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hCG Levels | The American Pregnancy Association

HCG (Human Chorionic Gonadotropin) is often called the pregnancy hormone because it is made by cells formed in the placenta, which nourishes the egg after it has been fertilized and becomes attached to the uterine wall. Levels can first be detected by a blood test about 11 days after conception and about 12-14 days after conception by a urine test.

Typically, the hCG levels will double every 72 hours. The level will reach its peak in the first 8-11 weeks of pregnancy and then will decline and level off for the remainder of the pregnancy.

1. As you get further along in pregnancy and the hCG level gets higher, the time it takes to double can increase to about every 96 hours.
2. Caution must be used in making too much of hCG numbers. A normal pregnancy may have low hCG levels and result in a perfectly healthy baby. The results from an ultrasound after 5 -6 weeks gestation are much more accurate than using hCG numbers.
3. An hCG level of less than 5 mIU/mL is considered negative for pregnancy, and anything above 25 mIU/mL is considered positive for pregnancy.
4. An hCG level between 6 and 24 mIU/mL is considered a grey area, and you’ll likely need to be retested to see if your levels rise to confirm a pregnancy.
5. The hCG hormone is measured in milli-international units per milliliter (mIU/mL).
6. A transvaginal ultrasound should be able to show at least a gestational sac once the hCG levels have reached between 1,000 – 2,000 mIU/mL. Because levels can differentiate so much and conception dating can be wrong, a diagnosis should not be made by ultrasound findings until the hCG level has reached at least 2,000 mIU/mL.
7. A single reading is not enough information for most diagnoses. When there is a question regarding the health of the pregnancy, multiple testings of hCG done a couple of days apart give a more accurate assessment of the situation.
8. The hCG levels should not be used to date a pregnancy since these numbers can vary so widely.
9. There are two common types of hCG tests. A qualitative test detects if hCG is present in the blood. A quantitative test (or beta) measures the amount of hCG actually present in the blood.

Guideline to hCG levels in weeks during pregnancy

* These numbers are just a guideline – every woman’s level of hCG can rise differently. It is not necessarily the level that matters, but rather the change in the level.

What Does a Low hCG Level Mean?

A low hCG level can mean any number of things and should be rechecked within 48-72 hours to see how the level is changing. A low level can indicate:

• Miscalculation of pregnancy dating
• Possible miscarriage or blighted ovum
• Ectopic pregnancy

Is a High hCG Level a Bad Thing?

A high level of hCG can also mean a number of things and should be rechecked within 48-72 hours to evaluate changes in the level. A high level can indicate:

• Miscalculation of pregnancy dating
• Molar pregnancy
• Multiple pregnancies

Should I Check My hCG level Regularly?

It’s not common for doctors to routinely check your hCG levels unless you are showing signs of a potential problem.
A health care provider may recheck your levels if you are bleeding, experiencing severe cramping, or have a history of miscarriage.

What Can I Expect After a Pregnancy Loss?

Most women can expect their levels to return to a non-pregnant range about 4 – 6 weeks after a pregnancy loss has occurred.
This can differentiate by how the loss occurred (spontaneous miscarriage, D & C procedure, abortion, natural delivery) and how high the levels were at the time of the loss.
Healthcare providers usually will continue to test hCG levels after a pregnancy loss to ensure they return back to <5.0.

What Can Interfere With My hCG Levels?

If you get a positive test result, you are most likely pregnant. False positives are extremely rare. However, there are some conditions that may cause a false positive, such as certain types of cancer and early miscarriage. Some antibodies may also interfere with test results.

Medications that contain hCG may interfere with hCG levels, as well.

These medications are often used infertility treatments, and your health care provider should advise you on how they may affect a test.

All other medications such as antibiotics, pain relievers, contraception or other hormone medications should not have any effect on a test that measures hCG.

Want to Know More?

• Pregnancy Calculator
• Calculating Gestation Age
• Concerns Regarding Early Fetal Development

Compiled using information from the following sources:

1. U.S. Food and Drug Administration

www.fda.gov

2. Bashir, I; Ihenetu, K; Miller, J.J.; Gim, M.; Lippmann, S. A Positive Pregnancy Test in the Post-Menopausal Psychiatric Patient — What to Think? Psychiatry (Edgemont). Feb. 2006.

Beta-subunit of human chorionic gonadotropin (beta-hCG)

Beta-subunit of human chorionic gonadotropin is one of the subunits of a specific hormone molecule - chorionic gonadotropin, which is formed in the shell of the human embryo. The analysis is carried out for the purpose of early diagnosis of pregnancy, detection of its complications and diagnosis of diseases associated with impaired hCG secretion.

Synonyms Russian

Beta subunit of hCG.

Synonyms English

Human Chorionic Gonadotropin, hCG, b-HCG, Quantitative hCG; Beta hCG, Total hCG, Total beta hCG.

Test method

Electrochemiluminescent immunoassay (ECLIA).

Detection range: 0.1 - 1,000,000 IU/L.

Units

IU/l (international unit per litre).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

• Do not smoke for 30 minutes before the test.

General information about the study

Human chorionic gonadotropin (hCG) is a hormone produced in the fetal membrane of the human embryo. It is an important indicator of the development of pregnancy and its deviations. It is produced by the cells of the chorion (the shell of the embryo) immediately after it is attached to the wall of the uterus (this happens only a few days after fertilization). The fetus at this stage of pregnancy is a microscopic vesicle filled with fluid, the walls of which are made up of rapidly multiplying cells. From one part of these cells, the unborn child (embryoblast) develops, while from the cells outside the embryo, a trophoblast is formed - that part of the fetal egg, with which it is attached to the wall of the uterus. Later, the chorion is formed from the trophoblast.

Chorion performs the function of nourishing the embryo, being an intermediary between the body of the mother and the child. In addition, it produces chorionic gonadotropin, which, on the one hand, affects the formation of the child, on the other hand, it specifically affects the mother's body, ensuring a successful pregnancy. The appearance of this hormone in the body of a future mother at the initial stage of pregnancy explains the importance of the test for early diagnosis of pregnancy.

Chorionic gonadotropin stimulates the secretory function of the corpus luteum of the ovaries, which should produce the hormone progesterone, which maintains the normal state of the inner lining of the uterine wall - the endometrium. The endometrium provides reliable attachment of the fetal egg to the mother's body and its nutrition with all the necessary substances.

Due to a sufficient amount of human chorionic gonadotropin, the corpus luteum, which normally exists for only about 2 weeks during each menstrual cycle, does not undergo resorption after successful conception and remains functionally active throughout the entire period of pregnancy. Moreover, it is in pregnant women under the influence of chorionic gonadotropin that it produces very large amounts of progesterone. In addition, CG stimulates the production of estrogens and weak androgens by ovarian cells and promotes the development of the functional activity of the chorion itself, and later the placenta, which is formed as a result of the maturation and growth of the chorionic tissue, improving its own nutrition and increasing the number of chorionic villi.

Thus, the role of human chorionic gonadotropin lies in the specific and multifaceted effect on the body of a woman and the fetus in order to ensure a successful pregnancy. Based on the analysis for chorionic gonadotropin, the presence of chorionic tissue in the woman's body is determined, and hence pregnancy.

According to its chemical structure, chorionic gonadotropin is a combination of protein and complex carbohydrates, consisting of two parts (subunits): alpha and beta. The alpha subunit of chorionic gonadotropin is completely identical to the alpha subunits of the luteinizing, follicle-stimulating and thyroid-stimulating hormones of the pituitary gland, which perform functions that are largely similar to the function of chorionic gonadotropin, but not during pregnancy. The beta subunit of chorionic gonadotropin is unique, which, on the one hand, determines the specificity of its action, and, on the other hand, allows it to be identified in biological media. In this regard, this test is called "beta-subunit of human chorionic gonadotropin (beta-hCG)".

Knowing the level of beta-hCG in the blood, it is possible to diagnose pregnancy already on the 6-8th day after conception (in the urine, the concentration of beta-hCG reaches the diagnostic level 1-2 days later). Normally, during pregnancy between the 2nd and 5th weeks, the amount of beta-hCG doubles every 1.5 days. With multiple pregnancy, it increases in proportion to the number of fetuses. The maximum level of hCG reaches the 10-11th week, and then gradually decreases. This is due to the fact that from the beginning of the 2nd third of pregnancy, the placenta is able to independently produce enough estrogens and progesterone, with the participation of which the endometrium functions normally, regardless of the secretion of hormones in the ovarian corpus luteum. At the same time, the concentration of CG in the blood of a pregnant woman gradually decreases, and the corpus luteum can function without the effects of CG. During this period, the role of the hormone is to stimulate the production of testosterone in the fetus, which is necessary for the normal development of the external genital organs of the embryo.

Thus, during pregnancy, the level of beta-hCG in the blood first increases and then decreases. According to this indicator, one can judge the successful course of pregnancy and identify violations of the development of the fetus. The test for hCG in the blood is the most reliable method for determining pregnancy in the early stages. HCG appears in the body of a woman from 6-8 days after fertilization. A common rapid pregnancy test that every woman can use at home is also based on measuring hCG in the urine.

Below normal hormone levels at various stages of fetal development suggest ectopic pregnancy, fetal growth retardation, threatened miscarriage, non-progressive pregnancy, or placental insufficiency. The reason for the increased content of beta-hCG may be toxicosis, diabetes mellitus, or an incorrectly set gestational age. A high level of the hormone after a mini-abortion indicates a progressing pregnancy.

Determining the level of hCG is included in the triple test study, the results of which can be used to judge some anomalies in the development of the fetus, but an accurate diagnosis cannot be made. The study only allows you to classify a woman as a risk group for this pathology. In this case, further investigation is necessary. In non-pregnant women, CG is normally absent, but it can be secreted by some abnormal chorion-derived tissues (hydatidiform mole, chorionepithelioma) and some other tumors.

What is research used for?

• For the diagnosis of pregnancy, including multiple, ectopic and non-developing.
• To monitor the progress of pregnancy.
• To detect fetal growth retardation, threatened miscarriage, placental insufficiency.
• For the diagnosis of amenorrhea.
• To monitor the effectiveness of induced abortion.
• As part of a comprehensive examination to identify fetal malformations.
• For the diagnosis of CG-producing tumors.

When is the test ordered?

• If pregnancy is suspected, in particular multiple pregnancy.
• When monitoring the progress of pregnancy.
• When there is an assumption about a complication during pregnancy: fetal growth retardation, the threat of spontaneous abortion, non-developing or ectopic pregnancy, chronic placental insufficiency.
• Confirm successful induced abortion if necessary.
• With a comprehensive examination to identify fetal malformations.
• When finding out the reason for the absence of menstruation (amenorrhea).
• When is the diagnosis of tumors producing hCG.

What do the results mean?

Reference values ​​

Causes of high beta-hCG levels

In the absence of pregnancy, the result of the beta-hCG test should be negative. The detection of beta-hCG suggests that at least 5-6 days have passed since fertilization. Between the 2nd and 5th weeks of pregnancy, during its normal course, the level of beta-hCG doubles every 1.5 days and soon reaches its maximum. Then it starts to slowly decline. The results of the analysis are compared with the normal values ​​for each period of pregnancy. For a correct interpretation of the results, it is necessary to know exactly when the conception occurred.

In pregnant women:

• multiple pregnancies (the rate increases in proportion to the number of fetuses),
• toxicosis,
• prolonged pregnancy,
• maternal diabetes mellitus,
• fetal malformations,
• taking synthetic hormones.

Not pregnant:

• hCG-producing tumors,
• surgical abortion (first 4-5 days after the procedure),
• taking hCG preparations.

Causes of low beta-hCG levels (during pregnancy):

• ectopic or non-developing pregnancy,
• fetal growth retardation,
• threatened miscarriage,
• chronic placental insufficiency,
• fetal death (in the 2nd-3rd trimester of pregnancy).

What can influence the result?

• When diagnosing pregnancy, taking the test too early - when less than 5 days have passed since conception - can lead to a false negative result.

Also recommended

• Alpha-fetoprotein (alpha-FP)
• Antiphospholipid antibodies IgG
• Antiphospholipid antibodies IgM
• Placental lactogen
• Free estriol
• Pregnancy - Prenatal screening for trisomies of the first trimester of pregnancy (Down syndrome), PRISCA
• Plasma pregnancy-associated protein A (PAPP-A)
• Pregnancy - Prenatal screening for trisomies of the second trimester of pregnancy, PRISCA
• Antibodies to steroid-producing cells of the placenta

Who orders the examination?

General practitioner, obstetrician-gynecologist, oncologist.

Literature

• Handbook of Clinical Laboratory Testing During Pregnancy, edited by Ann M. Gronowski. Springer-Verlag LLC, New York, 2004
• Prenatal Diagnosis in Obstetric Practice. M. J. J. Whittle, Blackwell Publishers 1995
• Endocrinology of Pregnancy. Fuller W. Bazer, Humana Press 1998
• Blood Biochemistry. N J Russell, G M Powell, J G Jones, P J, Winterburn and J M Basford, Croom Helm, London and Canberra, 1982
• Blood Chemistry and CBC analysis-Clinical Laboratory Testing from a Functional Perspective. Rychard Weatherby N.D and Scott Fergusson, N.D., Bear Mounting Publishing, 2002.
• Tietz Clinical Guide to Laboratory Tests. Alan H. B. Wu, Saunders/Elsevier, 2006
• Laboratory and Diagnostic Tests. Joyce LeFever Kee - Pearson, Prentice Hall, 8th Edition 2010
• District Laboratory Practice in Tropical Countries. Monica Cheesbrough, Cambridge University Press, second edition, 2005.
• Clinical Chemistry. A Laboratory Perspective. Wendy L. Arneson, Jean M. Brickell, F.A. Davis Company, 2007
• Clinical Chemistry. Michael L. Bishop, Edward P. Fody, Larry E. Schoef, Lippincott Williams & Wilkins, 2005

The norm of hCG during pregnancy. Table of hCG values ​​by week. Elevated HCG. Low HCG. HCG in ectopic pregnancy. hCG during IVF (hCG after replanting, hCG at 14 dpo).

hCG or beta-hCG or total hCG - human chorionic gonadotropin - a hormone produced during pregnancy. HCG is formed by the placenta, which nourishes the fetus after fertilization and implantation (attachment to the wall of the uterus).

• What is hCG (= beta-hCG)
• When to donate blood for hCG
• HCG norm. Deciphering the analysis of hCG. HCG level during pregnancy
• Normal HCG doubling time
• HCG norms by week. HCG table
• Low hCG. What does hCG below normal mean?
• Negative hCG or hCG indicative of non-pregnancy with missed period
• hCG and biochemical pregnancy
• hCG and ectopic pregnancy
• Increased hCG. What can hCG levels above normal mean?
• HCG and multiple pregnancy. hcg and twins.
• Bubble skid
• HCG test after embryo transfer. HCG for IVF
• hCG and ovarian hyperstimulation syndrome
• Elevated hCG levels in non-pregnant women and men
• How does hCG change after miscarriage, abortion, childbirth?
• What medications affect hCG levels?

HCG or beta-hCG or total hCG - human chorionic gonadotropin - a hormone produced during pregnancy. HCG is formed by the placenta, which nourishes the fetus after fertilization and implantation (attachment to the wall of the uterus). HCG is measured in mIU/mL (mile international units per milliliter).

HCG partially crosses the placental barrier. The level of hCG in newborns is approximately 1/400 of the level in maternal blood. And it is approximately 10-50 mIU / ml at birth. The half-life is 2-3 days. Thus, at 3 months of life, the level in newborns corresponds to the norm of hCG for an adult.

An increase in hCG in the blood can be detected a few days before the expected menstruation. The optimal time for a blood test to determine hCG is after a missed period.

A single determination of hCG cannot be used to diagnose miscarriage or ectopic pregnancy.

An hCG level of less than 5 mIU / ml indicates the absence of pregnancy or that the test was taken too early. The level of hCG is above 25 mIU / ml - about the presence of pregnancy.

On average, a doubling of hCG levels occurs every 36-72 hours. The level of hCG reaches its peak at 9-11 weeks of gestation (from the date of the last menstrual period) and then decreases until the 15th week of pregnancy, remaining unchanged during the remainder of the pregnancy. In 85% of cases, the level of hCG in the early stages doubles every 48-72 hours. As pregnancy progresses, the doubling time for hCG levels increases to 96 hours.

HCG level Doubling time
1200 mIU/ml 48-72 hours
1200 – 6000 mIU/ml 72-96 hours
More than 6000 mIU/ml More than 96 hours

hcg calculator

At what hCG value should an ultrasound be done?

After reaching an hCG level of 1000 - 2000 mIU / ml, a fetal egg can be visualized by ultrasound. Since the level of hCG has a large variability, and the date of conception can be erroneous, the gestational age is determined by ultrasound or IVF data, but not by hCG.
A single determination of hCG is not enough, since it is important to evaluate the growth dynamics of the hormone every 48-72 hours.

These ranges are provided as a guide and should not be used to interpret a particular hCG assay.

• Not pregnant
• Error in calculating the gestational age
• Pregnancy arrest or miscarriage, biochemical pregnancy
• Ectopic pregnancy
• Threatened miscarriage

It is necessary to repeat the analysis for hCG in 1-2 days, perhaps the pregnancy came later than expected. If the level of hCG does not rise, it is necessary to look for other reasons for the delay in menstruation.

The so-called "biochemical pregnancy" is a condition in which an increase in hCG above normal was detected, but the pregnancy did not continue to develop. The level of hCG in this case rises slightly, and then in a short time decreases to zero values.

An ectopic pregnancy is a pregnancy in which the fertilized egg is outside the uterine cavity. With an ectopic pregnancy, there may be pain in the lower abdomen, spotting. The level of hCG during an ectopic (ectopic) pregnancy may not increase as quickly and not as significantly as with a normally developing uterine pregnancy. However, the low level of hCG does not allow such a conclusion to be made unambiguously. Starting with an hCG level of 1000 mIU / ml, a fetal egg can be detected in the uterine cavity. With an hCG level of 2000 mIU / ml and the absence of a fetal egg in the uterine cavity during ultrasound, the likelihood of an ectopic pregnancy is significant.

• Error in calculating the gestational age
• Bubble skid
• Multiple pregnancy
• Complications of pregnancy (preeclampsia)
• Maternal diabetes mellitus
• Taking synthetic progestogens
• Risk of fetal malformations

HCG and multiple pregnancy. hcg and twins.

The level of hCG in a multiple pregnancy is higher than in a single pregnancy, but the rate of increase in hCG is the same in both cases.

Vesicle drift is a rare complication of pregnancy in which the level of hCG will be significantly increased, on average 2 times higher than the average value for a given period. For example, the possible level of hCG with cystic mole for 36 days from the first day of the last menstruation can reach 200,000 mIU / ml, while with a normally developing pregnancy, hCG will be from 1,200 to 36,000 mIU / ml.

An hCG test is performed approximately 2 weeks after embryo transfer (12-14 days after transfer (dpp)). Usually the level of hCG at 14 dpo is more than 100 mIU / ml.

If the hCG level is less than 25 mIU / ml, pregnancy has not occurred. If the hCG level is more than 25, the test is repeated after 2 days, with the development of pregnancy, its level should increase. The hCG level will double approximately every 48 hours until 21 days after infusion.

Higher hCG values ​​(300-400 mIU / ml) are more likely to indicate multiple pregnancy.

In patients with ovarian hyperstimulation syndrome, hCG levels should be interpreted with caution. These patients may develop edema, which leads to thickening of the blood, which can lead to a false increase in the level of hCG, and when the blood composition is normal, to a false absence of an increase in the level of hCG.

The test for hCG is also included in the prenatal screening of the second trimester - an analysis that allows you to assess the risk of developing fetal defects.

Outside of pregnancy, hCG can be produced by the cells of some tumors (seminoma, testicular teratoma, neoplasms of the gastrointestinal tract (including pancreas, liver, colorectal cancer and stomach cancer).

With successful treatment of an hCG-producing tumor, the hCG level should decrease to normal.

In most cases, the level of hCG decreases. The half-life of hCG is 24-36 hours. The speed of reaching zero hCG values ​​depends on what exactly happened: spontaneous miscarriage, abortion, childbirth, curettage) and how high the hCG level was at the time of pregnancy loss. Doctors recommend continuing to assess hCG levels until levels are below 5 mIU/mL. If the hCG level remains high, you should consult a doctor.

The level of hCG is affected by drugs that contain hCG (Pregnil, Horagon).

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• Online hCG calculator during pregnancy

  The hCG calculator is used to calculate the increase in hCG (the difference between two tests taken at different times).

  The increase in hCG is important for assessing the development of pregnancy. Normally, in the early stages of pregnancy, hCG increases by about 2 times every two days. As the hormone levels increase, the rate of increase decreases.

• False positive pregnancy test or why hCG is positive but not pregnant?

  When can a pregnancy test be positive?

• The norm of a complete blood count during pregnancy. Hemoglobin, platelets, hematocrit, erythrocytes and leukocytes during pregnancy. Clinical blood test during pregnancy. Hematological changes during pregnancy.

  Translation of materials from UpTodate.com
  A normal pregnancy is characterized by significant changes in almost all organs and systems to adapt to the requirements of the fetoplacental complex, including changes in blood tests during pregnancy.

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  Prenatal screening data allow assessing not only the risks of congenital pathology, but also the risk of other pregnancy complications: intrauterine fetal death, late toxicosis, intrauterine hypoxia, etc.

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