Thursday, June 10, 2010

Games doctors play with HCG levels !

positive pregnancy testImage via Wikipedia

For a patient going through an IVF cycle, the most important number is the HCG (human chorionic gonadotropin) level - also known as the beta. HCG is a chemical produced by the embryo, and is the embryo's signal to the mother that pregnancy has occurred.

In a non-pregnant woman, the HCG level is less than 10 mIU/ml. A level of more than 10 mIU/ml is considered to be positive, and means that the embryo has implanted.

Many IVF doctors are very creative in manipulating the HCG results and in interpreting them, because they want to inflate their success rates !

How do they fool their patients ?

1. They give HCG injections during the luteal phase, after the embryo transfer, claiming this is for "luteal phase support". This HCG is then detected in the blood when doing the HCG blood test ( or in the urine, when doing a pregnancy test). Since the HCG test is positive, they then proudly proclaim that the patient is pregnant and that their treatment was successful. The cruel tragedy is that this just creates false hope and patients are on top of the world for a few days ! To make a bad situation even worse, they continue giving the HCG injections to "support the pregnancy". This means that the HCG levels remain positive for another few days. However , because the patient is not really pregnant, the levels soon drop. The doctor then claims that the IVF pregnancy miscarried because of "bad luck" and that the patient's best option is to try again. Patients feel that since they did get pregnant, this is a good IVF doctor - and they keep on doing IVF treatment cycles with him repeatedly.

2. They are very liberal with interpreting what a positive HCG level is ! Technically, a level of less than 10 mIU/ml is negative. This means that anything more than 10 can be considered to be positive. Thus, when patients get levels of 14 or 16, they proudly declare that the IVF was successful and that the patient is pregnant. In reality, in a healthy pregnancy, the levels should be at least more than 30 mIU/ml 14 days after the transfer ( typically, they should be abut 100 mIU/ml or more at this time).

It's quite easy for doctors to "game the system" - and the sad truth is that some doctors will do so ! That's why it's so important for patients to be well informed !

Need help in interpreting your HCG results ?

Need help in making sense of your lab results ? Please enter your lab values and your clinical details in our Free Second Opinion form and I’ll help you interpret your results !

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