Ectopic pregnancy and Negative HPT?

[RavenStar]

Has this happened to anyone?  Or to someone you know?  Most of the things I'm reading online say that in the majority of ectopic pregnancies, the woman gets a positive HPT result. 

I know the blood tests to check for hCG are more sensitive than urine tests.  I'm thinking about asking my Dr. for a blood test.

[Jaimee]

What makes you suspect you're experiencing an ectopic pregnancy?  How many DPO are you?   From what I've heard ectopic pregnancies can produce a variety of hCG patterns from crazy high (due to early implantation), to quite low and slow to double.  

[RavenStar]

Hi Jaimee!  Thanks for responding.

So I'm currently not temping.  I do write down the start date of my cycles and keep track of CM.  The reason I'm not temping right now is because I'm still nursing my toddler and waking up many times at night.

So my cycles for the last several months have averaged about 26 days.  Right now I'm at CD 31 with no AF so far.  The reason I'm concerned about a possible ectopic pregnancy is that I've been having pain in the lower left quadrant.  I'm having general pain in my hips, sacrum, lower back and pelvis.  Sometimes it radiates down my legs.  I'm having very specific, sometimes acute pain in the lower right side. 

For the past two days, I kept thinking I was just about to get my period because the cramping was more general.  Yesterday morning, however, the pain became more acute and severe.  I did go to the ER.

The ER Dr. said it's most likely a hernia.  He ruled out appendicitis and ovarian cysts just by the location of the pain.  They did a urinalysis which came back normal and said I'm not pregnant.

I've taken 2 pregnancy tests, both negative.  One was the day after my period was due, but was at night.  That was 4 days ago.  (I just couldn't wait and it was a $ store test)

I planned on taking one yesterday morning, however I had to pee in the middle of the night and did the test.  The test at the ER was in the middle of the day.  This one was negative also.

So DH is going to get another test for me to take tomorrow morning, with FMU.  I also am going to see my own Dr. tomorrow for a pelvic exam and to try to rule other things out.

I do think there is a great possibility I have a hernia.  I also just want to make sure something else isn't going on.  Especially since my period is so late.

[hildare]

when i had an ectopic, i first suspected something was wrong when i took 3 tests back to back and got a positive AND a negative.  false positives are really rare, and that was strange.

so in my experience, you can certainly have a negative hpt or a very faint positive. 

the real way to tell if it's ectopic is to have bloodwork done on two consecutive days and see where your hcg is.  if it is positive and doesn't double, then you'd get more bloodwork over the next few days.  ectopic hcg does weird things like rise and fall in an unpredictable way.  it will increase but not as in a healthy pregnancy.  and yet, just that alone doesn't help diagnose an ectopic, as other miscarriage situations can have hcg levels happen this way.

my advice is to go immediately and do the first draw and let the physician know you're suspecting an ectopic.  i cannot believe they didn't do a blood pregnancy test with what you're saying.

i hope it turns out not to be.  keep us updated!

[Jaimee]

RavenStar, I'm sorry for the pain and confusion you're going through.  It seems beta levels would be in order to truly rule out pregnancy as an issue so you can move on with any necessary treatment for another problem.  Good luck and keep us posted!

Hildare, can your hCG levels actually drop below previous beta levels and rise again with an ectopic?  Or do the levels just tend to rise in an erratic pattern- sometimes slowing increasing and other times spiking?  There is another poster on this forum that was told by an ER doc that she was likely m/c an ectopic pregnancy b/c she had gotten an HPT+ and then her blood level came back at 4.  Now she's reported another HPT+ less than 24 hours after that blood test.  I'm wondering if this scenario is possible or if one or more of the tests have been inaccurate.  Thanks for your insight and sorry to derail your thread a bit,  Raven!

[RavenStar]

Thank you, Hildare, for your response!  I'm not sure why they didn't do a blood draw either.  That's really helpful information.  I see my Dr. tomorrow at 11 am, CST.  I'll let you know what I find out.  In the meantime, I'm having all sorts of local and general pain.  I'm glad I will find out soon.

I am also going to take another HPT in the AM.

Jaimee, I don't mind at all!  One thing I love about these threads, besides the help I get, is helping others.  So I hope that someone else who is in a similar situation, can also get some help.  I'll keep you posted!

[hildare]

Jaimee, i'll try to find that post and answer.  i can't remember what my numbers were exactly, but it sounds like that person could have just had a very sensitive test!  i'd hate to take action that early and be wrong, you know....

[Jaimee]

Hildare, the original post is here: http://www.mothering.com/community/t/1327494/hcg-shot-to-make-me-ovulate-i-have-a-lump-in-my-throat-am-i-finally-pregnant   You'll find that the OP had an hCG trigger shot to stimulate ovulation, which complicates matters when testing.

[gozal]

Ravenstar, I'm so sorry to hear you're in this difficult place of not knowing what's going on. From the reading I did while going through my suspected ectopic, I think the answer to your question depends on the sensitivity of the hpt. For a 50 mIU hpt, it would not have picked up my EP until sometime in week 5, for instance. But with my super sensitive internet cheapies, I got a + hpt at 10dpo.

Originally Posted by Jaimee 
Hildare, can your hCG levels actually drop below previous beta levels and rise again with an ectopic?  Or do the levels just tend to rise in an erratic pattern- sometimes slowing increasing and other times spiking?  There is another poster on this forum that was told by an ER doc that she was likely m/c an ectopic pregnancy b/c she had gotten an HPT+ and then her blood level came back at 4.  Now she's reported another HPT+ less than 24 hours after that blood test.  I'm wondering if this scenario is possible or if one or more of the tests have been inaccurate.  Thanks for your insight and sorry to derail your thread a bit,  Raven!

Yes, it is possible for betas to drop and then rise again. My first beta was 44, second was 22, third was 48. After that they rose erratically.

Ravenstar, I hope you're able to get a beta. I'm also surprised that you were not tested at the ER. I think that will answer a lot of questions for you.

[RavenStar]

Thank you, gozal.   That's really helpful!  I saw my Dr. today and she ordered a blood test.  I'm still waiting for the results. 

I also took another HPT first thing this morning and it was negative.  My feeling is that I'm not pregnant, but I'm really happy to get this blood test.  They'll call with the results tomorrow.

My Dr. also thinks this may be a musculoskeletal issue and ordered an X-Ray of my hips.  This is the other reason for making sure that I'm not pregnant.

I do think it's possible that going back to work and changing how often I nurse (as a result of working almost full-time last week) is a factor in why my period is so late.  I'm just glad we're covering all of our bases.

Thank you, everyone!

[RavenStar]

Just wanted to update to say that I didn't end up with an ectopic pregnancy.  The blood test showed I wasn't pregnant and later that day I got my period.  As it turns out, I have a small hernia in my groin/pelvis area.  It's causing a lot of pain and I will have surgery to repair it on Tuesday.  Thank you for all the support and for the discussion.

[Jaimee]

So sorry about the hernia, but I'm glad you got it all figured out and hopefully will have some relief soon!  Best wishes for an easy surgery and fast recovery!