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HCG blood test - quantitative Information | Mount Sinai

Serial beta HCG; Repeat quantitative beta HCG; Human chorionic gonadotropin blood test - quantitative; Beta-HCG blood test - quantitative; Pregnancy test - blood - quantitative

A quantitative human chorionic gonadotropin (HCG) test measures the specific level of HCG in the blood. HCG is a hormone produced in the body during pregnancy.

Other HCG tests include:

• HCG urine test
• HCG blood test -- qualitative

Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.

How the Test is Performed

A blood sample is needed. This is most often taken from a vein. The procedure is called a venipuncture.

How to Prepare for the Test

No special preparation is needed.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

HCG appears in the blood and urine of pregnant women as early as 10 days after conception. Quantitative HCG measurement helps determine the exact age of the fetus. It can also assist in the diagnosis of abnormal pregnancies, such as ectopic pregnancies, molar pregnancies, and possible miscarriages. It is also used as part of a screening test for Down syndrome.

This test is also done to diagnose abnormal conditions not related to pregnancy that can raise HCG level.

Normal Results

Results are given in milli-international units per milliliter (mUI/mL).

Normal levels are found in:

• Non-pregnant women: less than 5 mIU/mL
• Healthy men: less than 2 mIU/mL

In pregnancy, HCG level rises rapidly during the first trimester and then declines slightly. The expected HCG ranges in pregnant women are based on the length of the pregnancy.

• 3 weeks: 5 - 72 mIU/mL
• 4 weeks: 10 -708 mIU/mL
• 5 weeks: 217 - 8,245 mIU/mL
• 6 weeks: 152 - 32,177 mIU/mL
• 7 weeks: 4,059 - 153,767 mIU/mL
• 8 weeks: 31,366 - 149,094 mIU/mL
• 9 weeks: 59,109 - 135,901 mIU/mL
• 10 weeks: 44,186 - 170,409 mIU/mL
• 12 weeks: 27,107 - 201,165 mIU/mL
• 14 weeks: 24,302 - 93,646 mIU/mL
• 15 weeks: 12,540 - 69,747 mIU/mL
• 16 weeks: 8,904 - 55,332 mIU/mL
• 17 weeks: 8,240 - 51,793 mIU/mL
• 18 weeks: 9,649 - 55,271 mIU/mL

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test result.

What Abnormal Results Mean

Higher than normal level may indicate:

• More than one fetus, for example, twins or triplets
• Choriocarcinoma of the uterus
• Hydatidiform mole of the uterus
• Ovarian cancer
• Testicular cancer (in men)

During pregnancy, lower than normal levels based on the gestational age may indicate:

• Fetal death
• Incomplete miscarriage
• Threatened spontaneous abortion (miscarriage)
• Ectopic pregnancy

Risks

Risks of having blood drawn are slight, but may include:

• Excessive bleeding
• Fainting or feeling lightheaded
• Blood accumulating under the skin (hematoma)
• Infection (a slight risk any time the skin is broken)

Jain S, Pincus MR, Bluth MH, McPherson RA, Bowne WB, Lee P. Diagnosis and management of cancer using serological and other body fluid markers. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 74.

Jeelani R, Bluth MH. Reproductive function and pregnancy. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 25.

University of Iowa Diagnostic Laboratories. Test directory: HCG - serum, quantitative. www.healthcare.uiowa.edu/path_handbook/rhandbook/test446.html. Updated February 10, 2022. Accessed March 11, 2022.

Yarbrough ML, Stout M, Gronowski AM. Pregnancy and its disorders. In: Rifai N, ed. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. St Louis, MO: Elsevier; 2018:chap 69.

Last reviewed on: 12/3/2020

Reviewed by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 03/11/2022.

HCG rate 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.
• Blister drift
• 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
• Threat of spontaneous abortion

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
• Blister drift
• 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.

Vesicular 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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  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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hCG, human chorionic gonadotropin, indications for prescribing, rules for preparing for the test, interpretation of the results and norm indicators.

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We remind you that independent interpretation of the results is unacceptable, the information below is for reference only.

Human chorionic gonadotropin (hCG, β-hCG, beta-hCG, Human Chorionic Gonadotropin): indications for the appointment, rules for preparing for the test, interpretation of the results and normal indicators.

Chorionic gonadotropin is a hormone produced by the outer shell of the embryo, and is normally determined in the blood and urine of a woman only when pregnancy occurs.

Chorionic gonadotropin consists of two subunits - alpha and beta. The beta subunit (β-hCG) used for the immunometric determination of the hormone is unique. To monitor the course of pregnancy, the determination of the beta subunit of hCG is used. The level of beta-hCG in the blood as early as 6-8 days after conception makes it possible to diagnose pregnancy (the concentration of β-hCG in the urine reaches the diagnostic level 1-2 days later than in the blood serum).

HCG has a multifaceted effect on the body of a pregnant woman: it affects the development of the embryo and fetus, stimulates the synthesis of estrogens and androgens by ovarian cells, promotes the functional activity of the chorion and placenta, and ensures the successful course of pregnancy.

The introduction of hCG into the body of non-pregnant women stimulates ovulation and the synthesis of sex hormones necessary for conception. In men, this hormone enhances the formation of seminal fluid, activates the production of gonadosteroids.

In early pregnancy and up to the 2nd trimester, β-hCG supports the production of hormones necessary to maintain pregnancy, and in male fetuses it stimulates cells responsible for the formation and development of the male reproductive system.

Human chorionic gonadotropin (hCG, beta-hCG, b-hCG, Human Chorionic)

Synonyms: Beta-hCG general. Human Chorionic Gonadotropin; hCG; Pregnancy Quantitative hCG; Beta hCG; Total beta hCG. Brief description of the analyte Human chorionic gonadotropin ...

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Indications for determining the level of hCG in women

1. Absence of menstruation (amenorrhea).
2. Exclusion/confirmation of pregnancy, including ectopic (ectopic).
3. Diagnosis of the state of the fetus at different stages of pregnancy.
4. Assessment of the state of the placenta at different stages of pregnancy.
5. Dynamic monitoring of fetal development during pregnancy, including in the diagnosis of malformations.
6. Suspicion of the presence of tumor diseases of the reproductive system, such as hydatidiform mole (a rare pathology of the fetal egg, in which instead of developing the embryo, chorionic villi grow), chorionepithelioma (a malignant tumor that develops from the epithelium of the villi of the fetal egg).
7. Performing artificial termination of pregnancy.

Indications for determining the level of hCG in men:

The presence of suspicion of tumors of the testicles.

Deadline for this study is 1 working day, excluding the day of taking the biomaterial.

Rules for preparing for a blood test to determine the level of hCG

non-specific: it is enough to refrain from smoking and drinking alcohol on the eve of the procedure, limit stress and intense physical activity for a week; blood donation is carried out on an empty stomach.

The determination of hCG in the blood is possible already on the 6-8th day after conception. The use of urinary test systems (rapid pregnancy tests) will be informative starting from the 7th day after the fertilization of the egg. To confirm the result, it is recommended to re-determine the level of the hormone a few days after the first analysis.

You can take a blood test for hCG (thyroid stimulating hormone, thyrotropin, Thyroid StimulatingHormone, TSH) at the nearest INVITRO medical office. The list of offices where biomaterial is accepted for laboratory testing is presented in the "Addresses" section.

Reasons leading to high levels of β-hCG

1. Multiple pregnancy.

2. Incorrect timing of pregnancy.

1. Pathological pregnancy: the appearance of edema, increased blood pressure, loss of protein in the urine (preeclampsia), convulsions (eclampsia), toxicosis.
2. The presence of a pregnant woman with chronic diseases (for example, diabetes mellitus).
3. Multiple fetal malformations (in such a situation, the determination of the level of β-hCG is used together with other indicators, the so-called "triple test". This study is used as a screening, and not for diagnosis.).

Reasons for fixing a decrease in the level of β-hCG

1. Incorrectly established terms of pregnancy.
2. Ectopic pregnancy.
3. Frozen pregnancy.
4. Threat of miscarriage.
5. Fetal or placental disorders (including placental insufficiency).
6. Intrauterine fetal death (in this case, it is informative to determine the level of the hormone in the first and second trimesters).

During abortions, the level of β-hCG is also monitored, the dynamics of growth / fall of which can be used to judge the completeness of the manipulation.

Determining the level of hCG, in addition to establishing the fact of pregnancy in the early stages, is part of the screening examination of pregnant women in the first trimester, along with ultrasound.

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Screening ultrasound of the 1st trimester of pregnancy (11-13 weeks 6 days)

Examination necessary to monitor the growth and development of the fetus in the first trimester of pregnancy.

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In gynecological practice, human chorionic gonadotropin is used to treat infertility, stimulate ovulation, and synthesize sex steroids. In urology, it is used in the treatment of cryptorchidism (undescended testicles) and infertility associated with impaired spermatogenesis.

Quantitatively, β-hCG is determined in the blood, for a qualitative determination, special test systems (pregnancy tests) are used, and in this case, urine serves as a biomaterial.

Quantitative determination of the level of hCG allows you to monitor the course of pregnancy in dynamics. To do this, obstetrician-gynecologists have developed tables for increasing the level of hCG, depending on the duration of pregnancy in weeks. The sensitivity of the determination is in the range of 1.2-1125000 mU/ml.

Reference values ​​of hCG levels in dynamics by gestational age

Values ​​ranging from 5 to 25 mU / ml do not allow unambiguous confirmation or denial of pregnancy, therefore, a second study is required after two days.

Since the hormone is produced by the placenta, during normal pregnancy, with placental pathology (for example, with fetoplacental insufficiency - a violation of the development of the fetus and placenta), with multiple pregnancies, the values ​​of β-hCG will differ. With a normal pregnancy until the fifth week, the level of the hormone rises exponentially: every two days its concentration doubles, reaching a peak by the 11th week of gestation. Accordingly, in a multiple pregnancy, the level of β-hCG will be even higher than in a single pregnancy.

If the indicator deviates from the norm, additional ultrasound of the pelvic organs (uterus, appendages) is required.

US examination of pelvic organs (uterus, adnexa)

Ultrasound scanning of the organs of the female reproductive system to assess the shape and size, as well as exclude pathology.

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However, with a normal hCG value, additional examinations may also be needed:

1. Ultrasound diagnosis of pregnancy (required to confirm pregnancy, clarify the term).

Ultrasound diagnosis of pregnancy

Examination to confirm pregnancy and determine the place of attachment of the ovum (to exclude ectopic pregnancy).

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2. Screening ultrasound of the 1st trimester of pregnancy (11-13 weeks 6 days) - to assess the characteristics and confirm the normal development of the fetus.

Screening ultrasound 1st trimester of pregnancy (11-13 weeks 6 days)

Examination necessary to monitor the growth and development of the fetus in the first trimester of pregnancy.

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3. Screening ultrasound of the 1st trimester of multiple pregnancy (11-13 weeks 6 days) - to confirm the presence of several fetuses, determine their characteristics; It is necessary for planning the subsequent actions of the doctor and the management of pregnancy.

Screening ultrasound of the 1st trimester of multiple pregnancy (11-13 weeks 6 days)

A study that allows you to evaluate the growth and development of fetuses, their position in the uterus, and make a plan for further pregnancy management.

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4. Fetal ultrasound according to indications (before the 20th week) - performed in case of suspected ectopic pregnancy.

Fetal ultrasound according to indications (before the 20th week)

Additional ultrasound, which is prescribed in the presence of concomitant pathologies to monitor the condition of the fetus.

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5. Lab tests to be performed in the first trimester are collected in the Pregnancy: 1st trimester (1-13 weeks) profile.

For professional assistance in interpreting the results, contact

obstetrician-gynecologist

.

Sources:

1. www.invitro.ru
2. Clinical guidelines "Ectopic (ectopic) pregnancy". Developed by: Russian Society of Obstetricians-Gynecologists, Association of Obstetric Anesthesiologists-Resuscitators. – 2021.
3. Clinical guidelines "Premature birth". Developed by: Russian Society of Obstetricians-Gynecologists, Association of Obstetric Anesthesiologists-Resuscitators. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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