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Miscarriage And hCG Levels: Does Dropping hCG Levels Mean Pregnancy Loss?

HealthcareOnTime Team 2024-02-15 2024-02-16 3 Min Read
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    Miscarriage is a condition where the mother suddenly loses the pregnancy, mostly before the 20th week, owing to certain abnormalities in the development of the fetus. Around 26% 1 of women experience miscarriage in their first trimesters, and some even later. 

    These include both unknown as well as positive tested pregnancies. While there are several factors (some constant while others are subjective) behind miscarriages, researchers have correlated dropping HCG levels with the future of pregnancy 2. This is because lower HCG levels have been a common symptom during miscarriage. 

    But that doesn't mean the lack of the hormone is the only potential reason for miscarriage, and the latter can have various other reasons, too. Are you in your initial stages of pregnancy with a low HCG level? That's not always a red flag. In fact, here's what you need to know about the interrelationship between HCG, pregnancy, and miscarriages. 

    What is an HCG Test? 

    HCG tests check the presence and quantity of the hormone in your urine. While most home urine test kits detect the presence of HCG, you might need a quantitative HCG test for more precise results. Moreover, HCG tests are taken twice within 48 hours in some cases to check the growth of the hormone and rule out any anomaly in the same. The doctor might ask you to rethink your pregnancy if the HCG levels do not double up or increase significantly, or even decrease within the phase of the test series, as it indicates a stunted growth of your embryo. 

    What is HCG Levels in Pregnancy? 

    HCG, commonly called the Human Chorionic Gonadotropin, is a hormone that your placenta produces once you conceive. Doctors also call it the "pregnancy hormone" because it helps in the nourishment of the egg so that it can grow. You can find this hormone from 11 days after you conceive and also measure it using an HCG pregnancy test. This test measures the presence of the hormone in 1 milliliter of blood to check if the levels are normal. 

    Normal HCG Levels in Pregnancy

    Your HCG levels will rise within 48 hours of implantation. So, you can see a change in HCG levels within two days after the egg attaches itself to the uterus. And this hormone generally doubles up every 48 hours in the first 8-11 weeks of pregnancy. Here are the following correlations between HCG and the growth of pregnancy 3

    • 800–1,500 (UI/L) of hCG: Gestational sack is visible
    • 4,500–7,500 IU/L of hCG: Yolk sack is visible
    • 8,650–12,200 IU/L of hCG: Heart movements of the fetus are visible

    Apart from these major phases throughout your trimesters, here is an overall count of normal HCG levels in your bloodstream based on your week of pregnancy 4-

    Pregnancy week 

    HCG level In Pregnancy

    3 weeks

    5–50 mIU/mL

    4 weeks

    5–426 mIU/mL

    5 weeks 

    18–7,340 mIU/mL

    6 weeks

    1,080–56,500 mIU/mL

    7-8 weeks 

    7,650–229,000 mIU/mL

    9-12 weeks

    25,700–288,000 mIU/mL

    13-16 weeks

    13,300–254,000 mIU/mL

    17-24 weeks

    4,060–165,400 mIU/mL

    24-40 weeks

    3,640–117,000 mIU/mL

    The HCG levels mentioned above show the normal count during the course of pregnancy. If your doctor finds dropping HCG levels beyond these levels or remaining the same, it might mean your fetus has some complications. 

    For instance, if your HCG levels in pregnancy drops from 120 mIU/mL to 80 mIU/mL or it only rises to 130 mIU/mL in two days, it means that your body is not producing enough hormone to nourish the embryo. 

    It is important to note that falling HCG levels might not indicate an obvious miscarriage in all the cases. Instead, doctors take it as one of the many indicators in determining a successful pregnancy. 

    In fact, sometimes lower HCG levels might also indicate unviable pregnancies, even if they do not necessarily lead to obvious miscarriages. 

    What Causes Low HCG Levels in Pregnancy? 

    There might be a couple of reasons for having low HCG levels  in pregnancy. Does that mean you will surely have a miscarriage? Not always. Of course, there is a possibility of having stunted growth in the embryo, but here are some other possible reasons for low HCG levels: 

    • Blighted ovum: In this situation, the egg does not develop after attaching itself to the womb. Naturally, the HCG levels do not rise since the egg doesn't grow, and it occurs in the early few weeks of pregnancy. 
    • Ectopic pregnancy: This is an unusual kind of pregnancy where the egg doesn't attach itself to the womb and keeps growing in the fallopian tube. It is a life-threatening pregnancy because it could lead to the rupture of the fallopian tubes, causing immense blood loss. Low HCG levels can often indicate an ectopic pregnancy. 

    Miscarriage and HCG Levels

    HCG Levels After Miscarriage

    HCG levels after miscarriage keep dropping and generally return to normal levels within 4-6 weeks, depending on the stage of pregnancy. Thus, mothers who experience miscarriage in the early stages of pregnancy generally get back to the pre-pregnancy HCG levels sooner. 

    HCG Levels During Miscarriage

    HCG levels keep dropping consistently during miscarriage. While this isn't the only indicator of pregnancy loss, it can be one of the important markers of the same. If your HCG level doesn't double up every 48 hours in the first 8 -11 weeks of pregnancy, your doctor might ask you to take two HCG tests 48 hours apart from each other to study the trends. In fact, serial testing of HCG levels can be a great way of tracking the production of the hormone. In cases of miscarriage, HCG is generally found to remain the same or even decrease. 

    While a slow rise in HCG levels might be subjective to each pregnancy, doctors consider a growth rate of less than 35% 4 in 48 hours to be significantly slow and declare it as an "unviable pregnancy." 

    Do Low HCG Levels Necessarily Mean Miscarriage?

    While researchers and doctors have often connected low HCG levels with pregnancy loss, it is not a definite marker of the same. While on the one hand, HCG levels are expected to double up 5 in the first few weeks of pregnancy, women also have successful and healthy pregnancies with lower levels. 

    However, in most cases, low HCG levels do indicate some underlying problems in the pregnancy. Additionally, low HCG levels along with the following symptoms might indicate miscarriage: 

    • Spotting 
    • Pinkish vaginal discharge
    • Sudden vaginal bleeding
    • Abdominal cramps

    It's worth mentioning that while you can track your pregnancy progress with serial HCG tests, the confirmation usually comes from an ultrasound scan when you can actually see the baby. Sometimes, additional tests like a transvaginal ultrasound or tests to check progesterone levels are also help in checking HCG levels. 

    What are the Other Causes of Miscarriage? 

    Some of the most common causes of miscarriage are as follows- 

    • Irregular chromosomal conditions: Nearly half to two-thirds of the total pregnancies suffer from miscarriages because of extra or missing chromosomes 5. During conception, the sperm fertilizes the egg and there are two sets of chromosomes coming from each parent. When this chromosome pairing is abnormal, it might lead to miscarriages. 
    • Molar pregnancy: Molar pregnancy is a kind of pregnancy where the sperm alone provides both chromosomes. Hence, the embryo is unable to receive the necessary configuration of two sets of chromosomes from two parents. There is no development of the fetus in such a pregnancy owing to the stunted and abnormal growth of the placenta. 
    • Diabetes: If you are suffering from diabetes, there are chances of excess amniotic fluid affecting your placenta. This might affect the growth of the fetus and increase the chances of miscarriages or stillbirths 6
    • Obesity: A higher Body Mass Index has often been connected to an increased rate of miscarriage 7. In fact, researchers have not just found a higher incidence of miscarriage in obese women but also a greater chance of repeated miscarriages in them.  
    • Cervix or uterus issues: Also known as "incompetent cervix", it is a condition where the cervix opens up early in the pregnancy, increasing the chances of miscarriage. On the other hand, if your uterus wall is too thin, it fails to hold your fetus as it grows, finally leading to miscarriage. 

    How to Confirm a Miscarriage?

    If you think you had or might have a chance of miscarriage, you might opt for taking the following tests to rule out any such possibility. 

    • HCG Pregnancy Test: You can take an HCG Pregnancy Test to determine the condition and growth of your embryo. HCG tests are generally conducted twice within 48 hours to map the change in its levels. If the doctor finds slow or dropping hCG levels, it might mean abnormal or stunted embryo growth. 
    • Other blood tests: Apart from HCG tests, there are other blood tests for pregnant women that check their progesterone levels, the presence of any dominant or recessive traits that might manifest in your fetus, and much more. 
    • Pelvic exams: Pelvic exams are often suggested by doctors to check the opening of your cervix, and if the opening is larger than usual in the initial days of pregnancy, the chances of miscarriage are higher.
    • Tissue tests: If you have already started getting cramps or sudden vaginal bleeding and notice tissues passing out, you can also send that for testing to confirm whether you had a miscarriage. 


    It is important to note that miscarriages most definitely reduce HCG concentration as the hormone is only found when you are pregnant. Thus, your hCG levels can keep dropping with pregnancy loss and gradually come to the baseline. However, it is false to assume falling HCG levels most definitely lead to miscarriages since the former is a symptom of the latter and not an underlying cause. 


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    Does low HCG levels always mean a possibility of miscarriage?

    Lowering HCG levels or slow growth in the first trimester might often indicate the chances of a miscarriage. This is because HCG levels are expected to rise or, in fact, double up every 48 hours for the first 8-11 weeks after conception 8. However, low HCG level is not just the only indicator of miscarriage since mothers have carried out successful pregnancies even with lower HCG counts. You should check for low HCG levels with other allied factors like vaginal discharge, spotting, or cramps to check for miscarriage. 

    Can I prevent pregnancy by taking artificial HCG?

    HCG is a hormone that the body produces naturally after conception and helps in nourishing the embryo. The lack of HCG already means some anomaly in the embryo. Hence, artificial HCG injections cannot prevent pregnancy losses. There has been no substantial evidence that artificial HCG helped in retaining an already unviable pregnancy. In fact, low HCG level is often a symptom of miscarriage and not always the reason behind the same, so by the time you detect low HCG levels, it might already be after your miscarriage. 

    Can low HCG in my previous miscarriage mean repeated miscarriages?

    It is difficult to draw such a strong correlation between low HCG levels and future miscarriages. If you had low HCG in your previous pregnancy, it might not necessarily mean it would occur the next time, too, or even if HCG is low, it will cause miscarriage. However, if you have experienced repeated miscarriages, it is better to undergo other tests and detect any other underlying problems followed by proper treatment. 

    What should be my HCG levels in IVF?

    HCG levels are tested after 12-15 days of the embryo transfer 9. Embryo transfer is the phase during which the embryo is transferred to your uterus. Unlike normal conception, where HCG levels can be tested immediately after conception, IVF can take around two weeks to show HCG changes and concentration in your body. A concentration of 100 mIU/ml is considered positive pregnancy, whereas anything lower than 5 mIU/ml is considered negative 10. Values between these two counts show an intermediate stage and thus need to be tested within the next 48 hours again. 

    Can boosting hCG levels prevent pregnancy loss?

    No, increasing hCG levels does not ensure that pregnancy loss will not occur. hCG (human chorionic gonadotropin) is secreted by the growing placenta during pregnancy. Low hCG levels are not the only cause of miscarriage; they can be an indication of one.

    Although hCG injections have been recommended for certain women who experience repeated losses.  Since hCG injections constitute a medical procedure, they should only be administered under a doctor's supervision.

    How fast does hcg levels drop after miscarriage at 5 weeks?

    hCG levels usually decrease following a miscarriage. This is because, after a pregnancy is no longer viable, the hormone is no longer produced by the body.The precise rate at which hCG levels fall can change. Every 48 hours, on average, hCG levels may drop by almost 50%.Typically, hCG levels are still rather low at week five. This suggests that, in contrast to a subsequent miscarriage, it might take them less time to return to their pre-pregnancy levels.

    Depending on a number of variables, it may take one to nine weeks for hCG levels to fully recover to zero following a miscarriage. Due to lingering hCG in the body, some home pregnancy tests may still yield a positive result even after a miscarriage.


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