance for your consideration
Neda
I would definitely recommend doing 2 blood tests (each about 2 days apart). The urine test is not that sensitive.
However, if at 24, this cycle doesn't work, perhaps we should talk. If interested, have her call 800-780-7437 and set up a phone consultation with me.
Geoff Sher
b
Dr. Sher -
I have a quick question about estrogen levels after FET. I transferred 2 CCS normal embryos.
8dp5dt – Beta 158, Progesterone 16
10dp5dt – Beta 393, Estrogen 116
To supplement the estrogen my clinic had me on 4 Vivelle patches – changed every 2 days, plus 1 2mg estrace pill a day. They added in a second Estrace pill after receiving my results today.
Is this sufficient? What are the chances of miscarriage with this low estrogen level?
Thank you.
I personally do not use this approach but it should be fine.
Geoff Sher
My wife has donce a ICSI treatmet (age 29). Two Embryo were Transferred. After transfer the hcg results are
12 Day – HCG value was 22
14 Day – Hcg Value was 64
Doctor wanted to repeat hcg test in another couple of days. as per Doctor P4 value are also doubling. Is that a good sign. Doctor still claiming that the HCG value are low and they were not able to confirm the pregnancy. What should i do !! Kindly advice
Dr.sher,
we just tranferred 2 embroyos on 09/14/2011. Hte first blood test was on 09/27 and the number was 1173. they did a second one on 09/29/2011 and the # was 1808. What are our chances of a viable pregnancy.
Thanks for your help
kris
It is hard to say! The rise is not a doubling. However, go in for an ultrasound ASAP. That will be more definitive!
Good luck.
Geoff Sher
Dr. Sher:
After an embryo transfer on 9/16, my first beta on 9/26 was 28; 9/28 52; 9/30 68; today, 10/3, 123. My doctor would like to perform a D&C; by this Thursday as he sees a risk for ectopic pregnancy. Are these numbers sufficiently low, or should I wait and get an ultrasound? Thank you so much.
oops: today's value was 132, not 123. Thank you.
Dr Sher,
I have ET on Sept 14. Tested positive on Sept 30 and HCG level was 43. It was too low and have chance to get ectopic pregnancy. Same day, I started spotting and last for 4 days. My Dr. told me to go back for blood test tomorrow. I am very nervous.
Do I have ectopic pregnancy?
I wish I could give you assurance but alas that is not possible. You will have to cautiously wait for this to play itself out!
Good luck!
Geoff Sher
Hello Dr,
My sister had gone with IVF on 26 and after 2 weeks I got my HCG level as .5 and in next blood test it came as 1.5.
Is there any positive sign ?
Frankly, this does not look good , i am afraid.
Geoff Sher
Hi Doc,
I had two unsuccessful ivf transfers done, one in dec 10', result: ectopic, and then in March: Negative. I tried again with a frozen transfer with 2 eggs on Sept 23rd. I went in on 10/5 and my beta was 651, then on the 7th is was 1591. I had some brown discharge from time to time when I went to the bathroom, so I went for another beta to make sure today, 10/12, my beta is 10,968. Any thoughts on single, twins, triplets (is that even possible with 2 eggs?)?
GOOD LUCK …I COULD BE WRONG BUT IT SOUNDS LIKE A SINGLE PREGNANCY.
GEOFF SHER
Hi Doc,
I am 42, had a single 6 day blastocyst transfer on Oct 8th. Today, 7 days after transfer I started having light bleeding with some cramping. My beta is on the 18th, still 2 days away. I am not sure, if I am having my period or miscarrying. Could you please advice what I should do now? Thank you.
Hello Dr. Sher,
Thank you so much for posting such great information and answering all of these questions it's so helpful.
My wife is 33, this is our first attempt with IVF as she has bilateral blocked tubes. Our Dr. advised this seems to be the only issue. We did a 3 day transfer of what we were told were "grade A" 2 embryo's on Oct 7. She was having some mild hyperstimulation so we went back to check that a few days ago and it was "OK". We went again today and they also did the beta test. The nurse just called and advised results were negative (though didn't say what the level was). Also advised stop taking progesterone suppositories.
I have been reading through many of the posts, do you think it's wise for us to insist on another test on 10-19 and keep taking the progesterone?
I strongly recommend a second beta as well. Sometimes there is a delay in the rise.
Geoff Sher
Bleeding is of course not a good thing…but I would be guessing if I were to predict here. You will have to be a little patient , I am afraid.
Good luck!
Geoff Sher
Greetings! Thank you for doing this! My older sister had a 5 day blastocyst (well almost blastocyst) transfer after PGD (for a single gene disorder). Her first HCG level was 37.
Dates:
Retrieval: 10/5/11
Transfer: 10/10/11
First HCG: 10/20/11
We have heard PGD can lower the level seen for the first HCG but we are still concerned as she was told "100" would be the best number.
What are your general thoughts on this?
Thank you for your time!
Hi Suriyah,
You are correct! This beta is a little on the low side but indeed after PGD, the rise is sometimes a little slower in the beginning. Hopefully when you do another beta 2 days later, it will have doubled and you can breathe a temporary sigh of relief pending ultrasound confirmation about 2 weeks later.
Good luck!
Geoff Sher
Thank you! She repeated it at her onsite RE's lab ( she was at different one before) and it was 30 or 32 ( I do not recall).
Could this be intralab variability?
If it is, would it still be expected to rise in one day? It was 37 on 10/20 at one lab and 30 or 32 on 10/21 at her RE's lab.
Or does this look like it will not be successful?
She is to repeat it on Monday.
That is somewhat alarming but wait 2 more days and then repeat it again.
Good luck!
Geoff Sher
Dr Sher,
I have had 3 successful pregnancies without drugs or IVF. My second husband had a vasectomy and instead of a reversal, we decided do IVF. Our first try resulted in a negative result. The Dr. transferred 2 – fresh 5 day blastocyst, the second time, he transferred 3 – 3 frozen day 8 cell. I took a hpt yesterday and it was negative. I went for my beta this morning and I am waiting on the results, I am not expecting good news. I don't understand how I can have 3 healthy pregancies with no problem conceiving and now the Dr and embryologists have done all the work and my body is not accepting the embryos. We have 1 – 5 day blastocyst and 3 – 3 day frozen. We will try one more time and hope for the best. Any advice?
Dr Sher,
I had my ET on 4/112 Day 5 blastocyst 4AA grade embryo. On 4/23 my first BCHCG was 39 (first the lab said it was 390 and then said they messed up and it was 39). Then in 4/25 it was 5.3 and on 4/27 it was 120.2. My nurse co-ordinator says it is on the low side and thus might not be a viable pregnancy. I am not sure what I should be thinking at this point. I am scheduled for one more test on 5/3 to see if my hcg is doubling.
Should I have any hope at all from my situation or just be prepared to loose it all? This is my first IVF and there is physically nothing wrong with me or my husband.
Any advice will be great.
This is quite bizarre. Not only did they get the 1st beta level wrong but the 2nd one dropped before going up very decisively 2 days later. Frankly I do not quite know what to make of it.
You need to repeat the beta in 2 days from the time of the last e and it should around 250 or higher.
Good luck!
Geoff Sher
I had two 5 day blstocyst transferred on April 25th (7days ago). I did do a trigger shot which was on April 18th (14 days ago). Took a first response hpt that was a stong positive. Can trust this result? Beta is in 2 days
Dear Dr. Sher,
We had a 5 day blastocyst FET on 4/24 with one”great” (a/a) embryo and two others graded at poor & fair.
Today is day 9 and my reproductive endocrinologist brought me in for a beta hcg test which was negative (below 2.5).
The doctor has instructed me to stop all medication (vaginal progesterone x3/ day and 400mg prometrium at night).
Background: We’re very fortunate as to have had two (first attempt) positive fresh IVF cycles and have two wonderful kids (there’s hope everyone!) but very much want to continue to expand our family.
With our first fresh IVF cycle we were tested (i believe) day 10 and had a negative HCG and we were told to stop medications. I had had a positive HP test and insisted on continuing meds… day 12 was positive. Numbers were low – 3 and rose slowly but ended in a healthy baby girl.
With our second pregnancy, HCG was positive butlikewise low during the first blood test, I believe day 11. Numbers were on the low end of doubling but ended w a healthy birth.
The doctor today told me and my husband to stop all medications that the result was definitive and that he will let us continue meds for a few more days and retest Saturday or Monday for closure but doesn’t think it worthwhile. He said we could skip the tests and stop the meds if we think about it and change our minds.
What do you think and what is your experience with FET day 5 blastocyst transfer beta testing?
Thank you so much for your time and help!!
Based on past experience, I would hang in there for a while and retest the beta 2 days after the last one. If it does not rise then I would stop.
Good luck!
Geoff Sher
Thank you Dr Sher. I appreciate your input.
Can I ask on what day post transfer of FET d5 do you test for beta HGC?
Thanks again,
Sigal
You are most welcome!
Geoff Sher
Hi,
Dr, My wife had ET last sunday i.e 29th April and we were told to Have Beta HCG done on 6th May (Sunday) 7 days after the ET. i got the results today and its negative. can you please advise?
Regards,
Repeat the beta in 2 days,. Sometimes there will be a surprise.
Good luck!
Geoff Sher
I came across this website after a very rough couple of days.. I’m hoping for some help… We are on our 3rd ivf cycle after 2 failures this time we tried icsi. We had 3 embryos transferred 13 days ago… They were grade A, 8 cell… I am 38 yrs old my husband is 35.. I had a tubal 8 yrs ago after my 2nd child in a previous relationship. Yesterday i woke up to some brown spotting and this morning some spotting and I took a hpt and got a negative response.. Very heart wrenching i thought i was doing everything right.. We had perfect embryos and i took very good care of myself.. I am still using crinone inserts. Should i go for the blood work or consider this a failed cycle.. The spotting seemed to go away, it was brown and spotty. Please help its been a very frustrating month.
It is unlikely that this p[pregnancy took. The bigger question is why you are having repeated failures. It could well be a hitherto undiagnosed implantation dysfunction (perhaps immunologic in origin).Please go to http://www.IVFauthority.com and when you get to the home page find the “search bar” in the right hand column. Type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
1. “Unexplained IVF failure”
2. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
3. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
4. “IVF success: Factors that influence outcome”
5. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
6. “A stepwise approach to IVF at SIRM” (posted March,9th, 2012)
You might also consider calling 800-780-7437 or 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
I had my first beta today and it is currently 11 days past a 3 day transfer through IVF…My beta was 11…I have to go back on Wednesday for another test….what do you think?……
Could well be a potentially viable pregnancy…if it doubles in 2 days.
Good luck!
Geoff Sher
Hi,
Dr, I had ET on 26th April and we were told to Have Beta HCG done on 9th May i,e tomorrow. can you please tell me how much is the good value and also any advise.
It ideally should be >10 and should double every 48 hours or so. A slower rise could be cause for concern and more than doubling, might in some cases suggest a multiple implantation.
Good luck!
Geoff Sher
Hi,
My first beta was 273 at 9dp5dt and my second beta was 700 at 13dp5dt. My RE would have liked to see at least 800. I will test on 16dp5dt. Do you think I have a shot of a viable pregnancy? What range beta should I want to see? Thank you
I agree with your RE, but yes…you certainly do have a shot.
Geoff Sher
I had my daughter 15days ago and went to get started on my shot and i had a positive urine test and then they dod the blood test and my level came back 35. My doctor said that coild be normal but all the nurses said iy wasnt do i need to go get a second blood work done or could it be normal that my levels are still high??
That is expected. It takes several weeks (or longer) for the beta to drop to zero.
Geoff Sher
I am going through my first FET cycle. We had our first baby through IVF fresh cycle. I have a question…a general FET related question I’m confused about. I am totally normal but we had to do IVF because my husband has almost zero chance of making me conceive naturally. Why then am I being fed estrogen and prometrium ? If my system is normal and if I do conceive, should I not be able to sustain the pregnancy without hormones ? Sorry, but this occured to me only now, after my FET. Tomorrow is my first blood test. The home pregnancy tests were negative on day 9. Thank you.
An FET can be done in a natural cycle, but this establishes a very narrow window of implantation and thus the ET must be very carefully timed. With hormonal preparation, the window is wider and very precise and accurate timing of the transfer is not an issue. Another factor is that a natural cycle, especially when you are under stress (as with an FET cycle) is subject to fluctuations in hormone balance that can be avoided through hormonal preparation for ET.
Good luck!
Geoff Sher
The issue is advancing age (42y) having a negative impact on egg quality (chromosomal integrity, which is the main determinant of outcome. Also, the protocol of ovarian stimulation, if not strategically selected and implemented can increase the percentage of chromosomally abnormal (aneuploid) eggs and thereby negatively affect embryo competency. Also, you have diminishing ovarian reserve (DOR) …as evidenced by your AMH=0.16 and therefore will make fewer follicles/ eggs. Finally, older women and those with DOR if the protocol for ovarian stimulation, if their protocol for ovarian stimulation is not very strategically selected and implemented will find that the percentage of chromosomally abnormal (aneuploid) eggs/embryos will be increased.
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. Age and IVF outcome”
3. “IVF success: Factors that influence outcome”
4. “A Stepwise Approach to IVF At SIRM” (Posted on March 9th, 2012)
5. Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
6. “Egg Donation”
7. “Embryo Banking”
You might consider calling 800-780-7437 or 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
DHEA is in my opinion not advisable in women with diminished ovarian reserve (see below)
Hi, I’m 37 years old. i had an IVF transfer on April 22nd. On May 1st my results came back positive but with a low beta hcg of 24.
May 3 – 25
May 5 – 28
May 7 – 58
May 11 – 204
I got my period on May 8th. it was heavy the first day then it got lighter on the 3rd day. The doctors are finally going to do a sonogram on me on Tuesday. Do you think there is still hope?
thank you for looking into this.
Unfortunately this does not look very hopeful. However have your doc follow your hCG levels to make sure they go down to zero.
Geoff Sher
Hello, I had a FET on May 7th 2 perfect blast 100% cell survival. I did a hpt this morning and it is negative. I am reading about all these woman that got a positive on day 4 and 5. My blood test is scheduled for 9pt. Should I have got a positive by now or is it too early for a urine test?
Warm Regards,
Jennifer
It is too early for a HPT.
Good luck!
Geoff Sher
Dr. Sher,
I underwent a 3 day ET of 3 8 cell embryos. I tested with a HPT 9dpt and it was neg. Is there any possibility that my BETA could be positive? This is my second IVF first ended with a healthy pregnancy 3 yrs ago. this time we had to do ICSI as my husband had poor morphology.
You need to do blood testing. Urine test s are notoriously unreliable.
Good luck!
Geoff Sher
Dear Dr Sher, I was on my second IVF course, did the embryo transfer on 5th May and started having some brownish discharge on 12th, when the doctor asked me to do a beta HCG test and the result was 53, he asked me to have an injection (progesterone) – the discharge became less and heavier, i did another blood test today and the result was 11. The doctor asked me to stop taking all medications so that I start having my period – that the embryos stopped developing. Have they stopped growing or have I lost them with the discharge ? What could be the reasons for this drop within two days ? Could there still be hope I am carrying at least one still ?
Sadly, this was a “chemical pregnancy” that did not make it.
Discuss this with your RE and try to ascertain the possible reason (s). Alternatively, consider calling 800-780-7437 or 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
G-d bless!
Geoff Sher
thanks Dr for your prompt response, I live all the way in Bahrain – will give you a call in a few days.
Interesting.
I am currently treating a couple from Qatar.
Geoff Sher
I got a beta hcg of 0.15 miu/ml. Today is 15th day past ovulation for me. Is there still any hope for a successful pregnancy.
I am afraid it is not likely!
Geoff Sher
Thank you Dr. Sher. I was hopeful as I have missed my periods by almost a week. Thank you again!!
You are welcome!
Geoff Sher
Hello Dr.,
I had my first beta yesterday which was 12dpt…my beta was 699!! That’s really high for 12 days out…I took my progesterone shot about 30 min before I had my beta dne…could that have caused my levels to be that high…I go back Monday 15dpt…what should I expect my levels to be?
Not at all! Progesterone would not have affected the beta level.
Good luck!
Geoff Sher
hi doc.
ihad my egg retrieval on 6th may
egg transferred on day 3 – 9th may
and today i done my 1st hcg beta counts 19 .is there any hope for me to get pregnant..i will repeat my blood test after 2 days..
what r ur comments on this…
thanx…
I wish I could give you the news you want to hear, but without another beta doubling two days after the 1st one, I would be guessing and you don’t need that.
Geoff Sher
hi doc..
i already discussed with u about me beta ..
it was–first beta was 19 on date 19thmay and 2nd beta is 97 on date 22 may..iwas happy that its working but on the same night 22th mayi do hav some lotts and heavy bleeding at night and on the other morning means on 23th may morning starts clotting again..so what this means…i m afraid..had i lost my baby…….plz reply me..i will appreciate..
thanx…..
This does not sound very good I am afraid.
Go in and see your RE and have a repeat hCG test done.
So sorry!
Geoff Sher
Hello and thank you for answering questions. I had a FET of two 5 day AA and AB embryos on 5/5/12. Beta level on 5/15/12 was 214, on 5/17/12 514. On 5/18/12 felt some r lower abdominal cramping noticed some bleeding that has since stopped. Repeated Beta today 5/19/12 and level dropped to 467. Nurse at RE office states this may be a vanishing twin. Is this possible to still end up with a good outcome considering the considerable drop in the hcg level? Repeating Beta again in 48 hours.
It could be a “vanishing twin”….we will just have to wait and see. If it is such then the next beta (2 days later) should be 900+.
Good luck
Geoff Sher
Hello,
The beta 2 days later rose to 592 on 5/21/12. Any thoughts? I was thinking it should be in the 900+ as well. The Beta on 5/19/12 was drawn in the late afternoon and the one on the 21st was drawn at 7am. So technically, not a full 48 hours later.
Thank you!
Ideally it should have been higher, but perhaps the time difference night account for the shortfall. Repeat in 2 days .
Geoff Sher
Beta today 5/23/12 was 1031. I am not even sure what to think at this point?
Has ultrasound on 5/23/12 it showed a small sac measuring 4mm and 5wks 1 day exactly where we should be at. The also notes small structures within the sac but to early for anything definitive. Will repeat u/s in 1 week. Today had small bleed again. No cramping just a quick bleed.
It sounds OK. Keep me in the loop please.
Geoff Sher
Beta on 5/23/12 was 2314. RE did ultrasound and saw area with a blood clot so that explains the bleeding. Also saw a sac measuring 4mm with a yolk sac within. Go back in 1 week to see if we see a heartbeat. Looks like it may have been a vanishing twin and Beta is now quickly doubling.
This happens much more commonly than most people realize.
Good luck!
Geoff Sher
We are now 8 weeks 4 days. We had an U/S done yesterday and everything looked great. Heart rate of 179 and measuring right on track.
hi i m new here..i m on ivf prog. and my egg retrieval was on 6th may and transfer was on 9th may ..and today is 19th may and had done my lab test today… ya i got my results online and it says borderline and it says-Choriogonadotropin Intact+Beta Subunit A 19 IU/L
Borderline -suggest repeat in 48 hours
IU/L (3rd International Standard)
i dont knw whether its +ve or _ve…….
just worried……
i will appreciate if u reply me sir..
thanx
That is an OK value. Repeat in 48 hours…If it doubles you are on the right track.
Good luck!
Geoff Sher
Hello Dr. Sher,
So thankful for your blogs! I am wondering if you think my initial betas sound promising? I had a donor egg transfer of 2 blastocysts and 8dp5dt my beta was 22. Two days later at 10dp5dt my beta was 33. Do you think this could still be a viable pregnancy? Thank you.
That is a slow rise. However, time will tell. If it does not double in the next 2 days…that would not be good.
Good luck!
Geoff Sher
hi doc..
thanx for your reply…i had ist beta 19..then 2 days after 23 may ,beta was 97, starts clotting and cramps then after one day on 24 may done my other blood test and it becomes beta 103 , bleeding and so much cramps……what it means….
thanx
Where are you getting your CGH-normal banked eggs. I was not aware that this is available anywhere in the U.S.A. Also, unless the eggs were karyotyped using metaphase CGH and NOT array CGH, I would question the reliability of the result. The reason v(in my opinion) is that aCGH cannot be reliably performed on the minute amount of DNA in a single cell….mCGH can!
Geoff Sher
Oops that is a slow rise over a period of 24 hours. It concerns me a bit. Repeat in 2-4 days.
Good luck!
Geoff Sher
Hi, I had my ivf transfer on May 11. The first beta on May 22nd was 15. The doctor said it was most probably ectopic. The second beta on May 24 was 43, and the last one today (May 26) is 143. Do you think that there is a hope in my pregnancy? Or is it ectopic? Thanks
Impossible to say. Give it another 7-10 days then do an ultrasound to determine the viability and location of the pregnancy.
Good luck!
Geoff Sher
hello Doctor…I did my AMH and FSH levels today before starting with IVF cycle. AMH is 1.4 and FSH is 11.13. My age is 31. Do you think there are chances of conception? Thank you for your help!!
Absolutely there are. You have a borderline AMH and a slightly elevated FSH so time is of the essence!
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Agonist/Antagonist Conversion Protocol”
3. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
4. “IVF success: Factors that influence outcome”
5. “A Stepwise Approach to IVF At SIRM” (Posted on March 9th, 2012)
6. Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
You might also consider calling 800-780-7437 or 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
Thank you Doctor. I will sure setup a consultation with you.
Hi Dr. Sher, I did a 5day transfer on 5/21 and I have had absolutely no symptoms other than some mild cramping and a slight headache the first few days after. I am 44. They are my own embryos, frozen when I went thru IVF#1 when I was 32. My first beta is tomorrow. I’m concerned that I have no symptoms save for a couple of dizzy spells this past week.
Symptoms or subjective. Please just be patient.
Good luck!
Geoff Sher
Doctor…in reference to my earlier query with AMH=1.4 and FSH = 11.13, is there a possibility of increasing ovarian reserve with DHEA supplements? If yes, how long does it take to benefit from it?
It does not work . You cannot improve reserve. Besides, in my opinion, DHEA is not good for egg development( Please read elsewhere on this blog on “nutritional supplements in IVF).
Geoff Sher
doctor
i am 34 years old , married from 8 years , i did IVF three times (2007,2009.2012) but it failed ,In your opinion, what should be my next step (my hormons are good)
The information you seek can be found on this blog. Please go to http://www.IVFauthority.com and when you get to the home page find the “search bar” in the right hand column. Type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
1. “Unexplained IVF failure”
2. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
3. “Agonist/Antagonist Conversion Protocol”
4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “IVF success: Factors that influence outcome”
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7. “A personalized, stepwise approach to IVF at SIRM” (posted March,9th, 2012)
You might also consider calling 800-780-7437 or 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
Doctor Sher….how fast are the reserves depleted? Do i have just a couple of months before I would loose a chance of bearing a child or can I wait for a few months before I got for IVF?
Hi Dr.Sher:
I am 37 y old, I have history of miscarriage and ectopic pregnancy.
An just done with my first IVF cycle , transfer of 3rd day post fertilization two embryos of good quality resulted in hcg of 17 on day 11 post transfer, the doctor told me that this low. I read a lot of published papers about the predictive value of hcg and most of them proved that low hcg means bad out come and I was very sad. Two days later the hcg was 34 and 4 days later it was 350, I started to have a hope when I read ur answers to the other ladies. 4 days after that my level raised only to 700, my doctor is not optimistic and she think I have to do a procedure to check the location of the pregnancy.
I am very sad and I don’t know what to do, do u think there is still hope. It’s the same story of my first miscarriage , do u think I need more evaluation.
Thanks
That is somewhat discouraging. You will have to wait it out for a definitive answer.
Good luck and G-d bless!
Geoff Sher
Two days later it’s 1150 then after two days hcg is 1550 and the ultrasound showed intrauterine gestational sac that is 8 mm , am so sad and confused
I don’t understand. How far along are you and precisely what did the US show?
Geoff Sher
I am 6 wks and 2 days, the u/s showed gestational sac that is 8 mm in diameter with tiny shadow that the technician is not sure about but it could be the embryo. Nothing else. The doctor wants to repeat it next wk. I don’t know if this can lead to normal pregnancy or I have to be ready to miscarriage ?
Hi Dr. Sher,
We really need your advice. We’ve been dealing with infertility for 5+ years and have done many IVF cycles. It wasn’t until cycle #7 that the doctors realized I had a chromosomal imbalance. So we just did a frozen cycle using a donor egg. We were thrilled to recieve a BFP, but my beta has been quite low.
The first beta was 31 – 9 days after transfer
The second beta was 73.5 – 11 days after transfer
The third beta – today was 331 – 18 days after transfer
They also did an ultrasound this morning and saw something that the doctor said could be either fluid or a gestational sac.
We go back in for another ultrasound in a couple of days. Should we prepare ourselves for bad news or is there still hope?
Many thanks in advance for your guidance.
this is a very slow rise but you will have to wait, I am afraid. Any opinion now would be speculation.
Hang in there!
good luck!
Geoff Sher
Sorry my phone decided to undo what i wrote, I ment to say that my first beta was 76. I was 11 days post 3 day embryos transfer. And i go back for my 2nd beta tomorrow morning. Is my first beta number to low? I am on progesterone oil injection and progesterone suppositories.
Hi DR SHER this Viv, i just did my 2nd round of ivf and im worried because i have no symptoms. what should i expect when i go for my blood work on Monday? also the first ivf didn’t work. i am so nervous. i did my home test and came back negative. Ivf was done on the 5/June today is 13/June 2 frozen embryos transfer.
Urine testing is much too insensitive to be helpful so early on. I am afraid you will just have to wait this out. Symptoms are subjective too.
Geoff Sher
No! To the contrary, this is encouraging.
Good luck!
Geoff Sher
Thanks Dr. Sher. We have another beta and ultrasound scheduled for tomorrow. In the last day or so, I’ve noticed significantly more hot flashes and nausea. Could this be because I have more progesterone and estrogen in my body or could it be rising hcg levels? Appreciate all your help and guidance.
Let’s wait and see…Hopefully it is a pregnancy effect…A good sign maybe!
Geoff Sher
I am 39 and this was my 2nd attempt at IVF. 6/5/12 5 day transfer with 1 blastocyst and 2 morula. Blood test 8 days post transfer: negative 2. I was advised to discontinue progesterone and estrogen patches. A 2nd test is not scheduled. Was the blood test too soon? After one of your previous posts about a woman that had her test at 12 days post transfer, neg test, inj discontinued, then no period 30 days later and a after a miscarriage, I really would like a 2nd test for reassurance. Please advise your thoughts. Thank you.
Dr. Sher,
I had two 6 day FET on 6/1. My first beta was Monday (6/11) and measured 58. Today, 6/13, I had my second beta at it only measured 61. The doctor is requesting that I continue with my meds and repeat the test on Friday.
It seems fairly hopeless to me that the level did not double. I did not get to talk to the doctor, just got a call from his staff.
Thank you for any input you may have!
You should continue on meds because this slow rise could be due to a “vanishing twin”.
Good luck!
Geoff Sher
Hi Dr. Sher,
To recap:
6/11- beta 58
6/13- beta 61
6/15- beta 114
6/19 2:30am, heavy bleeding and mild cramping, but it has sinced stopped. It’s around 7:30am.
I’ve read so much stuff online, and it seems this could go either way.
Time will tell,yes, but do you have any insight? Anything would be greatly appreciated.
Thank you very much!
Dee
This does not sound encouraging!
So sorry!
Geoff Sher
Hi Dr. Sher,
Just a quick update…good news!
6/11 – beta 58
6/13 – beta 61
6/15 – beta 14
6/19 – 2:30am heavy bleeding, cramping for about an hour. Trailed off to zero over the next couple of hours.
6/19 – beta 502, U/S could actually see one implanted and was still in there!!!
6/21 – beta 981and no more bleeding since Tuesday!
I don’t know what to make of it. My progesterone was low at 19, but possibly I was losing the “vanishing twin”?
In any case, I wanted to let you know how it has progressed since you were kind enough to respond to me.
I won’t do back in for one week now and hope to see a little heartbeat then.
All the best,
Dee
So sorry for the problems you are having, Dee. All you can do now is wait for your next visit for an ultrasound.
Good luck!
Geoff Sher
Whoops, typo!
6/15 – beta 114 (not 14)
Hello Dr. Sher,
I had two natural pregnancy. I recently went for an IVF – on 26/05/12 a 3 days Transfer…. my first beta was done on 08/06/12 was 88.1 and second beta was done on 11/06/12 was 174, the third beta on 14/06/12 was 346….
My ER told it is not as high as they expect it to be… they have asked me to come again for another beta test on 18/06/12… I am really worried and confused… Kindly let me know your opinion.
Thanks alot..
Veron
Only time will tell but yes…although the rise is slowish, there is hope!
Geoff Sher
My hcg at 10dp5dt was below 1.5 on 12th june 2012 . disappointed i couldnt belwive thati am not pregnant despite transferrring 2 grade A best quality embryos.i continued vaginal sticks and other medications.tomorrow once more i will do hcg test in hope of late implanters . Am i right?
NOT VERY ENCOURAGING BUT YOU ARE DOING THE RIGHT THGING.
BE SURE THAT BEFORE YOU TRY AGAIN YOU GET A REASONABLE EXPLANATION FOR WHAT WENT WRONG. GO ELSEWHERE ON THIS BLOG AND READ UP ON “UNEXPLAINED IVF FAILURE.
GEOFF SHER
Hi Dr. Sher –
So we got more beta news today and I would love to hear your thoughts. To recap:
The first beta was 31 – 9 days after transfer
The second beta was 73.5 – 11 days after transfer
The third beta was 331 – 18 days after transfer
The fourth beta – today was 361 – 21 days after transfer
The RE saw a gestational sac during the ultrasound today.
Given that the fourth beta did not rise very much, is all hope lost?
We go in next week for more beta bloodwork and another ultrasound, but the waiting is very tough
Thank you Dr. Sher for your reply…
Regards,
Veron.
Copy! You are welcome!
Geoff Sher
In regards to surrogacy would a surrogate be disqualified to carry again if she previously took blood thinners during a pregnancy with no known history of any blood clotting disorders but secondary to a previous late term loss due to VCI?
Not at all!
Geoff Sher
Hello Dr,
We had 2 high quality FET transfered, 9 days after the transfer, Beta was 59, 2 days later is was 83 – they said cause for concern, now 3 days later it was 100. My wife is devastated. Do you think this pregnancy is viable? Thank you
Sadly, this is discouraging. Repeat the beta in 2-4 days once again, but it really does not look good.
So sorry!
Geoff Sher
My beta HCG was only 4 (negative) 7dp6dt, my clinic told me I need to have another test in a few days, is there really hope that I am pregnant?
Thanks.
Repeat it again in 2 days. If it >doubles, there is indeed a chance.
Geoff Sher
Hi Dr. Sher,
I am 6dp5dt. I have had undocumented chemical pregnancies in the past so my clinic agreed to do a beta for me early when I got a positive HPT. Today, my HCG was 64. The clinic said that this was low, and that they usually look for a number of 100. I’m wondering if they are putting this in the context of their normal timing (usually 13dp5dt) and forgetting how early I am testing, or if my number is really low.
Also, are the chances of a chemical reduced at all once you reach a certain level of HCG?
Thanks!
Nicole
This hCG value taken in isolation does not mean that much. What is much more important is whether it doubles in 48 hours. Thus, repeat the test in 2 days. If the level doubles (or more), I would not be over concerned. In 2 weeks, do an ultrasound for confirmation of a viable pregnancy.
Geoff Sher
i just find out that im not pregnant my blood work just came back negative and my home test came back faint pink line for last 4 days. i don’t know what to think right now. can you help DR SHER? what is wrong with me? why this don’t work for me?
hi, this is my 5 th IVF. 2 blastocyst 5 days, and 9 days later I fid the beta HCG test, (two days ago, it was 55,99. I repeated it today and it was negative < 2. is it possible, may I have to repeat once more or it's over?
It does not look good, I am afraid. Repeat the test again 2 days later and see,.
Good luck!
Geoff Sher
Dr. Sher
I had ET on 14th day of LMP. 10 days later (i.e. on 26th day of LMP) had first bHCG test it was 45, then on 28th day it was 91, it was positive. On 32th day i had some pain in lower abdomen and pinkish/brownish discharge. We checked bHCG the next day it was 278. Our doctor says its worrisome if the level do not rise. Is it a pending M/C or ectopic pregnancy. Please advice, we are worried
Thanks,
Anne
I wish I could tell you what you want to hear, but alas I cannot.
Only time will tell. Try and be patient.
Geoff Sher
I had fresh donor day 3 embryo transfer on 06/16. I’m on this medication, progynova(estrogen) 2mg/3 times a day, Crinone once a day, Susten(prometrium 400 mg) twice/day, folgard, baby aspirin.
I had blood test on 06/19 and E2-1300 and Progestrone-26. DO you think medication and hormone levels looks adequate?
It looks OK…good luck!
Geoff Sher
Quite adequate.
Geoff Sher
I’m also taking sidenafil citrate (caverta)suppositories 50 mg twice for 7 days.
I’m also taking sidenafil citrate (caverta)suppositories 50 mg twice for 7 days. Do you think I should stop it after embryo transfer, will it be harmful now.
Dear Dr Sheer,
I had my beta done today and its below 5, I transfered a grade A blast 14 days ago using donor egg (age 27). I had two fresh embryos also failed, I have nothing wrong as my doctor said but its the embryo’s genetics, any other idea or advice or comment please about what is going on with me? I fell very bad..
I had follow up blood test,
Day 3 Embryo transfer -06/16
06/19 – E2-1393, Progestrone-26
06/22- E2-1245, Progestron-20.
I’m on same medication, Do I need to be concerned with the drop in E2 and progestrone levels? Thanks you so much for reply, you are such a great help.
Hi, Dr. I wrote a post before when i was 11 days post 3 day embryo transfer. My beta was 76. It did double up on day 13 dpo 3 day embryo transfer. My embryo transfer was may 30th. Today is june 23rd. That should be 24 days post 3 day embryo transfer. I went for an ultrasound and there Was a visible Sac but no fetal pole, is this bad news for me?? I have to go for another transvaginal ultrasound on June 26th. I am scared and worried that i will never see a fetal pole. I haven’t stopped crying. The doctor said i should be 5 weeks and 6 days. Can he be wrong. I never get my period every month and i usually don’t ovulate normally. I had stage 4 endometriosis. Please give me some hope. This will be my first time having a baby.
Try hand in there. It could be a little early to draw definitive conclusions. In a week from now you will know for sure.
My heart goes out to you but be strong!
G-d bless!
Geoff Sher
Hello Dr Sher,
How about my question? can I ask for a reply? I am really concern..
Thank you very much for all your help
SarahA
I had follow up blood test,
Day 3 Embryo transfer -06/16
06/19 – E2-1393, Progestrone-26
06/22- E2-1245, Progestron-20.
06/25 – E2-740, Progestrone-12.5 and BHCG Negative
I’m on same medication, Do I need to be concerned with the drop in E2 and progestrone levels? and is it too early for hcg. Thanks you so much for reply, you are such a great help.
This does not seem abnormal. Hang in there and see what the beta’s are about 12 and 14 days post-ET.
Good luck!
Geoff Sher
Hi Doc Sher,
My wife went through IVF, here are the info.;
Harvest: June 1
Transfer (2 blastocysts) : June 6
HCG levels;
June 17: 7.77
June 20: 13.11
June 23: 26.48
June 26: 42.99
What is the meaning of these numbers? I know the are low.
Between the 3rd and 4th (HCG 26.48 & HCG 42.99), value on 4th did not double. Is it normal? Is it just following the graph on this
web site? http://www.babymed.com/tools/hcg-calculator
Thanks,
-Ron
Dear Geoff Sher
Hoping you can offer some advice, we had two 5 day blasts put back (one not yet at blast stage) previously had a miscarriage, then ruptured ectopic, now on 2nd ivf
We got a negative test at day 10 past transfer, then positive HPT on 12 th day
Had beta at day 10 and it was 26
Beta then at day 12 was 149
Is this normal? The clinic said it was low.
What do you think?
Thank you in advance
This is a great rise in beta hCG. Good luck and G-d bless!
Geoff Sher
*Sorry made a mistake in the beta days, hope it does not change anything?
Dear Geoff Sher
Hoping you can offer some advice, we had two 5 day blasts put back (one not yet at blast stage) previously had a miscarriage, then ruptured ectopic, now on 2nd ivf
We got a negative test at day 10 past transfer, then positive HPT on 12 th day
Had beta at day 12 and it was 26
Beta then at day 14 was 149
Is this normal? The clinic said it was low.
What do you think?
Also, Is there any risk in having to much progesterone? Our clinic want to stop it at 6 weeks and they said the implantation creates it, everything I have read says 12 weeks though.
Thank you in advance and sorry for the mistake, look forward to your reply
The beta rise looks good, and I doubt that prolonging or even increasing progesterone administration would be harmful in any way.
Geoff Sher
Dear Dr Scher
i got this result today 10 days after transfer first ivf, amh was good in nov , am 42 and partner had vasectomy so we decided ivf , my first attempt at pregnancy, had 17 eggs frozen 2 years ago
The beta was 4.
Very low positive.
Best to repeat on Friday 48 hours later.
should i not expect a pregnancy ? if we do next round would you advise we try the frozen eggs rather than a fresh ivf cycle , partner sperm biopsied and frozen
This is not a very good level, but repeat the beta in 2 days and we will see what happens.
I honestly do not think with that many eggs that you should give up on using your own eggs.
I do suggest that you call 800-780-7437 and set up a phone consultation with me so we can talk.
Good luck!
Geoff Sher
I am carrying as a surrogate. We transferred 2 5-day blast on the 19th. Had first beta test today, 9 days post transfer. Hcg at 209. Good chance both little sugars implanted?
Very possibly so!
Good luck!
Geoff Sher
Dear Dr. Sher, It is really very nice of you to answer questions of so many people.
I am hoping to get some advice from you.
I am 31 years old and suffering with endometriosis. I had surgery for my right ovary to have the endo removed, at which time I didnot have any problem with my left ovary. But, after the surgery my left ovary also started to develop endo. It is now about 7 cm. I had IVF in May. We did a 5-day transfer of two good embryos. My first beta was 23, after 3 days it was 56, and 3 days later it was 170. When I went in for my 6 week ultrasound, the RE could not find any sac and determined it as chemical pregnancy. The hcg level also dropped down to 4.5.
My question is, did my endo interfere with the development of embryo. If I plan on doing another IVF, would it help to first do a surgery for the endo and then try IVF.
When would it be a good time for me to go with another IVF. Would it even help to try another round.
Should I undergo any testing to identify what might have gone wrong the first time.
What can I do to have a successful IVF next time, will treatments like acupuncture help me.
Please read elsewhere in this blog on “Immunologic Implantation dysfunction and on Endometriosis and immunologic implantation issues. The reason is that in 1/3 of endometriosis cases, regardless of severity, there is just such a problem which either prevents implantation altogether or gets it off to a poor start, leading to a chemical pregnancy or miscarriage. Failure to address this issue (should it exist) will prevent a successful outcome.
Also, an endometriotic cyst (endometrioma) can compromise egg development in the affected ovary. Please read up on this also, elsewhere on this blog.
Feel free to call 800-780-7437 if you would like to discuss your situation with me by phone or video conference. If you live in the U.SW.A or Canada there is no cost for this consultation.
Geoff Sher
It is indeed very possible that the endometriomas interfered with egg development and embryo quality. Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Endometriosis and IVF”
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
You might consider calling 800-780-7437 or 702-699-7437 to set up a web-based video conference or a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
Need advice, please!!!!!!! Had 29 eggs retrieved, 18 inseminated. 11 fertilized. Day 3 transfer with 2 embroyos grade 5, with 8 cells each through PISCI, a step above ISCI. By day six, the remaining 9 fertilized embroyos didn’t make it, so we have none to freeze. My blood test is scheduled for Tuesday, July 10. I’m concerned bc of the 11 fertilized, there were 4 embroyos that were a perfect grade of 5. Two of those were implanted and the other 2 didn’t make it. What are the odds that the 2 in me attached, since the others didn’t?
Any info would be greatly appreciated, ESP since this is our first IVF and we don’t know what To expect.
I understand an appreciate your reasoning and the reason for concern, but with a day 3 transfer it is hard to say…especially since other good looking day 3 embryos never made it toi blastocyst.
You unfortunately will just have to wait and see…but if there is no pregnancy, please remember that in almost all cases, embryos that fail to reach blastocyst are abnormal…thus other than the “convenience factor” it is my opinion that it is hard to see the benefit of doing a day 3 transfer.
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Agonist/Antagonist Conversion Protocol”
“IVF success: Factors that influence outcome”
“A Personalized, Stepwise Approach to IVF At SIRM” (Parts 1 &2 posted in on March, 2012)
Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“Blastocyst transfers”
If this last cycle does not work out for you, consider calling 800-780-7437 or 702-699-7437 to set up a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
Dear Doctor
I had a succesful IVF cycle resulting with a single birth and two frozen 5 day blasts. I had them transferred and my first hcg came back at 4. I am scheduled for a repoeat in a few days. My doc has advised me to continue with medications until told otherwise. She mentioned possible ectopic. I read on different sites that implantation can take upto 4 weeks. Do you think there could be a viable pregnancy?
Could be…just follow his/her advice. It is quite appropriate.
Geoff Sher
Thank you for your quick response,this is a stressful time. I am on progesterone lozenges 3x a day with vag progesterone supp 3x day and estrace 2mg 2x a day. If I am to miscarry, will I bleed if I am on all these hormones? I have not had any spotting, mild cramping hot flashes, sensitivity to tastes and smells like when I had my first baby. I was very fortunate to have had my son via first round if. My husband had a reversal and had developed antibodies.so I am grateful, but these were our last eggs
Dr. Sher,
This is just the site I needed to come across tonight. My husband and I have attempted IVF for the first time. This would be the first pregnancy for both of us. I am due to get my blood drawn for beta tomorrow at 7:45 am. It is 9:00 pm EST. I fel so much better having read some of the comments on this site. Your answers are prompt and straight forward. I can’t find better info. on the internet regarding IVF beta results. Thank you for your time!!! I feel I can go into my appointment tomorrow with a better outlook and with more of a “crutch” to lean on. Now for my question … I went to the Dollar Store today and bought 3 of their pregnancy tests. They were all the same brand. I tested using all three, and all three came out -. Tonight, I am 11 days passed a 3 day embryo transfer. What are the chances my beta test will be + tomorrow? I know you mentioned that home pregnancy results show up + when the blood hcg level is > 20. Could it be that my blood level is < 20 and the Dollar Store HPT just didn't detect my HCG? I would kindly appreciate your comment, as I am trying to remain hopeful, yet realistic throughout the night.
HPT’s are notoriously insensitive. I would say that if it is still negative by Monday, that would not be good. However, a blood test is advised.
Good luck and thanks for the kind remarks.
Geoff Sher
Dear Dr. Sher
I’ve just done ICSI cycle, I had the embryo transfer on 25-th of June with 1 morula, today I’m 12-th day post embryo transfer, I did one HPT before two days and one today both of them were negative, my concern is that today I expect my period too, my doctor said that I should repeat the HPT after two days. Please what do you think, I expect your advice, too. Thanks in advance.
The HPT is not very sensitive. I would do a blood test…but your RE is correct, it should be +ve within about 2 days, so yes! Repeat the HPT then.
Good luck!
Geoff Sher
Thank you for such a timely response,what a blessing. I was wondering since I am on all these hormones,could I still bleed while on them? Do you see viable pregancys with such allow first beta?
Sometimes yes!
Geoff Sher
Hello Dr. Sher,
I had my third ivf on June 29 and today I had my blood test which came out negative. Was it to early to test and should I try again in a couple of days?
I think I have implantation problem because everything else looks nice and healthy based on my doctor.
Thanks a lot for your time.
It could be too early. Repeat in 2 days.
If for any reason this cycle does not work out, feel free to call 800-780-7437 or 702-699-7437 to set up a web-based video conference or a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“IVF success: Factors that influence outcome”
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
Good luck!
Geoff Sher
I forgot to mention that June 29 was the first day p5d so today is day 10 after returning the fertilized embryos.
Hi Dr Sher
I am 3wks and 6 days post embryo-transfer. My initial bhcgs were good but I had one done today for “reassurance” as I have had 3 previous chemical pregnancies. My level today was only 5900. For this stage can I still be hopeful of a successful pregnancy? (other tests were 65 on 26 June, 470 on 30th, 1850 on 04 July and the 5900 today on 9th. I am falling apart from the nerves. Can you please give me your opinion?
AS you stated, there is a slowing down of the beta levels. However, with the level where it is, an ultrasound would be able to pick up a sac. I suggest you do this stat and repeat the beta hCG test serially.
Geoff Sher
Dear Dr Sher
Thank you for your kind reply at a time when I was at my wits end and had no-one objective to talk to or ask advice from. I am just posting back today to let you know that my bHCG continued to rise at a less-than-average but steady rate and I have indeed gone on with a successful pregnancy. I am now 28 weeks pregnant with a little girl on the way. I just want to thank you for your quick reply that day. I live half-way across the world from you but I felt your kindness from here. I hope that life is treating you similarly in return. Kind regards…
Hi Kal,
You are surely most welcome.
Congratulations and G-d bless
Please send me a picture when your little girl arrives (sher@sherinstitute.com).
Geoff Sher
Dr Sher,
I had a Fet cycle with2 blastocysts transferred on day 5, on Thursday was positive HCG level at 55. Went back today and hcg levels dropped to 21. Told me more than likely will be biochemical, no spotting or anything. Also took a pregnancy test and it was positive. Any chance I won’t miscarry?
So sorry!
This does not look good!
Geoff Sher
Hello,I will be undergoing frozen embryo transfer on 6th August12 after failed fresh transfer on 2nd June12 .I am on BCP from 19thJune.No other medications for improving lining or for any other improvement are prescribed. wondering if this is standard procedure or i am not given personalised attention? please revert
Different programs have different protocols in this regard. Without much more detailed information on the proposed protocol, I could not comment further.
Good luck!
Geoff Sher
Sir, i will be undergoing FET on 6th august with 3 embryos.I want to send you pics of three embryos for you to see which ones are good. your email id or howto send pics?
Unfortunately, photographs are not adequate. Besides, I cannot intervene between a patient and her treating physician without being requested by that physician to do so.
Good luck!
Geoff Sher
Hello Dr. I had a question. My husband administered the HCG trigger shot for me but he did it in the wrong place. He put it under my venus dimple. He said that he got nervous and just put it there. I wanted to know if this was a problem. I received a diagram from doctor, hubby just made the mistake. Does this mean that the ER will not be able to happen. Will we have to do cycle all over again? I am so devastated but do not want to make the hubby feel bad. Please let me know what you think Thank you for your time.
Dr. Sher,
This site is easing my mind about low beta HCGs. I am now 18 days post-5-day-transfer. At 11 days my beta HCG level was 25.4; it rose to 66.7 by day 13, and to 166 by day 17. I’m nervous that the doubling slowed down over the last 72 hour period. I am scheduled for an u/s in 3 days (I would be 5 weeks, 5 days). Do you think this is too soon? How do these numbers look, in your experience?
Thank you!
It might be too soon for an US. I prefer to do these only when the beta reaches >2000.
Good luck!
Geoff Sher
Hello, I had an Fet on July 2. My first 3 betas were 1101, 2131, and 3275. They were all 2days apart. I’m a worried about the third one. Advice ?
Time for a definitive ultrasound.
Good luck!
Geoff Sher
Hello, I had a FET on July 2. My first three betas were: 1101, 2131, and 3275. They were all done 2 days apart. The last one was lower than my dr. was hoping for so she scheduled me for a US on Monday. What are your thoughts? Is this what you would suggest and are these levels worrisome? Thank you for your time.
By now an ultrasound would be helpful. I suggest you have one done soon.
Geoff Sher
Dr. Sher -
I was 11 dp3dt yesterday and my first beta was 42.6 I have been told that is low and I should be “cautiously optimistic” Is that a low beta in your opinion?
Thank You for your time.
I do not agree. To me that is quite a good number.
Good luck!
I look forward to receiving good news from you!
Geoff Sher
Thank You Dr. Sher. My second beta is tomorrow. My RE has me really worried and my symptoms are coming and going – is that normal?
Symptoms are very subjective, I am afraid.
Good luck!
Geoff Sher
Thank You Dr. Sher…one last question….if I was your patient and my first beta was 42.6, what number would you be comfortable with from the 2nd beta?
Thanks again!
We had a successful IVF due to a male factor with ICS in 2003 in Connecticut and we had a boy who is 8 years old.
June 2003 : 2 Transferred negative pregnancy
Sept 2003: 3 Transferred Positive pregnancy
We wanted to have second child tried IVF in Boston area.
June 27, 2012 Retrieval
July 4, 2012 Transfer ( 2 day- 5 Blast Embryos) ( 1 Early blast Embryo saved)
July 11, 2012 –July 13 Heavy periods with clotting
July 13 –Scheduled HCG-29.5
July 16 –Scheduled HCG-143
July 19 –Scheduled HCG-443
July 21-22 –Light bleeding
July 23 –Scheduled HCG-300-Dr asked us to stop Progesterone supplements and they expect a declining HCG to Zero** The nurses have told us that it chemical or m/c.**
July 26 –HCG and Ultrasound/Dr Consult
I have a heavy bloating ( I look like 3 months Pregnant) from the last HCG trigger shot, I am tired and sleep well ( I have sleep issues). We have convinced ourselves we may not have clinical Pregnancy and want to make sure my health is not impacted by bloating & unexplained bleeding, and wanted if there are chances of Ectopic pregnancy does not happen?
Based on your judgment what our chances or what is really happening? Is my health impacted ? What are the tests to see what is going on?
I urge you to go in and see your MD for an exam, an ultrasound, and a beta hCG. You need to have a diagnosis and avoid a complication such as a possible ectopic, putting you at risk.
Please keep me in the loop.
Geoff Sher
Dear Dr. Sher,
I have a gestational carrier who is helping me during this process. The first IVF transfer was a grade AA, did not take. Transfered 2 an AB and a BB. They had my GC go a day early for her bloodwork which should have been taken today. The HCG level is 7. They are cautiously optimistic – and are having her re-take blood test tomorrow 7.27.12. IVF Clinic indicates to me lowest they have ever seen is a 12 that resulted in a pregnancy – so I think they are trying not to get my hopes up. I just was hoping for some thoughts on the situation to date. Many thanks. Regards, Beth
Dear Dr,
Thanks for your prompt reply. Much appreciated
We went and met our Dr. They did a physical exam and Ultrasound and said that, no over stimulation and miscarriage has happened when bleeding happened 5 days ago ( a day before the lower HCG-300). However, the levels are now at 643. We are confused. Do we need see gynecologist for a second opinion? Can we schedule chat with you( we are in Greater Boston area) ?
You really do not need me. Go in and see a gynecologist in your area, who would be able to advise you appropriately.
Good luck!
Geoff Sher
Hello,
Today 27th July on day13 Estradiol level was 148.00 and Endometrial thickness 7.1mm triple layer .I was taking progynova2mg from 2nd day .Are these levels ok for FET on August 6th or I have to increase dosage?My RE has fix medications for everyone and does not change for individual patients.Please revert as i do not want another BFN this time.
In my opinion the blood E2 should preferably be >500pg/ml and the endometrium >8mm with the ideal thickness being >9mm. I do not know whether at this stage, increasing the Progynova or adding Viagra vaginal suppositories would help. I personally would not do an FET with the lining <8mm.
Good luck!
Geoff Sher
Dear Sir,
My result of fresh transfer on 2nd June of two good quality embryos was BFN and I am going for FET of three remaining embryos on 6th August .Yesterday 27th July on day13 Estradiol level was 148.00 and Endometrial thickness 7.1mm triple layer.Pelvic ultrasound reported 1.7cmX1.0cmX1.4cm hypoechoic mass lesion in fundus posteriorly and retroverted uterus with fibroid.Can we go for FET despite lesion and fibroid?
Indeed you can! The superficial outer fibroid would not affect your chance of having a baby.
Geoff Sher
dear sir, im after frozen 5 days old embyo transfer done 21 july,
first beta – 6 days after – 2,5
second – 7 days after – 5,8
any chances? im repeating beta on monday
dear sir, im after frozen 5 days old embyo transfer done 21 july,
first beta – 6 days after – 2,5
second – 7 days after – 5,8
any chances? im repeating beta on monday
If you are say6ing that y6ou had your 2nd beta 1 day after the 1st, then you are still in the running. If it was 7 days after the 1st beta, then no…this is not a viable pregnancy.
Geoff Sher
it was 1 day after the first beta, 2,4 – 24 hours later 5,8 – 48 hours later 13 – but unfortunatelly next 24 hours later 12,9. :- (((( but Thank you very much for your answer.
If I am understanding this correctly, the beta is still at least doubling every 48 hours. If so, don’t give up quite yet.
Geoff Sher
i thought so… i hope 13 will be my lucky number…., but today, after 48 hours my beta 11,9. Next month next criotransfer, the last one unfortunately… and only one embryo – maybe the lucky one I hope
BTW i’ve got turner mosaic caryotype (22% X0), i know we should have done genetic diagn. of embryos, but turner anathema appeard after we’ve done fresh cycle. Do you think i still have a chance for normal, healthy baby? with this awful diagnosis? with regards Maria
Indeed you could have a chance but you will need to be on a very individualized, aggressive and strategic ovarian stimulation protocol and IVF treatment would of necessity have to include include PGD.
Give us a call at 800-780-7437 so we can discuss.
Geoff Sher
thats great idea, i will call you for sure but im from Poland i need your number with detailed telephone code you know the full direction number.
BTW im also a doctor (anaesthesia&intensive care), i hope i’ll be able to understand!! Greetings from Poland
P. S please give me your localisation so i could check time zone
To call the Las Vegas Sher Institute office from Poland, dial 0-1-702-892-9696
Hi,
I had a ivf 3 day transfer on July 13th then took hpt on the 22nd it showed positive and then went for my blood test on the 27th and it showed postive but the nurse told me to come back today for another test which i did and now is telling me to go back for another test two days from now, to keep using the progestarone and that we are gonna go from there…
What does this mean? Is there a chance im having a chemical pregnancy or is this all part of thr process?
Thanks!!
Sounds like part of the process.
Good luck!
Geoff Sher
Dr. I had embryo transfer on july 25, 2012. The embryo’s were 5 days old and was in a blastocyte stage. July 30- I had spotting which was red blood. The doctor did blood work and my progesterone level was 6.1. Is the progesterone level within normal limits for me on a 5 day post transfer? can my pregnancy be still viable? they also checked my hcg and said it was <2. I know its too early. Any advice? I am on progesterone suppositories.
I wish I could be reassuring but it is too early to tell and you will have to wait it out. Indeed,the progesterone level is lowish. Discuss with your RE.
G-d bless and good luck.
Geoff Sher
Dr Sher, I am on my day 5 of the stimulation cycle and a poor responder to injections. On day 5 it shows just 3 follices. My doc is suggesting that I convert this to an IUI cycle. Is there a chance that I could still produce more follicles in a couple of days to come? Shall I go with IUI with injectibles? My AMH was 1.14 and FSH 11.13 before the cycle.
It is probably unlikely that you will produce more follicles through an adjusted dosage of gonadotropins. However, with an AMH of 1.14, a day 3 FSH of 11.13 and only 3 follicles, you clearly have diminishing ovarian reserve. Age would also have an impact, especially if you are in your late 30′s or above.
In my opinion, given the above information, there could be a window in which, given the appropriate aggressive stimulation with an individualized protocol of ovarian stimulation (see below) you could respond better for IVF, but time is certainly a factor.
You might consider calling 800-780-7437 or 702-699-7437 to set up a web-based video conference or a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Most importantly, please go to http://www.IVFauthority.com and when you get to the home page find the “search bar” in the right hand column. Type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Agonist/Antagonist Conversion Protocol”
“IVF success: Factors that influence outcome”
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“Staggered IVF”
“Egg Donation”
“Embryo Banking”
Regards!
Geoff Sher
hi i have been vomiting and having pregnancy symptoms and have had faint positive home pregnancy test but when i went to the ER they said i wasnt pregnant and that my HCG levels were only 5 ml and the transvaginal ultrasound said endo thick what does this mean and could i be pregnant im confused. thanks in advance.
So hard to tell. Repeat the beta hCG in 2 days and then reassess.
Good luck!
Geoff Sher
dr sher…i had 4 blastocysts transferred on 18th july,,was a frozez transfer,,,had beta hcg at 28th july as 404.9 and at 30th july was 996.0….ma scan is due on 11 august…should i get a third beta hcg done? help me out plz
I just did my second round of IVF as a surrogate. The first time the embryo did not take and this time we have 9 home pregnancy test that are positive as well as a positive blood test. We went in a day early to do the first blood test and the level was a 7, the next test was a 17, then a 60 and now back down to 16. Is there any other possibility that my levels could go back up. We implanted two frozen embryos. Could that have something to do with it. I have had symptoms of pregnancy with no signs of bleeding or anything.
my level on fridays test went back up to 21. is there any way it could still be a pregnancy
I am afraid…only time will tell!
Keep me in the loop please!
Geoff Sher
Hi dr. Sher. I had a 3 day transfer on July 13 – 2 embryos 4+ iand 3+ 8 celled.
I was given supplements of hcg 2500 last one on July 19. My beta was tested on tues July 31 – it was 1170. I had it rechecked After 48 hrs and it’s 1730 today. I was told to come on Monday for a third. What do you think? Thanks!!
Great site! I have heard mixed reviews about my initial beta. Some say it is fine but my research indicates that most women who started with a low beta like this might have had doubling betas but not a successful pregnancy. Any thoughts?
11dp5dt- 64
13dp5dt- 133
Do you think it is too low?
Looks good to me…Good luck!
Geoff Sher
Hi Dr. Sher,
I had my first IVF cycle in July with a 5 day transfer on July 19. Beta hcg done on July 31 was 50.4 and then 48 hours later was 78. What do you think? Could I just have slow growers or is an ectopic pregnancy likely? Thanks so much for your advice!! This is so scary!
Could be either, but the greater likelihood is that this is a chemical pregnancy.
Sorry!
Geoff Sher
dr sher…i had 4 blastocysts transferred on 18th july,,was a frozen transfer,,,had beta hcg at 28th july as 404.9 and at 30th july was 996.0….ma scan is due on 11 august…should i get a third beta hcg done? help me out plz
Hello Dr Sher,
I am 49 years old and had 2 good quality eggs transfered after 3 days. I am ow on day 10 since transer and my Beta HCG level is 5, is that bad news for me? I am going back in 4 dats for another HCG Beta test!
It is on the low side, but with own eggs at 49, the chance of success is VERY low .
Geoff Sher
Oh forgot to say they were my own eggs not Donor!
Copy!
Geoff Sher
hi dr sher!
i had an embryo transfer last july 24, and last 3 days ago got a pregnancy test at home and its positive- but today i had beta HCG and its 12.0- does it mean that im not pregant? and if i am pregnant why is it so low ( thsi is my 2nd time but got miscarriage after 5 weeks of being pregnant)
thank you so much- please acknowledge
Depending on how many embryos were transferred it could be more than one baby.
Good luck!
Geoff Sher
Dr. Sher,
Is there anything to worry about if a beta doubles very rapidly?
7/30 – 9dp5dt or 14dpo beta – 220
8/1 – 11dp5dt or 16dpo beta – 891
db time of 23.79 hrs.
I have a repeat beta scheduled for 8/8. It looks like multiples to me, which is great, however I worry that even then it is increasing very rapidly. My RE has added progesterone suppositories to my current P4 injections. I assume they think it’s just multiples too…???
Thanks in advance,
Kristina
My wife had two 3-day old embryos (from a donor) transfered 13 days ago. This afternoon her HCG was measured at 4803 MIU/ML. During an ultrasoung this morning, the OBG did not detect the babies. Our IVF doctor had told us to wait two weeks after the first HCG (We only went to the OBG so that my wife could get another prescription for progesterone). The OBG sounded alarmed about a possible ectopic pregnancy just because she could not see any baby in today’s U/S and the high HCG. My wife is not taking any HCG medications. Should we be concerned?
What difference a day and another U/S machine make. We went today for another U/S and the pair of sacks was visible! Such a relief!
Congratulations and G-d bless!
Geoff Sher
I am a little concerned at your having no visible intrauterine conceptus at that high of a beta hCG. I am sure your MD will keep close tabs.
Keep us in the loop please.
Geoff Sher
My wife had a Embryo transfer on 27th jul, doctor trasfered 3 embryos. We did the first BHCG on 11th day after ET and it was 10.55 we did the second test on 13th day and it was same 10.55. doctor has asked to do one more BHCG. can you please tell us what can be the reason the BHCG was same for both days. and should we go for another BHCG.
This sounds as if it is a chemical pregnancy…so sorry!
Geoff Sher
Hello Dr. Sher
So glad to see you are helping us. Please help me with you advise.
Had an failed IVF in Feb. Second IVF in July, transfered 2 great embryo 3 days, my beta levels are:
first beta 31.07.2012 – (12 days post transfer) 5.1
second beta 04.08.2012 – 38.3
third beta 08.08.2012 – 96.2
Next beta on sat. I know they are very low, but still rising, what is happening, I am pregnant?
Doctor says it might be late implant but…not convinced.
Please tell me do I have a chance?
Thank you
Lilly
Forget to tell you, I am 26 y old, 2 years TTC, nothing is wrong with me and my husband, seem to be perfect but unexplained infertility.
Thanks in advance
Lilly
This could be a chemical pregnancy.Be sure to exclude an implantation issue (possibly immunologic) and do not let anyone tell you to ignore this because if it is a problem, this could recur over and over.
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in ” Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
Then consider calling 800-780-7437 or 702-699-7437 to set up a web-based video conference or a telephone consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.
Geoff Sher
Dear Dr. Sher
By chemical pregnancy do you mean I never had a baby inside me?
I wrote about Immunologic Implantation Dysfunction, but in my both cycles, I take an intralipid before the embryo transfer. Doctor said that I should get pregnant naturally with such a perfect embryos, but sometimes they look good but are not good by inside. This could be solved with PGD. I live in Kosova, we do not have such an advance technology to do PGD here.
Do you think if I go outside my country and take IVF with PGD, it will work for me?
I think I have implantation problems, but what can I do, once my dr. told me that I should wait until my uterus accept by itself the embryo, couse it is not ready yet. I am not ready to be a mother. I dont understand…I am the only one in my family that have infertility issues, everybody in my family have children so its all about me.
I am so desperate I will never have a baby.
Please let me know if I ever have a change te have a baby.
Thank you very much
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“IVF success: Factors that influence outcome”
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“Staggered IVF”
“Embryo Banking”
I suggest that you call my office at 702-699-7437 to set up a web-based video conference or a telephone consultation with me so we might discuss your case in detail.
Geoff Sher
Hello Dr. Sher,
I had two embryos transferred on 7/23/12 (ICSI, one was an 8 cell, 20 fragmentation – the other one was 5 cell not very good quality). The day 14th test showed an HCG level of 47.5, 2 days after it was 77 only. I had a D&C in April: I had an empty sac due to trisomy 16, and now I am very worried because the levels are lower than they should be (the IVF nurse told me it should be closer to 100 at this point). Do you think the lower HCG levels show that we might have a problem again?
Thank you so much!
Hi Hanna,
I am afraid that this does not look good. However, do not throw in the towel until you get another beta done 2 days later and it fails to rise appropriately.
I may be able to help you down the line. Call 800-780-7437 if you wish to consult.
Geoff Sher
Dear Dr Sher
I did my beta today (remeber I told you on sat) and the results are 307… Is there a chance I am pregnant real pregnant not just chemical?
Sorry for disturbing you, thank you for helping me
Regards
Lilly
Indeed it is…So repeat the beta in 2 days and if it doubles this increases the likelihood that you have an implanting pregnancy.
Geoff Sher
Dr Sher,
I am 31 years old. I already did 2 IVF cycles, both ended in chemical pregnancies. In both we transferred 2 perfect 5 day blasts. Does this increase my risk for future chemical pregnancies? Or is it just a matter of finding the right embryo?
It could well…because the reason for the chemical pregnancies you had, could well be due to an implantation dysfunction (possibly immunologic), in which case it could be recurrent until that problem is addressed. Please go to http://www.IVFauthority.com and when you get to the home page find the “search bar” in the right hand column. Type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“IVF success: Factors that influence outcome”
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
Consider calling 800-780-7437 or 702-699-7437 to set up a web-based video conference or Skype, consultation with me (which is free if you reside in the U.S.A or in Canada) to discuss your case in detail.
Geoff Sher
Hi Dr. Sher,
I’m pregnant after IVF (transferred 2 5 day blasts grades AA and AB). Betas were 539 12dpt, and 1142 15dpt). I was told to schedule two OB Scans–one for tomorow, when I will be 5.1 weeks pregnant, and one for next week, when I’ll be 6.2 weeks.
Can I expect to see anything tomorrow? Is it too early to even see a fetal pole or heartbeat?
Also, we’re hoping for a singleton, what are the chances of that? Could this be a very eager early implanter?
My history-37, male factor infertility, one daughter after first IVF at 35, one failed IVF at 36, one MC last March after FET, this is a fresh cycle, Chronic Urticaria.
Thanks for your thoughts!
In my opinion, doing an US before 7 weeks is not optimal as early US exams can be misleading and result in unwarranted stress. With the information at hand, it is hard to say if it is single or multiple.
Good luck!
Geoff Sher
I had two frozen embryo’s transferred on July 31st. I went for my beta test on August 9th, my number was at 9.71, I took it again on the 11th and it went to 25, I took another on on the 13th and it was at 110, do you think this is going to be a pregnancy or chemical? I go for a ultrasound on 18th to see if there is a gestational sac, just would like to know your thoughts. Thank you for your time
It looks OK to me.
good luck!
Geoff Sher
Hi Dr. Sher,
My wife has been really stressed about her betas and our most recent ultrasound and we were looking for some guidance. She did a frozen transfer of 2 embryos after 5 days and her beta 11 days after the transfer was 64, 13 days- 133, 16 days-358, 18 days- 713 and 20 days- 1296. The numbers have essentially doubled at a rate of 45 to 55 hours since the initial beta and she should have been 6 weeks and 1 day at yesterday’s ultrasound. However, the doctor told us based on the beta results that he thought the embryo may have implanted late and was probably only 5 1/2 weeks. On Friday we saw a gestational sac and possibly the beginning of a yolk sac and yesterday (3 days later) we saw a gestational sac and a clearly visible yolk sac. The doctor said everything looked great and told us to come back in one week to see the heartbeat. Is it really possible we are only 5 1/2 weeks? Thanks Max.
The US exam so early on is often not that accurate/reliable. Try and be patient. Repeat the US in 1 week and that should be more indicative.
My gut feeling is that it will probably turn out fine.
Good luck!
Geoff Sher
Hi Dr Sher,
I have just come into the 5th week of pregnancy. I did a B-HCG on 11th Aug and it came out to be 1913 and then did another on 14th Aug and it came out to be 4424. Doctor did an US on 14th but could just see a sac. Doctor mentioned that the B-HCG levels are not doubling in 48 hours and there could be a problem. Please advise Doctor.
Thanks
Shailly
It is too early to get a definitive confirmation of a viable conceptus in the 5th-6th week. Repeat the US in about 10 days.
Good luck!
Geoff Sher
Dr. Sher,
I had IVF on July 31 with a 5 day DE. On 8/10 tested positive, hcg was 24, 8/13 was 59 and 8/16 is was 121. Today received a call saying hcg 114 and to stop all meds. Is there a chance for success?
It looks very much like a chemical pregnancy, I am afraid.
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“IVF success: Factors that influence outcome”
You might consider calling 800-780-7437 or 702-699-7437 to arrange a video conference (or Skype) consultation (free of charge to those who reside in the United States or Canada). If need be, someone from SIRM-Patient Relations can contact you in advance of the consultation and assist you in setting this up through your computer. Such audiovisual interaction it is much more personable than a discussion by telephone. However, if you prefer the latter, this too can be arranged.
Geoff Sher
I appreciate your response and what you are doing for us out there. This is the most frustrating thing my husband and I have ever gone through. I think I will schedule a consultation. Thank you!
I look forward to to talking with you Cindy!
G-d bless!
Geoff Sher
Dr Sher,
My betas are as follows:
10dp5dt: 76
12dp5dt: 154
17dp5dt: 845
My nurse told me they would have like to see the numbers rise a little faster but to be cautiously optimistic until the ultrasound which is 8/23/12. What are your thoughts on these numbers. Do you think I should be really worried?
I’m sorry, let me correct the last beta. That was at 18dp5dt, not 17dp.
Thanks!
See below
They look good to me!
Good luck!
Geoff Sher
Dr. Sher thank you so much for all the help you have given to all of us women going throught this, one last thing, my numbers are at 3013 and I am at 6 weeks, they see a gestational sac but no yolk my doctor has recommended a d&c, I go back for one last scan on 8/26/12 I did start out with a low number at 9.71 but they kept doubling until this point they went from 2000 to 3013. I just want to make sure the d&c is the best thing to do at this point.
Thank you so much once again!
Dr Sher,
I recently had two embryo’s transferred and tested positive. However my HCG levels have fluctuated and the clinic have voiced their concern that it could be ectopic. HCG Levels are as follows:
Day 16 – 174
Day 18 – 185
Day 20 – 321
Also, my progesterone levels on ‘Day 16′ were quite low at 34 but on Wednesday had increased significantly to 180.
Do I have cause for concern ?
Thanks in advance
Caroline
This concerns me. You will have to repeat the beta in 4 days to see if it quadruples.
Good luck!
Geoff Sher
Dr Sher – thank you for your response and I have further update with my numbers
Day 24 – 521
Also, my progesterone levels have dropped from 180 to 134, I am due to see the doctor to review and decide how we move forward. I admit I fear the worst – please can you provide me some insight into your. Once ensure and what this means.
Many thanks
Caroline
Hi Caroline,
This does not look good, I am afraid!
Geoff Sher
Hi, I had my first beta of 548, 15dpo3dt, just had my 2nd beta today (2days later), and it was 850-something, can’t now recall exact number she gave me but it was around that. Because did not double, nurse said I need to have beta again in 2days. Do you think these numbers are ok and this is just precautionary? Really feeling nervous. Any medical advice/input would be so appreciated.
Answered before!
Geoff Sher
Hi, Tina again, First beta of 548 was 15 days past the 3 day transfer. (I think I put it wrong in first message). We transferred 3 embryos (was told only that they were a 5, 6 and 9 cell). The 2nd beta was 48 hours later and around 850…can’t recall if she said 830 somethig or 860 something now, I am freaking out. same question as first message.
Thanks so much!
Same answer!
Geoff Sher
sorry, Tina again, called nurse for my 2nd beta and it was 874. So first was 548 and 48 hours later was 874. Is this good or bad?
Thanks for any input.
That is a slow rise. Repeat again in 48 hours to see if it doubles.
Geoff Sher
Pls dr, i am 36yrs and my period comes regularly every month, i last saw my period on 26th of July and i underwent ivf treatment, my 18eggs was retieved on 14th of August, fertilized and transferred 3eggs with 8 cells. Three frosen. i started bleeding on the 25th and it ends on 28th of August. and was asked to do my HCG test on 31sth and idid it at home with one step urine HCG pregnancy test and it read negative.if i go to the hospital for blood test, is it going to be positive?pls help me with an answer. Thanks.
The urine test is very insensitive. You need to do 2 blood tests 48h apart. It should double if you are on your way to a viable pregnancy.
Geoff Sher
I’m pregnant 26+ weeks by early scan due to late concieve. My Ultrasound Scan report as follows:
BPD: 6.6 cm
Femoral Length: 4.5cm
Abdoinal Circumference: 21.6cm
Based on Measurement: 26 weeks
Amount of liquor adequate
Placenta anterior, upper segement, Grade I
And Test of my Blood are as follows:
Haemoglobin: 8.7 G/dl
I also have a problem in my Thyroid and I’m taking 2 tablets Thyroxin/day. And also using following medicne and milk powder as per my Dr.
Foreva 1/day
CalciLock-D 1/ Day
Prignovate 1/day
Mamilac Milk 2glass/day
CAC1000 1/day
My Dr. saying that there is no problem only just Thyroid problem is a measure complication in my pregnancy.
My step by step TSH level before pregnancy and after pregnancy are:
Before Pregnancy:
06/05/2011 TSH result is 33.75
After taking 1/day thyroxin tablete the result is
17/06/2011 7.28
They did test after a month on 05/07/2011 and result was 7.34. After advise by Dr. I was starting taking thyroxin tabletes 1 and half/day and result on 10/09/2011 test was TSH 1.19.
In January 2012 I usualy not regular taking Thyroxin tablete and after confirmation of my pregnancy test result positive Dr. saying to test for TSH and result was 7.64 Dr. asked about the tablet and I confirmed her that not taking regular basis. Then Dr. advise to take this tablet regular basis and now I’m taking from 18/2/2012 thyroxin tablets 2/day. But after 26+ weeks of pregnancy there is no test taking from the Dr. about TSH.
Please advise what to do. Because today I’m visiting your website and really impress to see that you are providing such a good services for new MOM. Thanks in advance.
Regards,
Maria
And my weight in 26 weeks pregnancy is 57KG
Hi maria,
This is something you need to discuss with your OB or with a perinatologist! It is not in the scope of Fertility!
Geoff Sher
Hi Dr. Sher,
I did get the third beta, so my numbers (every 48hrs) have been:
548, 874, 1272. I also had a transvaginal ultrasound today (3 days after the 1272 beta number), and does not appear ectopic, small gestational sac noted, but not sure about yolk sac, etc. Is it too early for that? (I had my egg retrieval on 8/10). I also had a beta this morning too, so waiting on those 4th results. Do you think the slow rise could be vanishing twin type of thing? I did have 3 embryos transferred. Thank you so much for any input.
Looks encouraging. You are still early on. Give it a week and repeat the US.
Good luck!
Geoff Sher
Ok, I just got my 4th beta: (three days after the 1272)
The number is 3312.
I am going for next ultrasound on Tues 11th and hoping to see something!
What do you think of this 4th beta rise?
Time has come for an ultrasound exam. It should be definitive by now.
Good Luck!
Geoff Sher
I had a FET with 3 perfect embryos. My 1st IVF was a fresh cycle with 2 perfect embryos and resulted in no pregnancy. This time with the FET, it resulted in a pregnancy that started out great. Today would make me 5 weeks, but i fear i’m going thru a miscarriage right now. I can’t get my Dr. to give me any answers and was hoping you could help. My 1st Beta, 9 days after a 5 day, was 74. The 2nd one done 2 days later was 199. That was on Friday. On Saturday night i had cramps like AF was starting and began to spot. I have been spotting ever since and they kept telling me it’s normal and not to worry. I had HCG #3 yesterday on 9*4(4 days after the last one) and my # was bad at 316. She said it wasn’t good but my progesterone and estrogen were perfect–does that even matter at this point? Doesn’t this mean i’m losing the baby? She seemed to think i had a chance and it doesn’t appear to be. I’m still spotting today. 1st day of spotting was pink with 1 dot of red and it has been brown ever since.
Indeed this is concerning but all is not lost. It could be a vanishing 2nd twin. As long as you are not having heavy bleeding and the cramping does not escalate, you might still be OK. Get another beta 2 days after the last one. It shoukld be >650.
Good luck!
Geoff Sher
Hi DrSher!
I was instructed to use Prednisolon 20 mg/day before my next IVF. Unfortunately, I have started the steroid earlier . I’ve been using it for four weeks, and I still have two weeks to the ovarian stuimulation (4 weeks to the embryo punctio). During the ovarian stimulation I will also receive IVIG immuntherapy.
I understand that Prednisolon can cause poor quality of embrios, and high insulin reaction. Should I stop with Prednisolon or can you recommand other alternatives? I am 42, AMH 0,1 and it is my last IVF .
Responded above!
Hello DR.Sher,
We did our 1st ICSI on Sep 6 (3dpt) with Grade II – 2cell embryo and Grade II-III 6cell embryo. Is there any chance of getting pregnant with this values and how soon i can take the beta test.
It is possible but I do not see any values of hCG in your text.
Geoff Sher
Had our test today and it was < 1. BFN. Frustration continues and not sure how to tackle this…..
Why don’t you call 800-780-7437 and set up a free video-conference call with me?
Geoff Sher
Hello Doctor, my wife`s FSH is 6.12 and LH is 1.74. Is this a good sign or she symptoms poor ovarian reserve. Our first icsi has failed and we are looking for the next cycle. We are from india. Pls let us know what to be done to get it positive for the next time. Also whether poor ovarian reserve affect when we do ivf.
These are are not abnormal results that would point to diminished ovarian reserve, provided the concurrently measured E2 was <70pg/ml. I suggest that an AMH be done.
Good luck@!
Geoff Sher
Hi Sherr, i Undergone ICSI embryo transfer on 27aug. First beta result on 10sep (after 14 days) is 37.7. Second hcg level on 14 sep was 108.40. Is that a hopeful positive sign?
It is a very good rise and reason for optimism.
Good luck!
Geoff Sher
First beta result on 10sep (after 14 days) is 37.7.
Second hcg level on 14 sep was 108.40
Third was on 16th sep – 206
Next was scheduled on Sep 22
My doctor is saying the progress is slow. Can you share ur thoughts on this?
I think based on these results it is still quite hopeful.
Good luck!
Geoff Sher
First beta result on 10sep (after 14 days) is 37.7.
Second hcg level on 14 sep was 108.40
Third was on 16th sep – 206
Fourth was on 22nd sep – 1109
doctor advised to come for scan on 26th sep
can u share ur opinion on this?
Looks promising!
Good luck!
Geoff Sher
Dr. Sher,
my wife had frozen embryo transfer of 3day . Her hcg level after 14 days of transfer was 1302.Is this a sign of twins.
Thanks,
Rohit
Could be…hard to tell for sure.
Congratulations and good luck!
Geoff Sher
Dr. Sher,
Thank you for such a great site. We transferred 2 5-day pre-blastocyts on 8/31. We had a positive on 9/7 on a hpt, but then it went away, so we assume a vanishing twin. But then, we got a positive on Monday, much to our surprise, and the betas have gone as follows:
9/10 – 11.3
9/12 – 16.7
9/14 – 30
9/17 – 90
RE was fairly pessimistic with the 16.7, but since it was still positive, she said to keep monitoring. With the 30, she said she was “encouraged.” Seems like with the 90, we have even more reason to hope (that was yesterday and I haven’t spoken to her about it). But then, the numbers are still comparatively low, so we are trying to keep our hope in check. We have reason to think that it was a late implanter due to the hpt’s around the time of the vanishing twin, so we think both of these could factor into our low numbers. Any thoughts? Do you think since we’ve got a good doubling pattern going that we should feel good–or do the low numbers make you concerned? Also, I am older and using donor eggs. I’ve also read that some older women give off less hcg. Thanks.
Of course there is still hope here…but please be sure to have your MD keep a close lookout for an ectopic (tubal) pregnancy at the same time.
Good luck!
Geoff Sher
hi Doc,
My wife had done IVF with 3 two day embryos.
The 14 dpo was 361
and 16 dpo was 985.
Do this hcg values suggest chance of multiples?
Thanks in advance
It is hard to say but yes…it could be a multiple pregnancy on the make.
Good luck!
Geoff Sher
Dear Dr Sher,
I am 36 years have stage IV endometriosis. My AMH was 0.64 FSH 12 at the 5. cycle day. I just had my first IVF with the long protocol.
Punction was on 5.9.2012 (9 cells, 7 fertilised), transfer of 2 embryos (8 cells A, 4 cells B) on 8.9.2012.
My beta hCG on 19.09. 08:20 62 (14 days after punction)
on 21.09. 07:30 90
I have pain in my abdomen in the last 4 days.
The values are low and not really doubling… My theory is the the 4 cells embryo is implanted and if the fertilisation was a bit later these results could be still OK.
Thank you!
Hi Maria,
I am afraid this does not look very promising. It is likely going to be a “chemical pregnancy”. While your age is still young enough for you to be able to propagate good quality eggs/embryos with an optimal protocol of stimulation, your diminishing ovarian reserve (DOR) means that you will not produce many eggs/embryos. That is why I think that , before it is too late, you should be considering aggressive stimulation, with Embryo banking and CGH embryo selection. Please read the articles referred to below in this blog, http://www.IVFauthority.com. Simply go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“IVF success: Factors that influence outcome”
“Staggered IVF”
“Embryo Banking”
You might consider calling 800-780-7437 or 702-699-7437 to arrange a video conference (or Skype) consultation (free of charge to those who reside in the United States or Canada). If need be, someone from SIRM-Patient Relations can contact you in advance of the consultation and assist you in setting this up through your computer. Such audiovisual interaction it is much more personable than a discussion by telephone. However, if you prefer the latter, this too can be arranged.
Geoff Sher
Went through donor IVF, clinic put 2 blastocytes on Sept 12, on Sept 22 got negative blood test, food cravings and tiredness, now slight brown blood spots also taking prednison. What is your opinion?
You are probably going to have a period soon.
Sorry that it does not seem to have worked for you this time.
Geoff Sher
Call 800-780-7437 if you wish to discuss with me.
I had a fet on sept 12. We put in 2 day 6 blast(grade 2). Betas were 8 days post transfer 70, 10 days post 198, and 12 days post 487. Do these beta looks like a strong singe?? or possibly twins? Thanks
Responded to above.
Geoff Sher
thoughts on betas: i had a fet with 2 blast (day 6) on 9/12
beta 1 on 9/20 was 70
beta 2 on 9/22 was 198
beta 3 on 09/24 was 487
do you think it could be twins or is this more likely a singleton. Thanks
Looking good…probably a single conceptus!
Good luck.
Geoff Sher
FET was on 9/6. First beta was on 9/14 and came back at 47. Second beta was 9/17 and was 1.26. I started spotting, but that is all it has been doing since then. I did start on birth control, for my next FET, however ahve not stopped spotting, and have been on BC since 9/22. As this is not normal protocol for how things happen with me, should I at all think to have another beta done?? Its just very werid, and I certainly do not feel pregnant, however, the BC usually stops any bleeding, no cramping.. just confused.
I did not get the 2nd beta. If it was 126, all could be well . If it was 1.26 (as you stated), then that is bad news, I am afraid.
Don’t over stress about the spotting. If the beta is rising properly, it could be OK!
Good luck!
Geoff Sher
Dr Sher, my husband and I are contemplating our options. first IVF attempt on 09/07 slow rise in hcg 17–224–321 (after 4 days) and 700 (after another 4days, D17 post transfer). I am not optimistic. It could be a chemical pregnancy or ectopic. If it is an ectopic , what options do I have? I do not want o be treated with MTX. We would like to have a second child, my first was conceived naturally after 4months of effortless trying. The specialist say this an unexplained secondary infertily although my AMI? is low at 1.2. I am 36. 13 eggs fertilized, 2 transfered. What would you suggest
Disheartened
I really think we should talk after this is over. You might consider calling 800-780-7437 or 702-699-7437 to arrange a video conference (or Skype) consultation (free of charge to those who reside in the United States or Canada). In the interim, might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“IVF success: Factors that influence outcome”
“Ectopic Pregnancy”
Good luck!
Geoff Sher
Thank you. I did read alot of the articles posted. The details on immunologic implantation are difficule to understand even though I am in the medical field. I do understand that every situation is different but had wanted so brief additional input with regards to options. Anyhow, thanks. I will read the articles again.
Good luck. Consider calling to discuss with me.
Geoff Sher
Dr. Sher,
The ET (3-day Embryo) was done on Sep. 12th to my surrogate mother. The 1st Beta-HCG test was done on Sep. 25th, the number is 42.47. However, the 2nd Beta-HCG test result done on sep. 27th dropped down to 27.7. Do you think this is a non-viable pregnancy? The clinic will do the 3rd test soon!
Ping, Sep. 28th, 2012
The 3rd Beta-HCG test has come as 15.6. So it dropped from 42.79 to 27.7 then to 15.6. It’s a failure but what happened?
Answered below!
Geoff Sher
So sorry….It does not look very promising I am afraid.This is likely to be a chemical pregnancy.
When this cycle is over, you might consider calling 800-780-7437 or 702-699-7437 to arrange a video conference (or Skype) consultation (free of charge to those who reside in the United States or Canada). If need be, someone from SIRM-Patient Relations can contact you in advance of the consultation and assist you in setting this up through your computer. Such audiovisual interaction it is much more personable than a discussion by telephone. However, if you prefer the latter, this too can be arranged.
In the interim, Might I recommend I invite you to go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“Gestational Surrogacy”
“IVF success: Factors that influence outcome”
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
Sincerely,
Geoff Sher
Hi Doc,
I have got 3days old 4 embryos transfer on 15th September, 2012. On that day doc told me the embryos were not looking good. I have got my first b-hcg test today(29.09.2012) and the result is 31.31 mIU/ml. My doc says it’s positive but low!! Do I have a chance?
Dear Dr Geoff
I think it is wonderful that you take the time out to help us with our questions.
I AM 42 We are on our 4th IVF Transfer this one is a frozen one they took the last 6 frozen ones to Blast I lost 3 and we transferred 1 x Expanded Blast, 1 x Blast, 1 x 16 cell. This was a natural cycle and I am on pessaries morning and Night. I have excellent egg reserve for some reason at my age. in the last two years I have had 2 failed fresh IVf both cycles Resulting in 8 m/C and a 10 Week Natural pregnancy resulting in M/C. So I get so far and then I loose them.
They keep telling me its my age and I should look at a donor egg. But I struggle with this as I would like my own child.
we already have a 19 year daughter so I can fall and keep a baby, I had a M/C before I fell naturally pregnant with her.
I am fit and healthy we live in Australia.
I make between 12-14 eggs at a time during a fresh cycle.
But just cant past the post.
Would you have any advise for us.
I am currently on the two week wait, I am on day 9 of the 5 day blast transfer and I did a shop test this morning and it was negative, I maybe to soon to test, but I started having cramps and back ache and bloating.
Anyway would love to here from you.
Bless you
Thank you Pearl,
Your Re is correct. Age is an independent variable that impacts egg/embryo “competence”. You see, the older you get, the more likely it is that your eggs, that have been in your body all your life), would through “wear and tear” be chromosomally abnormal (aneuploid). As an example. About 1 out of 2 eggs/embryos are chromosomally normal at age 30, while by 45 fewer than one in 15 will be normal and capable of propagating a “competent” embryo. Aneuploid embryos, either do not make it to blastocyst, make it but fail to attach to the uterine lining, miscarry or (albeit rare) cause a chromosomal birth defect such as Down syndrome. This is why the chance of a viable pregnancy is in the single digit (percentage) range per cycle of IVF using own eggs.
What is important to und3rstand is that each “competent” (i.e. chromosomally normal, euploid embryo) will usually propagate a viable pregnancy about 60% of the time regardless of the age of the egg provider. It is the fact that so few embryos derived from the eggs of women in their mid-forties are euploid and that aneuploid embryos are often microscopically indistinguishable from competent euploid embryos which explains the very low pregnancy (<10%) rate and high miscarriage rate (>40-60%) in women undergoing IVF in their mid-forties. However, if a “competent embryo were to be found by CGH embryo-PGD and selectively transferred, the chance of a viable pregnancy would likely be 10 times greater at your age. The fact that in spite of age, you are still a good responder works in your favor, since you would have more embryos available for CGH testing. You could through “banking”, stockpile several blastocysts for CGH testing and then once a normal one is found transfer this to your uterus (see the articles on “staggered IV” and “embryo banking, below).
One last point, you should also be tested for immunologic implantation dysfunction (see below).
Might I recommend that you go to the home page on this site, find a “search bar” in the upper right hand column and type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“IVF success: Factors that influence outcome”
“Staggered IVF”
“Embryo Banking”
“Egg Donation”
You might consider calling 702-699-7437 to arrange a video conference (or Skype) consultation. If need be, someone from SIRM-Patient Relations can contact you in advance of the consultation and assist you in setting this up through your computer. Such audiovisual interaction it is much more personable than a discussion by telephone. However, if you prefer the latter, this too can be arranged.
Geoff Sher
Hi I have been doing fertility treatment not IVF i released the egg at 2.30pm on 21st sept, I had a blood test to check i ovulated last friday results tomo but i have taken 2 tests already which were negative is it likely i have taken them to early?
I cannot say!
You will need to wait a few days and do a blood progesterone test.
Geoff Sher
Dear Dr Geoff,
My AMH was 1.0 in March 2012 when it was first tested. After taking Ovigyn D for 3 months it was 2.3.
Then my doc started the IVF process at end of August 2012.
On 12th September 7 eggs were retrieved.
I have got 3days old 4 embryos transfer on 15th September, 2012. On that day doc told me the embryos were not looking good.
I have got my first b-hcg test on 29.09.2012 and the result is 31.31 mIU/ml. My doc said it’s positive but low!!
Again I got my second b hcg test on 1st October, 2012. Got the result as 5.9 mIU/ml. Doctor said the embryo implanted but got early miscarriage. He also said since embryo implanted my uterus quality is great.
Since I had low AMH the doc also said I very remote chance if I like to undergo IVF again. Please suggest.
This is a chemical pregnancy…but that does not mean that you are out of the running at all. The AMH is not that low and age and the protocol for ovarian stimulation in my opinion is much more relevant.
Go elsewhere on this blog site and read up on ” IVF Success: Factors trhat influence outcome”.
Feel free top call 800-780-7437 if you wish to discuss your case with me.
Geoff Sher
Lupus anticoagulant is not sufficient for diagnosing an immunologic implantation dysfunction. It is non-specific You need NKa/APA (a full panel of 21 varieties/antithyroglobulin and antimicrosomal antibodies /ANA and a reproductive immunophenotype…all on your blood and a DQ alpha and HLA tests on both your and your husband’s blood. The3se tests must be done in one of 4 reproductive immunology labs in the U.S.A. They cannot be done with sufficient6 sensitivity or specificity in a general reference lab. I use Reprosource in Boston or RIA in Van Nuys, CA.
AS for your beta levels. Repeat in 2 days to see if it doubled from the last one.
Geoff Sher
Dr Sher
I had 2 blastocysts transferred via fet 5 days old
first beta at 9dpt 110
second beta 12dpt 415
nurse said they wantto do another beta 15dpt
are these beta results good ?
It looks good to me!
Geoff Sher
Hello Doctor,
Thanks for your quick and motivating reply. My date of birth is 06.06.1982 and I have just crossed 30. Do you feel I still have good reasons to try IVF with my own eggs?
My husband’s sperm quality is good and we didn’t required ICSI for fertilization. He is 35+ now.
I am from India. Can I still call you?
Thanks a ton!!!
Tanusree.
Absolutely you can call 702-892-9696 and set up video conference call or a phone call with me.
I look forward to that.
Geoff Sher
Thank you so much Dr. I think your Blog is great and you are pretty amazing for being on here and helping girls like myself who are in the world of IVF its quite stressful!! There are not many Doctors that would take the time and have a Blog to help others, you definitely would be a Doctor of my choice….Thanks again so much, I go for bloodwork today so we are praying that things will work out. I will keep you posted!! THANKS AGAIN!!!
We are in the process of a second round of IVF after round 1 resulted in an ectopic pregnancy. With that previous schedule my number started at 23 and then rose to 32 and then 48 and then 100, etc. Highest I ever rose to was in the mid 400 range.
We transferred two blastocysts on day 5 (one was 4AA and the other was 4AB – although doctor felt that it was probably a 4AA). I was tested on day 11 after transfer and the beta was 377!! Two days later a different lab ran my next beta but it was only 562. They are retesting me tomorrow. Any indication what might be going on? I was so elated to have the 377 but now worried over the doubling time.
Unfortunately only time can tell…but with the beta rising (all be it slower than usual) there is still hope.
Good luck!
Geoff Sher
I had my first beta after transfer on 9/15 of 3 seemingly perfect 8 cell embryos. It was over 2000. Any idea what that means? Seems high …
It depends how long after the ER it was measured. If this was done within 2 weeks of the ER, it is awfully high and would raise concerns. Discuss with your RE.
Geoff Sher
Hi I am 10 dpo today & 4 days past a 6day transfer I took a hpt this afternoon it came back negative I’m 23 this is my 2nd cycle 1st failed 5 months ago my urine seemed a little diluted could it be anyway possible my beta which is due in 5 days time will be positive ? Please help I’m 23
It is far too early to do the beta now.
Geoff Sher
Thank you so much for understanding!!! =) I wanted to mention that my HCG went to 77 I go back tomorrow for an Ultrasound and more bloodwork to see where we stand.
Remember I mentioned Day 11 very early beta 3 day transfer was 60 then two days later 58.7 which would of been 14 day after transfer than 16 day 77 what the heck is going on if it was failing on day 14 wouldnt of kept failing instead of rising? THE BETA HELL
I had be first beta test done on Thursday (14 days post d3 embryo). My beta results can back with 465. I asked when my next blood test would be and my clinic told me that was not necessary and just scheduled an ultrasound for two weeks from now. Should I request this second test? I am worried that one test isn’t a good enough positive sign. Suggestions?
It is probably a healthy implantation. I do not want to be critical here, but I think it is always a good idea to repeat the beta at least once 2 days after the 1st one to make certain it is at least doubling.
Geoff Sher
Hello,
Blood work came back IT TRIPLED =)they are very pleased….We back in the game, I am beyond happy thought it was over, actually when they called today I made a joke and said “You sure you have the right number”? The HCG is really a nightmare in the beginning its human torture to go through this….Thanks again for your caring thoughts and your site is such a great help for Women like myself who need answers…. Keep up the good work you can tell you a Doctor that truly cares!!
Dear Geoff
i had 2 embryo transfer on 16 Sep 2012 at Blastocyst stage and they were grade A according to the doc.i had my B HCG done on 1st oct it was 304. Again doc got it done on 5th oct its 596 and on 8th Oct is another repeat test.what do u think are the B HCG doubling rate fine or not ? i am tense
Hi Doctor,
I had following beta hcg result can you tell me do i have a chance
beta hcg 23 9 days post 3 day transfer
beta hcg 96 12 days post 3 day transfer
beta hcg 125 16 days post 3 day transfer
do i have a hope
The levels do not seem to be rising as they should. Do another beta in 2 days to see if it picks up and doubles.
Good luck!
Geoff Sher
First of all, I think it is amazing that you take the time to answer all these questions!
This is my first IVF. Had 2 8 cell grade A transferred on Sept. 24.
Oct-4-12 – Beta 1 – 34.4
Oct-8-12 – Beta 2 – 198.7
Does this look promising to you? I was not scheduled for a third one. I have to go back in 2 weeks for the ultrasound. Oh, and progesterone is higher than 40..they said that was good?
Sometimes one just need some reassurance..you know?
Thanks for reading
Marcela
Looks very promising…Good luck!
I do not think there is a need for a 3rd beta here.
Geoff Sher
Hello Dr,
I have a question, what are the chances you would you have implantation bleeding if you could have a etopic pregnancy?
I did a FET on 9/27/12 and had my first blood work done today (10/9/12) and the HGC # was 23, is this a low number, should I be concerned that it didn’t take?
No this is cause for cautious optimism. Repeat the test two days after the last one and it should double.
Geoff Sher
hi Doctor, my 4th beta hcg came to be 24 and doctor said it is biochmeical abortion.I had 3 grade A embryos with doppler and harmonal test as normal.My endometrium was also 9.7 during transfer.What could be the cause of failure .Do I have hope in next IVF.It could result in same as this time also everything was ideal.
Also how long should i wait for next IVF
and are there chances of success
regards
Vibhu
I think I could be of help here but I would need a lot more information to say what went wrong. Certainly I would need to know the suggested cause of your infertility, your age, your husbands sperm parameters, the result of your sonohysterogram or hysteroscopy to prepare you for your cycle, the exact protocol for ovarian stimulation you were on, how thick your uterine lining was at the time of the hCG trigger, and whether you were tested for immunologic implantation dysfunction.
Please go to http://www.IVFauthority.com and when you get to the home page find the “search bar” in the right hand column. Type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
“Agonist/Antagonist Conversion Protocol”
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted March,21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“IVF success: Factors that influence outcome”
You might consider calling 800-780-7437 or 702-699-7437 to arrange a telephone or video conference (or Skype) consultation (free of charge to those who reside in the United States or Canada). An audiovisual (Skype) interaction it is much more personable than a discussion by telephone but either would suffice.
Geoff Sher