I have a pregnancy timing question The first day of my last period.

Patient

Q: I have a pregnancy timing question. The first day of my last period was January 30. I normally have a regular 28-29 day cycle. I unexpectedly had intermenstrual bleeding (heavy) from Feb 16-19. I slept with man #1 on Feb 21 and Feb 27.

I slept with man #2 on March 5 - he pulled out and I took Plan B 48 hours after (March 7). I had negative pregnancy tests on February 25 and March 7. I had a positive home pregnancy test on March 17 and a blood hcg of 444. I had another blood draw on March 21 and my hcg was 3955.

Understanding that it will be hard to *definitively* know, is the likelihood higher that this is Man #1's baby? (Disclaimer that this man is my husband -- whom I have never been unfaithful to until now -- so I'm really praying that it is). Assuming I DID ovulate at the exact moment on March 5 and the egg was fertilized and implantation happened exceptionally fast, does 444 seem like a high number for 12-13 days post ovulation? Likewise does 3955 seem high for 16-18 days post ovulation? I completely recognize that hcg is a difficult thing to go by and everyone has a range but in YOUR experience/opinion/expertise, do those numbers seem high for a March 5 conception date? Is the likelihood higher it is from the Feb 27/Feb 21 intercourse?

One last piece of background, I had an ultrasound this morning (March 28) and they were only able to see a yolk sac (no baby yet). That would make the baby 6w2d for a Feb 27 conception and 5w2d for a March 5 conception. I go back again in 2 weeks for another ultrasound but in the meantime the technician said the baby could be anywhere from 5-6weeks (which is what I already know).

I am just looking for a little insight into the numbers and likelihood of the different possible conception dates given your years of expertise and observations.

Any and all help would be incredibly appreciated. Thank you.

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
A 4 weeks pregnancy would have a hcg level would be around 426-444 . So, considering that pregnancy was 4 weeks on MARCH 17, so date of conception should be around feb 22-24.
Hence it is likely that the first man is likely the father of your child. A home pregnancy test would not have come positive if the conception would have been from march 5. A hcg level at 3 weeks pregnancy would have been 0 to 5 if the pregnancy would have occurred on march 5.
I hope that i have answered your query in detail,
Regards

Comments / Follow Ups

Patient: In your experience, which is more reliable this early on -- hcg bloodwork or ultrasound dating?
Doctor: In my experience hcg blood work is more reliable than usb dating in any case unless its an ectopic pregnancy or a partial mole.
Doctor: *thats usg dating and not usb.

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