One of the most important results for an infertile patient is the blood test for beta HCG ( human chorionic gonadotropin), which tells her definitively whether she is pregnant or not.
It’s a simple test to interpret, which is why I get disheartened when I find that most patients cannot make sense of their own beta HCG results .
I am going to simplify matters, so you don’t get misled by your doctor. The tragedy is that it’s very common for doctors to cheat their patients into getting a positive beta HCG test by giving her an HCG injection a few days before the test. This molecule will then appear in the blood, and the patient will think that she is pregnant and the IVF cycle has succeeded, whereas the reality is that she is not pregnant at all, and the doctor is just taking her for a ride.
Both the Urine Pregnancy Test and the blood test will check for the same molecule – HCG. However, the urine test is not as reliable , which is why doctors will use only the blood test when making a definitive diagnosis.
A level of less than 10 mIU/ml confirms that you are not pregnant . It doesn’t matter if the level is 8 or 2 – a level less than 10 means you are not pregnant. This is simply because the test has a very limited ability to measure very low levels reliably.
Also , a level of 12 or 15, or 18 is also considered negative for all practical purposes . This can be a little confusing , because it clearly says on the report that a level of more than 10 means you are pregnant. The problem is that patients often confuse the interpretation of a HCG level with a hemoglobin level . We know that a hemoglobin level of 11 is better than a hemoglobin level of 10 , but that doesn’t apply to HCG levels , because HCG levels increase exponentially . This means they rise very fast because they double every 48 hours .
Also, many unethical doctors fool patients by giving them a HCG injection before doing the test. The test then comes back as positive, and patients believe the IVF cycle was successful, and they are pregnant – but this is a cruel mirage, and their happiness is short-lived.
This is why we don’t interpret a single result in isolation . The easiest way to clarify any confusion is to repeat the test again after 48 hours , from the same lab . If it declines or remains the same , this clearly means that you are not pregnant . If the level increases , then this means you are pregnant , but doesn’t tell you anything about the health of the pregnancy , because there is an entity called a chemical or biochemical pregnancy , where the pregnancy produces enough HCG to be detected on the blood test, but is still not a healthy pregnancy . This can be quite confusing for patients, especially when doctors don’t bother to explain the details about how to make sense of an HCG level.
Finally, if the HCG levels are doubling, this confirms you are pregnant, but a positive HCG test only tells us you are pregnant – it tells us nothing about whether a pregnancy is viable ( some pregnancies will miscarry) ; or whether it is in the uterus or the fallopian tube ( also known as an ectopic pregnancy); and how many babies there are ( singleton or multiple). In order to determine this, we need to do a vaginal ultrasound scan to gather more details about the status of the pregnancy.
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