PLE-4096

A 22-year-old nulligravid, who has not had a period for 8 weeks, came in due to right lower quadrant abdominal pain with vaginal spotting. During the pelvic exam, right adnexal tenderness was observed. The pregnancy test came back positive and the hCG level is 3500. However, the ultrasound did not reveal a gestational sac. This condition is treated medically if the following criteria are present, except: