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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 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 in 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).

• ToRCH infections and pregnancy

  What are ToRCH infections, what are the dangers of these infections during pregnancy, how and when is the examination performed, how to interpret the results. Perinatal infections account for approximately 2-3% of all congenital fetal anomalies.
  

• Pregnancy tests in the CIR Laboratories

  In our laboratory, you can undergo a complete examination at the onset of pregnancy, take tests at any time, and in our clinics you can conclude an agreement on pregnancy management.

• 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.

• Risk assessment of pregnancy complications using prenatal screening

  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.

• Parvovirus B19 and parvovirus infection: what you need to know when planning and getting pregnant.

  What is a parvovirus infection, how is the virus transmitted, who can get sick, what is the danger of the virus during pregnancy, what tests are taken for diagnosis.
  

• Pregnancy planning

  Obstetrics differs from other specialties in that during the physiological course of pregnancy and childbirth, in principle, it is not part of medicine (the science of treating diseases), but is part of hygiene (the science of maintaining health). Examination during pregnancy planning.

• Prenatal screening of the 1st and 2nd trimesters of pregnancy ("double", "triple" and "quadruple" tests)

  Prenatal screening are tests conducted on pregnant women to identify risk groups for pregnancy complications.

• Testosterone during pregnancy. Androgens: their formation and metabolism during normal pregnancy. Hyperandrogenism during pregnancy. "Male" hormones during pregnancy.

  Testosterone and other androgens levels change during pregnancy. The change in these levels depends, among other things, on the sex of the fetus.

All articles of the section

HCG norms by weeks of pregnancy

Content

1. Table of average hCG norms
2. Table of average hCG rates when 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 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 (questionable result)	-
2-3 weeks	101-4870	5-25 (questionable 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 for carrying twins:

Table of average hCG values ​​after IVF with engrafted 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 period, 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 for 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 the 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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