low beta, high p4

[sophie6]

Hi Dr. Roseff,

I'm hoping you can help me figure out what's going on with my "pregnancy". News today isn't good, but according to my clinic, it's rather strange. On DPO 12: Beta 3.4. p4 60!!

I am 14 days past a 10,000 unit hcg trigger and am on 600mg prometrium vg, but doctor says this cannot explain high p4 level with such a low beta. Nurse suggested late implanation, but I know this is not the case since I have been testing positive on HPTs for 3 days . I have noticed though, that the lines have mostly stayed the same color (not getting darker).

This "pregnancy" is the result of a canceled IVF. Had only a 15mm and a 22mm and did timed intercourse. I'm 42.

Is the combo of the low beta / high p4 really that unusual? Should I expect a chemical preg?

Thanks very much,

Sophie

[Scott Roseff MD]

Hi Sophie,

Sorry to hear your not so good news....

I'm astounded that no one told you the following - A beta of 3.4 is negative (NOT considered to be a positive pregnancy test). A beta-hCG level of <5 is considered to be negative.

When you have a few follicles and take an hCG injection to trigger ovulation, the ovaries can form corpus luteum cysts from where the eggs ovulated. Each corpus luteum produces progesterone, so if you ovulated a few eggs, you may have persistently elevated P4 levels, certainly in the range of 60.

All of this is common and not strange. I'm frankly shocked that the folks at your "fertility clinic" don't know this. Are you SURE you're seeing a real, true, fertility specialist? Are you perhaps in a country outside of the U.S.?

[sophie6]

Thanks so much for your reply. I am here in the states, seeing a board certified RE. You are right about them and I will not be continuing with this clinic for a variety of reasons.

I had positive HPTs for several days (DPO 9 -12) before the 3.4 beta (and even on the morning of the beta) so I think I had a very early loss. I guess the high p4 wasn't that unusual then? They want me to come in for another beta, but all HPTs are now negative, so I don't see the point.

Thanks for confirming my opinion of this place.

Sophie

[Scott Roseff MD]

Hi Sophie,

High progesterone levels with a negative beta, in the face of what you described, would not be unusual at all. If a beta is 3.4 (negative) 12 dpo, then I don't see much utility in a follow-up beta.

A high P4 can delay menses until it drops down to low levels, so if menses doesn't occur within a reasonable period of time, be sure to follow-up with someone and recheck levels.

All my best,
Dr. Roseff in Florida

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