Flucuating hcg in 2 week period 56 to 168 to 286 to 243 to 650 to 443. ultra sound came back normal no ectopic at this time. everyone is puzzled help?

My guess: In a situation where a woman is has low levels of the HCG pregnancy hormone in blood tests, that aren't rising or dropping - my guess is that there is a very early blighted ovum that is either in the uterus or in the fallopian tube. A woman can have an ectopic pregnancy that is miscarrying, but too small to see on ultrasound. Options: keep observing, do a d ; c, consider methotrexate. Good luck.