Slowing betas... should I be worried?

[mars1234]

Grateful for any opinions on the below betas and doubling times, and whether I need to begin preparing for the worst...

I'm 4W6D/20DPO (hCG trigger used so this is pretty certain).

We're flying out on vacation tmrw and I won't have access to a lab for additional betas for at least seven days. Honestly freaking out. I've just left a msg with our clinic asking the on duty RE to call back.

Betas 1 (11DPO): 43.0 (Lab A)

Betas 2 (13DPO): 147 - 27.1 hours doubling time - 2 day increase 242% (Lab A)

Betas 3 (15DPO): 449 - 29.8 hours doubling time - 2 day increase 205% (Lab B)

Betas 4 (17DPO): 1310 - 36.25 hours doubling time - 2 day increase 150% (Lab B)

Betas 5 (19DPO): 2197 - 57.64 hours doubling time - 2 day increase 78% (Lab A)

Doubling time has been calculated using the precise time of each blood draw. I know that there's an element of uncertainty due to the two different labs.

No spotting. Intermittent, painful menstrual type cramping began around a week ago. No prior miscarriages.

First ultrasound is two weeks away. However, with the last beta at 2197, am I right in thinking that a gestational sac (but not yolk or pole) should now be visible on transvaginal ultrasound or is it still too early at just under 5W? Should I push for one today?

UPDATE (TW):
Following an ultrasound this afternoon, the RE said with 99% certainty that it's a non-viable pregnancy. The gestational sac is a very irregular shape (non circular). It was measuring 1 mm instead of the expected 4 mm for my dates (4W6D). Miscarriage expected to occur within the next week. I've been instructed to stop progesterone.

I'm honestly relieved I found out now rather than miscarrying during vacation.

 

[katrina2017]

@mars1234 I don't think you have anything to worry about. Betas slow down. But with the cramping and betas, I'm sure your doctor can bring you in for piece of mind before your trip.

 

[mars1234]

@katrina2017 Thank you so much for taking the time to respond. I'm trying to stay positive, however it seems that normal slowing is expected once betas reach 6000. I've not found anything to support slowing at 2000

I would like to think I'd be more chill about this if not facing a week in a vacation vacuum without further betas

 

[katrina2017]

@mars1234 I will say after you see (or don't see) betas increasing, more of them won't do much. So don't stress about not getting more on vacation! I'm actually surprised your doctor ordered so many. the most my RE ever ordered were 3.

 

[mars1234]

@katrina2017 Just wanted to say thank you again for replying. I've updated main post. RE says it's non-viable with 99% certainty. Sac shape and measurement were not even close to resembling what should be expected.

 

[dardan]

@mars1234 Studies show HCG should be in these ranges:

0-1,200 = 30-72 hour doubling
1,200-6,000 = 72-96 hours doubling
6,000+ = 96+ hours doubling

So your HCG itself was still doubling well within the bounds of normal and did not indicate an issue.

 

[dardan]

@mars1234 I’m sorry you have this concern.

Your HCG is fine and doesn’t indicate an issue in itself.

I’m confused by your ultrasound, though. Most studies show that you can’t visualize a GS