Understanding Tubal Pregnancy and Ectopic hCG Levels

Updated on February 26, 2019
leahlefler profile image

I am a mother of two who has gone through the experience a tubal pregnancy.

Human Chorionic Gonadotropin in Pregnancy

Human chorionic gonadotropin (hCG) is produced by an embryo once implantation has occurred. In a healthy pregnancy, the embryo implants in the uterus and the developing placenta causes hCG levels to rise. One to two weeks after conception (3-4 weeks of pregnancy, as dated from the last menstrual period), the hCG levels will be high enough to trigger a positive result on a home pregnancy test. According to the American Pregnancy Association, hCG levels will double every 48-72 hours during early pregnancy. They will typically peak between week eight and 11.

hCG levels can be monitored through a blood test. Quantitative beta hCG levels are determined every 48 hours to monitor pregnancies that are considered high risk. If the levels do not increase at the expected rate, the pregnancy is considered threatened. Slow rising hCG levels may indicate a non-viable intrauterine pregnancy, or may indicate an ectopic pregnancy has occurred. You can read this article that examines more insight and research into non-doubling hCG levels.

Ectopic Pregnancies

What Is an Ectopic Pregnancy?

When an egg is fertilized and implants in any location other than the uterus, the pregnancy is considered ectopic. "An ectopic pregnancy accounts for 1-2% of all pregnancies," says Dr. Tami Prince, an OBGYN at the Women's Health and Wellness Center of Georgia in Greensboro, Georgia. "They represent 2.7% of all pregnancy-related deaths according to the CDC and ACOG. 90% of ectopic pregnancies occur in the Fallopian tubes." Other times, a pregnancy may implant in the abdomen, in an ovary, or on the cervix—these cases are much rarer than a tubal pregnancy.

Spotting, cramping, and abdominal pain are often noted by the pregnant mother. If the pregnancy is far enough along, the ectopic pregnancy may be seen via a transvaginal ultrasound.

Can a baby survive an ectopic pregnancy?

When a pregnancy implants in a location outside the womb, the placenta cannot form normally and the hCG levels will not rise appropriately. The fetus does not get the necessary support it needs to develop. The embryo will rupture long before the fetus is viable.

What Does an Ectopic Pregnancy Feel Like?

According to New Kids-Center, here are some symptoms that you may feel if you are experiencing an ectopic pregnancy.

  • A mild to severe pain on the side of your pelvis. This pain may appear suddenly or gradually.
  • Vaginal bleeding that may seem different in color to menstrual bleeding. It may be more watery as well.
  • Painful bowel movements or even diarrhea.
  • Pain in your shoulder that increases when you lay down. This could possibly be internal bleeding that is irritating your organs.
  • Fainting. This is related to internal bleeding.
  • Heavy sweating.
  • Shortness of breath and/or rapid heartbeat.

Tubal Pregnancy

When an embryo implants in the Fallopian tube, the pregnancy is not viable and threatens the life of the mother.
When an embryo implants in the Fallopian tube, the pregnancy is not viable and threatens the life of the mother. | Source

hCG Calculator

Do you want to know how quickly your hCG levels are increasing? Try this hCG calculator.

This calculator will determine your doubling time and compare it to the average.

Slow Rising hCG Levels

In some healthy pregnancies, the beta hCG level does not double every 48 hours. However, this is not necessarily a cause for concern. Many women have had low hCG levels and have gone on to have healthy pregnancies. According to Dr. Amos Grunebaum, an OBGYN at Cornell Weill Medical College, you should not put too much stock in having hCG levels determine the viability of a pregnancy. With that said, there should still be some monitoring. A drop in hCG levels ranging around 36% and more could indicate a miscarriage or ectopic pregnancy.

In addition, once hCG levels reach 6,000, the rate of increase begins to slow in all pregnancies. Late in the first trimester, hormone levels begin to plateau—the hCG level may even decrease a bit in the early part of the second trimester to a new, stable level that will be maintained until the pregnancy is complete.

Can a blood test detect an ectopic pregnancy?

A blood test merely gives a reading on hCG levels. A single quantitative hormone level is not useful for the diagnosis of an ectopic pregnancy. Serial measurements must be taken over time to determine how likely a pregnancy is to proceed.

Quantitative beta hCG levels are not diagnostic for an ectopic pregnancy. These levels are simply part of a larger clinical picture – the diagnosis of an ectopic pregnancy includes the evaluation of hCG levels in addition to ultrasonography and a physical exam. If the pregnancy can be visualized in a Fallopian tube (or elsewhere), the ectopic is confirmed. If the pregnancy cannot be visualized at all, the pregnancy might be ectopic, depending on the hCG levels. If the hCG levels are above 1,800 and the embryo cannot be visualized in the womb, the suspicion for an ectopic pregnancy increases dramatically.

Normal vs. Slow Rising hCG

Starting with an hCG level of 160, this graph depicts a doubling beta hCG (blue line) vs. a hormone level rising by only 66% every 48 hours. Pregnancies with hCG levels rising slower than 66% typically fail, or are ectopic.
Starting with an hCG level of 160, this graph depicts a doubling beta hCG (blue line) vs. a hormone level rising by only 66% every 48 hours. Pregnancies with hCG levels rising slower than 66% typically fail, or are ectopic. | Source

Ultrasound Diagnosis of Ectopic Pregnancy

An ectopic pregnancy observed by ultrasound examination.
An ectopic pregnancy observed by ultrasound examination. | Source

Tubal Pregnancy Diagnosis

Many women suspect a problem early in pregnancy, as spotting and cramping or abdominal pain are often present. In some tubal pregnancies, there are no early warning signs, and the first sign of trouble may be a ruptured Fallopian tube.

If spotting and cramping are observed, a woman should call her physician immediately. A workup will generally be ordered, including beta hCG levels and ultrasound examinations to determine the location and viability of the pregnancy. If the hormone levels are rising less than 66% over a 48 hour period, an ectopic pregnancy will be suspected.

If the hCG levels are low (less than 1,800), the pregnancy may not be visible on the ultrasound machine. In this case, a woman is often presented with a choice to wait and monitor the pregnancy until it can be observed, or to have a procedure called a Dilation and Curettage (D&C) to determine if there is any pregnancy tissue is in the womb. If there is no tissue in the womb, the pregnancy is determined to be ectopic. This method of determining the location of the failing pregnancy is not preferred, as there is a chance that there is an intrauterine pregnancy, and a D&C will end the pregnancy. If this method is used, and a pregnancy is not found in the womb, the ectopic pregnancy may be treated with methotrexate. Methotrexate is injected and is often successful at ending an ectopic pregnancy without surgery.

If the hormone levels are over 1,800 and the pregnancy can be visualized in a Fallopian tube, the diagnosis is certain and treatment will be scheduled immediately (by methotrexate injection if the pregnancy is in a very early stage, or by removal of the pregnancy and Fallopian tube).

How Long Does It Take for an Ectopic Pregnancy to Rupture?

According to Dr. Antonette Dulay, a perinatologist at Main Line Health in Philadelphia, Pennsylvania, an ectopic pregnancy can rupture anytime between six and 16 weeks. The bleeding after the rupture can be very severe and life-threatening. The longer it takes for a rupture to occur, the more at risk the mother is of a life-threatening occurrance.

Symptoms of an Ectopic Pregnancy

Treatment with Methotrexate

If a tubal pregnancy is an early stage, it may be treated medically (as opposed to surgically). Methotrexate is successful at treating tubal pregnancies when:

  • beta hCG levels of 5,000 or less.
  • No cardiac activity of the embryo is observed.
  • The Fallopian tube is not ruptured or torn.

According to the University of Michigan, methotrexate works by preventing cell division and growth. The embryo breaks down and is passed from the Fallopian tube. If methotrexate is the chosen treatment option, hCG levels will be monitored on a regular basis until they have returned to 0.

"Methotrexate can be given as a single-dose regimen, two-dose regimen, and fixed multiple-dose regimen," says Dr. Prince. "The choice of regimen is guided by the initial hCG levels and discussions with the patient about the risks and benefits of the medication. There are similar success rates for both the single-dose and multiple-dose regimens. The latter is associated with an increased risk for adverse effects." According to Dr. Prince, these side effects include diarrhea, nausea, vomiting, dizziness, and stomatitis. "These side effects are directly related to the fact that methotrexate stops rapidly dividing cells in the body. This includes the linings of the stomach, bowel, and mouth."

According to Dr. Prince, here are some things that should be avoided during treatment.

  • Exercise.
  • Alcohol.
  • Sexual intercourse.
  • Medications, foods, or vitamins that contain folic acid. Prenatal vitamins and folic acid supplements should be discontinued during treatment.
  • Exposure to sunlight.
  • Non-steroidal anti-inflammatory (NSAIDS) medications such as Ibuprofen, Aleve, or Advil as they may interfere with methotrexate.
  • Medications and gas-producing foods that may either mask pain or be confused with worsening symptoms.

If the hormone levels begin to drop after the treatment is started, blood tests will be performed weekly until the hCG cannot be detected. This may take anywhere from 1-3 months to occur. "Two rounds of methotrexate are generally given before surgical intervention," says Dr. Prince.

Surgical Treatment for Ectopic Pregnancies

If medical treatment for an ectopic pregnancy fails, or if the tube ruptures or tears, surgical treatment will be required.

According to research from Dr. Vanitha Sivalingam, ectopic pregnancies are the leading cause of first trimester deaths in pregnant women. Between 1980 and 2007, there were 876 maternal deaths in the U.S. related to the condition. A ruptured ectopic pregnancy is a medical emergency and must be treated immediately to save the mother's life. An ultrasound examination will generally show a significant amount of "free fluid" in the abdomen, indicating internal bleeding due to the ruptured Fallopian tube. A salpingectomy (removal of the Fallopian tube) is generally performed to remove the pregnancy and to stop internal bleeding. In some cases, the pregnancy is removed without the removal of the entire Fallopian tube - this procedure is called a salpingostomy.

Both types of surgery may be performed through tiny incisions (laparascopic surgery), though they may sometimes require a larger incision (laparotomy).

hCG levels may be monitored by a physician until the hormone level falls to undetectable levels.

Fertility After Ectopic Pregnancy

If a Fallopian tube is removed via salpingectomy and the other tube is healthy, many women will be able to conceive again. According to the American Pregnancy Association, there is roughly a 60% chance of a successful pregnancy if the Fallopian tube has been left in place.

If, however, the other tube is also affected by scar tissue or other abnormalities, fertility will be significantly impacted. Fertility treatments such as in-vitro fertilization (IVF) may be required to conceive in this scenario.

After a woman has experienced a tubal pregnancy, however, she is at an increased risk for having another ectopic pregnancy. Approximately 10-15% of women with a prior ectopic pregnancy will experience another. For this reason, all future pregnancies must be monitored with beta hCG levels and early utlrasound examinations may be performed to verify the location of the embryo. You can read this personal account of a successful pregnancy following an ectopic pregnancy.

The Author's Experience with a Tubal Pregnancy

I was approximately 5 weeks pregnant and had frequent spotting, so beta hCG levels were ordered by my obstetrician. My first result showed a level of 1,411. Two days later, a repeat blood draw indicated the level had only risen to 1,629. Three days later (over a weekend), the levels rose to 2,100. While the levels were increasing, they were rising so slowly that the pregnancy was considered a failure. I was offered a D&C, but refused since we couldn't visualize the pregnancy via ultrasound. A few days later, I woke to severe pain and rushed to the emergency room - the pregnancy was ectopic and had ruptured. I was bleeding internally and my blood pressure was dropping. I had emergency surgery to remove the Fallopian tube and pregnancy. The physical recovery took approximately one week, and I was told my other tube was not scarred, which improves our chances for conceiving again.


  • Dulay, A. T. Ectopic Pregnancy. From Merck Manual.
  • Ectopic Pregnancy: Symptoms, Causes, Risks and Treatment. From American Pregnancy Association.
  • Grunebaum, A. Normal hCG Levels In Early Pregnancy. From BabyMed.
  • Human Chorionic Gonadotropin (HCG): The Pregnancy Hormone. From American Pregnancy Association.
  • Methotrexate for Ectopic Pregnancy. From Michigan Medicine.
  • Sivalingam, V. N., Duncan, W. C., Kirk, E., Shephard, L. A., & Horne, A. W. (2011). Diagnosis and management of ectopic pregnancy. The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists, 37(4), 231–240.
  • What Does an Ectopic Pregnancy Feel Like? From New Kids-Center.

Tubal Pregnancy Treatment Poll

How was your ectopic pregnancy managed?

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This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

  • My hCG level was 843 on Wedsnesday morning. Two days later, it increased by only 1. On Sunday, it went up to 889. Since then, a few days have passed, and it is over 1500. I still have a pregnancy of unknown location, but wondering if I'm still at risk of an ectopic. They are doing more blood tests on Thursday. If it has doubled again, can it be an ectopic pregnancy?

    The fact that your hCG doubled from the 23rd of September to the 25th of September is reassuring. It is interesting that your hCG did not double for a few days, but hopefully, your blood test will demonstrate an appropriate rise in level on Thursday. If your hCG continues to double, the chances of an ectopic pregnancy are greatly reduced, and your physician will continue to monitor until the pregnancy can be verified by ultrasound to be intra-uterine.

  • I received my methotrexate (MTX) shot on six days ago and my HCG was at 2160. After the shot it went up to 3200, which is odd. I was told this was normal three days later. My HCG today (twelfth day after the shot) is at 2979 and has dropped very little since my last test. Is it fine? I was not told about avoiding food rich in folate and have been having oranges and avocados. Could foods rich in folate slow down the drop in beta HCG levels?

    Unfortunately, folic acid can reduce the effectiveness of methotrexate. The medication works by interfering with folic acid, preventing embryonic cells from dividing and multiplying. If you consume a diet high in folates (including multi-vitamins), this may prevent the methotrexate from blocking enough activity to stop the ectopic embryo from growing. You need to return to your physician for a follow-up ultrasound and further testing to ensure the single dose was effective. You may need an additional dose of methotrexate or a different treatment to end the tubal pregnancy.

  • I found out I was pregnant on the 4th of July. My betas were rising properly than fell slightly than rose again. I feel like my doctor made a mistake. My highest HCG level was 56. I was given the methotrexate shot when the tech saw some free fluid around my right tube. I had no symptoms, and feel like they acted in haste. I feel like we should have waited to see what my betas were going to do. How often are viable pregnancies misdiagnosed?

    One way to confirm an ectopic pregnancy is to perform a dilation and curettage (D&C) of the uterus. If fetal tissue is found in the uterus, then the pregnancy is known to be intra-uterine. Since this method would end the pregnancy anyway, it is rarely performed instead before administering methotrexate. Since a D&C is rarely performed after methotrexate is given, it is difficult to estimate the number of false positives from beta hCG tests and ultrasound. A failure of beta hCG to double appropriately generally indicates the pregnancy is not proceeding as expected. Poor hCG numbers in the presence of fluid in the adnexa are highly indicative of an ectopic pregnancy.

    While it is stressful to wonder about the "what if" situation (and wonder if the pregnancy might have been typical), the likelihood is overwhelming that your pregnancy was, indeed, ectopic. Some women do choose to wait out the betas, but this is a very risky situation.

    In my situation, I did wait out the beta hCG, and the pregnancy was ectopic - my right Fallopian tube ruptured, and I lost a significant amount of blood and required emergency surgery. This is not a recommended course of action as it is extremely dangerous to the mother and there is nothing that can be done to save the ectopic pregnancy.

  • I had one tubal ligation 6 years ago. I missed my period this month and took a pregnancy test. It is positive. My hCG level is 5,000. Could this pregnancy be ectopic? I don't have any symptoms today and I am currently 6 weeks, 5 days pregnant.

    Since you have a beta hCG level, it sounds like your physician is taking blood beta hCG measurements. A single measurement is not as useful as serial measurements taken every other day to verify your hCG levels are increasing at the appropriate rate. A transvaginal ultrasound could be performed at this stage to verify the location of the gestational sac, to determine if the pregnancy is in the proper location. Pregnancy symptoms are sometimes not apparent early on in the pregnancy. I would contact your physician to find out what your care plan is, and to ask the following questions:

    1) Are my hCG levels rising appropriately?

    2) Could I have an early ultrasound to make sure the pregnancy is in the right location?

    Getting answers to these questions will determine the progress and location of your pregnancy, and will help to establish a good system of communication with your attending OB/GYN.


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    • leahlefler profile imageAUTHOR

      Leah Lefler 

      4 months ago from Western New York

      The hCG level rise is excellent for your stage of pregnancy. Any pain should be evaluated by your physician with an internal ultrasound. Visualizing the gestational sac will allow your physician to verify the location of your pregnancy. Please report back - I hope all is well with your pregnancy!

    • profile image


      4 months ago

      So I am curious. My last period was May 22. I took a pregnancy test 6 days before my period is due... between last period and pregnancy test I had a 5cm cyst rupture on my right ovary. I have pain from my shoulder to my hip (all on my right side). It was bad and then disappeared for awhile. Now today it returned and really hurts. My first HCG test was 211 on the 17th of June. By the 20th of June it was 998! I have a ton of pain on my right side and since my number skyrocketed I’m wondering if that is caused by an eco topic pregnancy as wel!

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      5 months ago from Western New York

      Some people feel pain and some do not, Ana. The most vital thing to do is to follow the advice of your physician and to receive regular monitoring until the location of your pregnancy can be verified. I have had two ectopic pregnancies and I had odd spotting/bleeding, but no pain until the pregnancy ruptured. When it ruptured, there was excruciating pain, but I had no pain symptoms before that time.

    • profile image


      5 months ago

      I had an IUD as a form of birth control. Missed my period on 5/15 took a pregnancy test and it was positive. My last period was 4/15. Ultrasound didn't show anything on my uterus and my hcg levels are 51. Doctor said that might have been the reason why she didn't see anything cause I'm too early. If it is ectopic, should I be experiencing pain right now? Or would it be too soon to feel anything yet?

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      7 months ago from Western New York

      Jane, it would be wise to consult your doctor as soon as possible due to your late cycle and pain. A medical professional will be able to help diagnose the cause of your symptoms, whether that is pregnancy or another condition.

    • profile image


      7 months ago

      Hi my periods are late by 12 days and I am having crampings in my abdomen but I didn’t had complete sex please help me in this situation

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      7 months ago from Western New York

      If I were in your situation, Kristin, I think I would ask my doctor for another beta hCG evaluation to verify the number has dropped to 0. If the ectopic pregnancy has resolved, this will give you reassurance. If the number has increased, it will give your doctor the information needed for different/additional intervention.

      In general, a beta hCG of less than 5 is considered negative for pregnancy, but a follow-up beta hCG and doctor's visit would be a good idea, particularly since you are still cramping and spotting.

    • profile image

      Kristin Carson 

      7 months ago

      Thank you so much for this informative article. I was diagnosed with an ectopic pregnancy earlier this year, and it took two rounds of methotrexate and 6.5 weeks for my hcg levels to go down. My last and hcg bloodwork my levels were at 2. My doctor said this meant that the ectopic pregnancy was resolved, but my nervous brain is trying to convince me that the pregnancy could possibly continue to grow. Have you ever heard of hcg levels going back up after they are at 2?

      Also, about 2 weeks after the levels were at 2, I have had some light cramping (like menstrual cramps) and very light spotting. I wonder if this could be a period? Has anyone else had something similar to this? Thank you!

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      8 months ago from Western New York

      Hi Angie, I am uncertain of the meaning of your comment. Where do you see any information about 48 days?

    • profile image


      8 months ago

      48 days?? Isn't it 48-72 hours??

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      10 months ago from Western New York

      I am sorry to learn that you have had some hearing loss, Jennifer. Methotrexate is actually used to stabilize hearing and prevent hearing loss in autoimmune diseases and is not listed as an ototoxic medication. I am sorry this has happened to you.

    • profile image

      Jennifer C 

      10 months ago

      They don’t tell you routinely but a possible side effect of Methotrexate is hearing loss and Due to two rounds of it to treat my ectopic ( it ruptured anyway ) I now am mostly deaf in my left ear Cam only hear 35% . This was traced to that medication. Take the surgery that medicine is not to be trusted.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      11 months ago from Western New York

      It is impossible to say at this early stage, though the fact that the pregnancy is in the womb is excellent news and this means that you do NOT have an ectopic pregnancy. My first pregnancy had a slow hCG rise that picked up and my son was born with no issues. I have also had one miscarriage and two ectopic pregnancies, which had very poor hCG rises that never increased to an appropriate rate. I wish you a very happy, healthy pregnancy and continued care by your doctor will let you know that everything is developing as expected.

    • profile image

      Aala Said 

      11 months ago

      thank you dear for answering

      i had an ultrasound yesterday and the Embryo was visualized inside the womb with expected age at 5 weeks so now am i still at the risk zone to lose it or it becomes a safe pregnancy?

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      11 months ago from Western New York

      Hello, Aala, the only way to definitively tell if a pregnancy is ectopic is by visualization via ultrasound or surgery. While your hCG levels are increasing, they are not increasing at the level one would expect, but additional hCG levels are required. It is extremely important to receive regular monitoring and care from a physician in this case.

    • profile image

      Aala Said 

      11 months ago


      i gound out that im pregnant in December 4 and the bhcg was 68

      after 84 hours it became 84 and after other 48 it became 264

      am i still facing the risk of ectopic pregnency ?

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      11 months ago from Western New York

      Sanya, I am so sorry you have lost the pregnancy. The lack of spotting and bleeding is a bit concerning, as typically when a miscarriage has occurred there will be bleeding. Was the sac visualized in the uterus or in your Fallopian tube? I would definitely seek a second opinion and have another beta hCG to ensure your levels have dropped to zero, as you should be monitored until there is absolutely no sign of pregnancy. With both of my ectopics, they never did visualize the sac in the tube at the OB/GYN's office. They did see adnexal fluid (fluid around the ovaries), but the ectopic pregnancy wasn't seen until I was admitted to the hospital after my tube ruptured. I think the ultrasound equipment at our local hospital was more sensitive than the one at the OB/GYN's office.

      I would call and be seen as an emergency appointment by another obstetrician in your area as soon as possible.

    • profile image


      11 months ago

      Got pregnant last week then I went dbgyn to confirm my pregnancy she did an ultrasound and she told me that I’m 4 weeks pregnant she saw the sac after 1 week later I went as she told me to go she took another scan and she said she couldn’t find anything other than a blood clot .

      She just asked me to back nd take one beta hcg so I got the result next day and it 84 by seeing the result she told me like your everything is gone there is nothing left

      I didn’t even have a light spotting or bleeding neither

      Actually I was tensioned so i forgot to ask her what might have happened

      She just asked me to stop tablets

      So it will go it’s you don’t need to take any further test or treatments

      Maybe I should change my gyn

      If anyone else had similar please help me with that

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      12 months ago from Western New York

      It might be too early to visualize the pregnancy, Wexx, though it is good you are being monitored carefully. I have had two healthy pregnancies and three miscarriages (two of the miscarriages were ectopic pregnancies). I had spotting in all of my pregnancies in the first month after I received a positive pregnancy test. The ectopic pregnancies had very poor hCG increases (increasing by only about 100 over a 2-day period, never coming close to doubling). The gestational sac is typically visualized with an hCG level of >1,000 - so your ultrasound on September 30 might have been too early to see anything. I hope your physician will repeat a transvaginal ultrasound soon, as a gestational sac would likely be visible at this point.

    • profile image


      12 months ago

      Hello i am desperate for some sort of answer or help. Something, anything!

      September 17 hcg was 28 (day of missed period),

      September 20 hcg was 104

      September 23 hcg was 348

      September 30 hcg was 794

      November 1 hcg was 1408

      Light brown spotting on sept.24 red bleeding sept.25,26. Brown spotting 27,28 ending on 29th. No pain or cramping. Ultrasound on sept.30 found nothing in uterus or tubes. Was put on prometrium 200mg daily. I dont know what to think.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      12 months ago from Western New York

      Thank you, RTalloni. This was an extremely difficult time for our family, and the angst waiting the beta hCG levels every 48 hours was agonizing. While it was a very difficult time, it has allowed me to connect with many others who have gone through (or are going through) a similar circumstance.

    • profile image


      12 months ago

      This informative post is helpful. Though I know ectopic pregnancies are dangerous conditions I did not know of the many variables involved. I am so thankful for the help you received, allowing you to be with your family and share your experience for the benefit of others.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      12 months ago from Western New York

      I am so sorry you are going through this, Bobby. An adnexal mass is a mass in the general ovarian area, so they are likely referring to the same visualization on the ultrasound. The level your hCG is increasing will give them additional information, as an ectopic pregnancy will not have a beta that doubles in the appropriate time frame. If they cannot visualize a sac in the uterus, observe a mass near the ovaries (adnexal), and the beta hCG increase is poor, then the signs point to an ectopic pregnancy. It is very good that you are seeing your doctor frequently and she will be able to advise you on the course of action based on the results of your beta hCG results and the ultrasound results.

    • profile image


      12 months ago

      Question-today I went to my doctor.its 9 days after from my missed period.at 1st she do TVS,in ultrasound room she says sac like structure seen in right ovary may be ectopic then she advice me to do beta hcg,result 640; but when I get ultrasound report then I see written adnexal mass and suggest do hcg after 48 hrs.now I’m confused what is right is it sac in right ovary or adnexal mass. It is ectopic or adnexal mass.please give me answer.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      19 months ago from Western New York

      Jo, my heart goes out to you. I have had two ectopic pregnancies and one full on rupture. I became very dizzy and the pain was staggering - like I had been shot in the side. I had difficulty standing up and had to be helped to the car. I have suffered from ovarian cysts my entire life and this pain surpassed a rupturing cyst. Persistent pain is not normal and I would insist on another follow up and/or a second opinion from another physician. I am so sorry you are going through this, as it is devastating.

    • profile image


      19 months ago

      Hi I've been diagnosed with an ectopic two.weeks ago I've had methatrexate to avoid surgery. My hcg levels are falling nicely from 2400 to.505 however I'm still getting pain that radiates.down my leg and into my back. The mass as they described did initially get bigger however is now 10% smaller. I've been in hospital twice already but I'm so worried this isn't normal and I will rupture. Ive been told to go back to.hospital when the pain is constant and severe! Ive a high pain threshold! Any advice would be appreciated.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      20 months ago from Western New York

      I am glad the article was helpful to you, Babur. If you have any questions, please let me know!

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      20 months ago from Western New York

      Marie, that is quite an ordeal. What does your physician say? I would certainly contact him/her to verify your bleeding is normal at this stage. I am so sorry you are going through this.

    • profile image


      20 months ago

      I have a ectopic pregnancy and we got my hgc levels down to 28 but I’ve been bleed for almost three weeks now. Goes from light to heavy.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      21 months ago from Western New York

      TeeGee, the waiting game can be very frustrating. Your first menstrual cycle may be up to six weeks after your ectopic, and I would certainly place a call to your physician for guidance if it takes longer than six weeks. With PCOS, you may take longer, but verifying with your doctor is always the safest way to go. I also had taken a pregnancy test on a whim with my first ectopic pregnancy, and was extremely grateful it was found - though there was uncertainty in where my pregnancy was as they couldn't visualize it on their ultrasound machine. We waited until we could confirm and I did lose my right fallopian tube. I later lost my left with a subsequent ectopic pregnancy. I am very glad you caught your ectopic right away to spare the fallopian tube!

    • profile image


      21 months ago

      I recently had an ectopic pregnancy which was terminated with the help of Methorexate. I was lucky that it did not rupture my fallopian tube. I had no signs of being pregnant and I am just thankful that I happened to take a pregnancy test on a whim and caught this soon and got immediate care. My question is, how long after the HGC comes back to normal, does one get a period? I have PCOS and dont ovulate at normal intervals; this waiting game is making me anxious.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      23 months ago from Western New York

      What, specifically, is the question about the video? With regard to hCG levels, they should double approximately every 48 hours in early pregnancy.

    • profile image

      Crystal McConnell 

      23 months ago

      On the video ... 48days or 48hrs???! Lol

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      2 years ago from Western New York

      I wish you much luck, Madhuri. HCG helps to trigger the release of eggs from the ovaries, and this can lead to an increase in the number of eggs released (and therefore fertilized). You may have a 20% chance of conceiving twins, and sometimes more are conceived. Hopefully your doctor can give you accurate statistics and is monitoring your condition carefully as you go through the treatments.

    • leahlefler profile imageAUTHOR

      Leah Lefler 

      6 years ago from Western New York

      Ectopic pregnancy is a frightening experience, teaches12345 - we were taken aback when my hCG levels weren't rising and my OB/Gyn thought it was ectopic. They couldn't find the pregnancy on the ultrasound, and that night I had terrible pain and the pregnancy ruptured. Fortunately we live close to the hospital and emergency surgery saved my life, but it is definitely a situation that must be monitored closely (and treated, once an ectopic is confirmed)!

    • teaches12345 profile image

      Dianna Mendez 

      6 years ago

      Well done, Leah. I didn't have any problems during my pregnancy and thankful for it. I am sure your post is going to help many women (and men) to understand tubal pregnancy and to receive encouragement.


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