Sunday, May 1, 2011

How To Interpret Positive BHCG Levels After IVF: When Will You Know For Sure?


My question is about beta levels, and how to interpret what they indicate.This is my first IVF / first pregnancy, so this is a constant learning process.

1st Beta at 14 dpo (11 days past 3 day transfer) was 158.
2nd Beta at 18 dpo was 704.
3rd Beta at 21 dpo was only 1537.

My beta levels started off doubling, but then slowed considerably.I have an ultrasound upcoming next week, but not sure what to expect at this point. I am feeling very concerned about this change, and not sure if it still falls into normal range or is a valid cause for concern. Should I request a 4th beta? Can an ultrasound at 5 1/2 weeks provide a definitive answer to the viability of a pregnancy?

Thank you so much for your answer! C. from New York


Hello C. from the U.S.,

Absolute values of the bHCG cannot be interpreted (although many people try to). bHCG's are evaluated based on their trend i.e. up/down and double every other day (actually it only needs to increase by 80%). I would caution you on trying to interpret how things are going by your bHCG levels unless they drop precipitously. The ultrasound will give you a better idea of how things are proceeding.

Viability cannot be established at 5-1/2 weeks. It is too early. That ultrasound is mainly to rule out an ectopic (tubal) pregnancy. Viability is established at 7-8 weeks gestational age.

You have a positive pregnancy test, which is a good thing! Now all you can do is wait and see how it progresses.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.


  1. I am 3 weeks post donor egg transfer, had a positive hcg test.Then i had moderate bleeding with clots 2 weeks following transfer.Went for ultrasound on day 20 of transfer,Dr. does not think my ultrasound looks good and that i may miscarry over the weekend. My Hcg level today is 4500 approx does this make sense? Thanks for reply.

  2. Hi,

    It is too early to draw any conclusions at this point. The ultrasound needs to be repeated in 2 weeks to see if there is any development. At 20 days post transfer (approximately 5 weeks gestational age), there is very little that can be seen on ultrasound except maybe the gestational sac. Viability of the pregnancy cannot be determined until at least 7 weeks gestational age, when a clear fetal pole and heartbeat should be present. bHCG levels are also not very helpful at this point. The absolute number is not interpretive so serial tests need to be done to see what the trending is. I think it is too early to give up.

    Good Luck

  3. I had my 3days egg transfer on the 13th of april,I had my 1st beta hcg on the 29th of april wit 586,the 2nd beta hcg on the 1st of may 790 and the 3rd beta hcg on the 3rd of may 935,my numbers are raising but not doubling,do I have a cause to worry with the beta numbers?

    1. I presume that these tests were done 48 hrs apart? The bHCG's are expected to increase by at least 80% every 48 hrs. If they don't, then the prognosis for a successful pregnancy decreases. That is not to say that you can't have a succssful pregnancy, but only that the signs are not good. All you can do at this point is to wait and see how it turns out.

      Good Luck

  4. After embryo transfer. my beta hcg levei is 180 is on 27 feb 2014 then again beta hcg done after 5 days on 3 march 2014 then level is 650. then ultrasound done on 19 march it shows nothing. then we have done beta hcg that level shows 18. ehat does it mean?
    its positive or negative?
    reply asap.

    1. It means that you had a chemical pregnancy, which is a form of miscarriage. At this point the pregnancy is lost.



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