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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.

hCG during early pregnancy

What is hCG and what is its role?

This contraction hides a hormone with the complex name "human chorionic gonadotropin", which triggers important processes associated with childbearing. So, thanks to hCG during pregnancy, the corpus luteum (a temporary gland responsible for the secretion of hormones necessary for the fetus, which is formed and absorbed during each menstrual cycle) is able to live 10-12 weeks instead of the usual two - until the placenta begins to perform these functions . At a later date, chorionic gonadotropin stimulates the activity of the placenta itself.

How does hCG change by week of pregnancy?

Its level begins to rise immediately after conception, when it occurs during embryo implantation, 6-8 days later. The dynamics of the concentration of this hormone in the blood and urine of a pregnant woman is very high - in the early stages, its level increases by one and a half to two times every two days. If before pregnancy the hCG rate is less than 5 mIU / ml, then already at the 3-4th week from conception (at the 5-6th obstetric) this figure rises to thousands, and in the peak period of 7-11 weeks it reaches tens and hundreds thousand mIU / ml. In the future, the level of the hormone begins to gradually decline.

Approximate norms of hCG depending on the gestational age are presented in the table below, these data are for reference only. It is important to note that measurement results may vary and depend on the equipment used.

Table. HCG levels during pregnancy depending on the period

How to measure hCG during pregnancy?

To determine its exact level, a venous blood test is performed. It is done on an empty stomach, it is also necessary not to drink for several hours before taking blood. The highest concentration of hCG is recorded in the first half of the day, so it is recommended to visit the clinic in the morning. If you are taking any medications, be sure to tell your doctor about it - some drugs can affect the results of the analysis.

The concentration of hCG depends on the methodology and laboratory equipment, therefore, to interpret the results, specialists use only the official tables of the laboratory where the analysis was performed.

Is it possible to measure the level of hCG at home?

Well-known rapid pregnancy tests work by measuring hCG in the urine. On the second test strip, test manufacturers apply specific antibodies to this hormone, and if its level exceeds the sensitivity of the test, the strip is stained. Usually they can determine the level of hCG above 25 mIU / ml, which allows such testers to be used to determine pregnancy on the first day after a delay. Starting from the fifth day of delay and beyond, due to the high concentration of the hormone in the urine, the second strip appears quickly enough.

Important!

Express pregnancy tests sold in stores and pharmacies, if the recommendations in the instructions for use are followed, have a fairly high accuracy of determining the fact of pregnancy.

Rapid test gives a quick opportunity to confirm or refute your guesses already in the early stages. However, it can only show the fact of an increase in hCG, but not measure its level. Only laboratory diagnostics is able to measure the concentration and demonstrate the dynamics of hCG by weeks, which can be important information for a specialist who is pregnant.

It is important to understand that a rapid test may give a false positive result. An increase in the concentration of hCG is possible, for example, while taking certain drugs, with certain diseases of the reproductive system, kidneys, etc. Whatever results the test shows, for a final answer about the presence of pregnancy, you must consult a doctor.

HCG norms by weeks of pregnancy

Content

1. Table of average hCG norms
2. Table of average hCG norms for carrying twins
3. Table of average hCG values ​​after IVF with engrafted twins
4. Guidelines for free β-hCG subunit
5. Norm РАРР-А
6. What if I am at high risk?
7. How to confirm or deny the results of screening?
8. The doctor says I need an abortion. What to do?

One of the main tests during pregnancy is the study of the level of the pregnancy hormone - hCG or human chorionic gonadotropin. If expectant mothers want to know if the hormone level is normal, we made a summary table of values ​​

Table of average hCG norms:

Gestation period	HCG in honey/ml	HCG in mIU/ml	HCG in ng/ml
1-2 weeks	25-156	5-25 (doubtful result)	-
2-3 weeks	101-4870	5-25 (doubtful result)	-
3-4 weeks	1100 – 31500	25-156	-
4-5 weeks	2560 – 82300	101-4870	-
5-6 weeks	23100 – 151000	1110 -31500	-
6-7 weeks	27300 – 233000	2560 -82300	-
7-11 weeks	20900 – 291000	23100 -233000	23. 7 - 130.4
11-16 weeks	6140 – 103000	20900 -103000	17.4 - 50.0
16-21 weeks	4720 – 80100	6140 – 80100	4.67 - 33.3
21-39 weeks	2700 – 78100	2700 -78100	-

Table of average hCG norms when carrying twins:

Table of average values ​​of hCG after IVF with implanted twins:

Free hCG β-subunit limits

Measuring free hCG β-subunit levels can more accurately determine the risk of Down syndrome in an unborn child than measuring total hCG.

Norms for free β-hCG subunit in the first trimester:

Attention! Norms in ng / ml may vary in different laboratories, therefore the data indicated is not final, and in any case you should consult your doctor. If the result is indicated in MoM, then the norms are the same for all laboratories and for all analyzes: from 0.5 to 2 MoM.

If hCG is not normal, then:

1. If the free β-hCG is higher than normal for your gestational age, or more than 2 MoM, then the child has an increased risk of Down syndrome.
2. If the free hCG β-subunit is below normal for your gestational age, or is less than 0.5 MoM, then the baby is at increased risk of Edwards syndrome.

PAPP-A norm

PAPP-A, or "pregnancy-associated plasma protein A" as it is called, is the second indicator used in first trimester biochemical screening. The level of this protein constantly increases during pregnancy, and deviations in the indicator may indicate various diseases in the unborn child.

Norm for PAPP-A depending on the duration of pregnancy:

Gestational age, weeks	HCG in ng/ml
8-9 weeks	0.17 - 1.54 mU/ml, or 0.5 to 2 MoM
9-10 weeks	0.32 - 2.42 mU/ml or 0.5 to 2 MoM
10-11 weeks	0.46 - 3.73 mU/ml, or 0.5 to 2 MoM
11-12 weeks	0.79- 4.76 mU/ml, or 0.5 to 2 MoM
12-13 weeks	1. 03 - 6.01 mU/ml, or 0.5 to 2 MoM
13-14 weeks	1.47 - 8.54 mU/ml, or 0.5 to 2 MoM

Attention! Norms in ng / ml may vary in different laboratories, therefore the data indicated is not final, and in any case you should consult your doctor. If the result is indicated in MoM, then the norms are the same for all laboratories and for all analyzes: from 0.5 to 2 MoM.

If PAPP-A is abnormal:

1. If PAPP-A is lower for your gestational age, or less than 0.5 MoM, your baby is at increased risk of Down syndrome and Edwards syndrome.
2. If PAPP-A is higher than normal for your gestational age, or more than 2 MoM, but other screening values ​​are normal, then there is no cause for concern.

Studies have shown that women with elevated PAPP-A levels during pregnancy are not at greater risk of fetal disease or pregnancy complications than other women with normal PAPP-A.

What if I am at high risk?

If your screening reveals an increased risk of having a baby with Down syndrome, then this is not a reason to terminate the pregnancy. You will be referred for a consultation with a geneticist who, if necessary, will recommend examinations: chorionic villus biopsy or amniocentesis

How to confirm or refute the screening results?

If you think the screening was not done correctly, then you should be re-examined at another clinic, but for this you need to retake all the tests and get an ultrasound. This method is possible only if the gestational age at the time of the examination does not exceed 13 weeks and 6 days.

The doctor says I need an abortion. What to do?

Unfortunately, there are times when a doctor strongly recommends or even forces an abortion based on screening results. Remember: no doctor has the right to such actions. Screening is not a definitive method for diagnosing Down syndrome and, based on poor results alone, a pregnancy should not be terminated.

Say that you want to consult a geneticist and undergo diagnostic procedures for Down syndrome (or other disease): chorionic villus biopsy (if you are 10-13 weeks pregnant) or amniocentesis (if you are 16-17 weeks pregnant).

The author of the article:

Ananyina Anna Alexandrovna

Obstetrician-gynecologist

Work experience since 2010
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Eat more foods rich in iron: beef tongue, liver, buckwheat and oatmeal, prunes, dried apricots, green apples, etc. But diet alone will not work to raise hemoglobin.
Medical therapy with iron supplements is required. If the problem is associated with insufficient intake of iron into the body, one set of drugs is needed, if with absorption, another. The doctor must select drugs.
Injection therapy may be required for more severe anemia.

If there are no contraindications, natural childbirth is possible. Only an obstetrician-gynecologist should decide on the possibility of EP.

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With an increase in the duration of pregnancy and the growth of the baby, the uterus increases - this can lead to increased tone. Sometimes tension arises in response to the movements of the child. Strong physical exertion, stress, overwork of a pregnant woman can also lead to increased tone.
In early pregnancy, uterine tone may be associated primarily with reduced progesterone production. In this case, the doctor prescribes the patient treatment with progesterone preparations.
Symptoms of increased tone
All pregnant women experience tone differently. Someone - like heaviness and tension in the lower abdomen. Others - as a pulling pain in the lumbar region. In the 2nd and 3rd trimesters of pregnancy, a woman can feel the tone by putting her hand on her stomach: the uterus becomes "stone", then relaxes.

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