Consistently low Hcg Level

Patient : My dtr has fluctuating Hcg levels that have ranged from 23-79. She has been getting her level drawn for about 4 or 5wks. The levels aren't consistenly decreasing and are fluctuating. 5 days ago it was 23 and today her level is 27. She has chronic lower back pain and is now suffering with a severe UTI and taking Bactrim. She does get occasional sharp right lower quadrant pains. Her US was negative. Her OB Dr. doesn't seem too concerned. I'm not sure what the next step is? I'm an RN and worry about ectopic preg. and believe she should be having additional work up to find out the cause of the abnormal hcg levels. Your thoughts?
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