What is hCG responsible for? What is hCG. Values ​​during pregnancy

What is human chorionic gonadotropin (hCG)?
Human chorionic gonadotropin is a special protein hormone that is produced by the membranes of the developing embryo during the entire period of pregnancy. HCG supports the normal development of pregnancy. Thanks to this hormone, the processes that cause menstruation are blocked in the body of a pregnant woman and the production of hormones necessary to maintain pregnancy increases.

An increase in the concentration of hCG in the blood and urine of a pregnant woman is one of the earliest signs of pregnancy.

The role of hCG in the first trimester of pregnancy is to stimulate the formation of hormones necessary for the development and maintenance of pregnancy, such as progesterone, estrogens (estradiol and free estriol). During the normal development of pregnancy, these hormones are subsequently produced by the placenta.

Human chorionic gonadotropin very important. In a male fetus, human chorionic gonadotropin stimulates the so-called Leydig cells, which synthesize testosterone. Testosterone in this case is simply necessary, as it promotes the formation of male-type genital organs, and also has an effect on the adrenal cortex of the embryo. HCG consists of two units - alpha and beta hCG. The alpha component of hCG has a similar structure to the hormone units TSH, FSH and LH, while beta hCG is unique. Therefore, laboratory analysis of b-hCG is crucial in diagnosis.

Small amounts of human chorionic gonadotropin are produced by the human pituitary gland even in the absence of pregnancy. This explains the fact that in some cases very low concentrations of this hormone are detected in the blood of non-pregnant women (including women during menopause) and even in the blood of men.

Permissible levels of hCG in the blood of non-pregnant women and men

How do human chorionic gonadotropin levels change during pregnancy?

During the normal development of pregnancy, hCG is detected in the blood of pregnant women from approximately 8-11-14 days after conception.

HCG levels rise rapidly and, starting at 3 weeks of pregnancy, double approximately every 2-3 days. The increase in concentration in the blood of a pregnant woman continues until approximately 11-12 weeks of pregnancy. Between 12 and 22 weeks of pregnancy, the concentration of hCG decreases slightly. From the 22nd week until delivery, the concentration of hCG in the blood of a pregnant woman begins to increase again, but more slowly than at the beginning of pregnancy.

By the rate of increase in the concentration of hCG in the blood, doctors can determine some deviations from the normal development of pregnancy. In particular, with an ectopic pregnancy or a frozen pregnancy, the rate of increase in hCG concentration is lower than during a normal pregnancy.

An accelerated rate of increase in hCG concentrations may be a sign of a hydatidiform mole (chorionadenoma), multiple pregnancies, or chromosomal diseases of the fetus (for example, Down's disease).

There are no strict standards for the level of hCG in the blood of pregnant women. HCG levels at the same stage of pregnancy can vary significantly among different women. In this regard, single measurements of hCG levels are uninformative. To assess the process of pregnancy development, the dynamics of changes in the concentration of human chorionic gonadotropin in the blood is important.

Days since last menstruation	Gestational age	HCG levels for this period honey/ml

Human chorionic gonadotropin normal graph

Norms of human chorionic gonadotropin in blood serum

Note!

In the last table, the weekly norms are given for pregnancy periods “from conception” (and not for the dates of the last menstruation).

Anyway!
The above figures are not a standard! Each laboratory can set its own standards, including for weeks of pregnancy. When assessing the results of the hCG norm by week of pregnancy, you need to rely only on the norms of the laboratory where you were tested.

Tests to determine hCG levels

To determine the level of hCG, various laboratory blood tests are used, which can detect pregnancy at 1-2 weeks.

The analysis can be taken in many laboratories on the direction of a gynecologist or independently. No special preparation is required for the blood test. However, before you get a referral for a test, be sure to tell your doctor about all the medications you are taking, as some medications may affect the test results. It is best to take the test in the morning, on an empty stomach. For higher test reliability, it is recommended to avoid physical activity on the eve of the test.

By the way, home rapid pregnancy tests are also built on the principle of determining the level of hCG, but only in the urine, and not in the blood. And it should be said that compared to a laboratory blood test, this one is much less accurate, since the level in the urine is two times lower than that in the blood.

It is recommended to carry out a laboratory test to determine pregnancy in the early stages no earlier than 3–5 days of missed menstruation. The pregnancy blood test can be repeated after 2-3 days to confirm the results.

To identify fetal pathology in pregnant women, a test for human chorionic gonadotropin is taken from 14 to 18 weeks of pregnancy. However, in order for the diagnosis of possible fetal pathologies to be reliable, it is necessary to take more than one blood test for hCG. Together with hCG, the following markers are given: AFP, hCG, E3 (alpha-fetoprotein, human chorionic gonadotropin, free estriol.)

Serum levels of AFP and hCG during physiological pregnancy

Gestation period, weeks.	AFP, average level	AFP, min-max	HG, average level	HG, min-max
14	23,7	12 - 59,3	66,3	26,5 - 228
15	29,5	15 - 73,8
16	33,2	17,5 - 100	30,1	9,4 - 83,0
17	39,8	20,5 - 123
18	43,7	21 - 138	24	5,7 - 81,4
19	48,3	23,5 - 159
20	56	25,5 - 177	18,3	5,2 - 65,4
21	65	27,5 - 195
22	83	35 - 249	18,3	4,5 - 70,8
24			16,1	3,1 - 69,6

Can an hCG test “make a mistake” in determining pregnancy?

HCG levels that are outside the norm for a particular week of pregnancy can be observed if the gestational age is incorrectly determined.

Laboratory tests can make mistakes, but the chance of error is very small.

Decoding

Normally, during pregnancy, the level of human chorionic gonadotropin gradually increases. During the 1st trimester of pregnancy, b-hCG levels increase rapidly, doubling every 2-3 days. At 10–12 weeks of pregnancy, the highest level of hCG in the blood is reached, then its content begins to slowly decrease and remains constant during the second half of pregnancy.

An increase in beta-hCG during pregnancy can occur when:

• multiple births (the rate increases in proportion to the number of fetuses)
• toxicosis, gestosis
• maternal diabetes
• fetal pathologies, Down syndrome, multiple malformations
• incorrectly determined gestational age
• taking synthetic gestagens

An increase in human chorionic gonadotropin can be a sign of serious diseases in non-pregnant women and men:

• production of hCG by the pituitary gland of the examined woman testicular tumors
  tumor diseases of the gastrointestinal tract
  neoplasms of the lungs, kidneys, uterus
  hydatidiform mole, relapse of hydatidiform mole
  chorionic carcinoma
  taking hCG drugs
  the analysis was done within 4–5 days after the abortion, etc.

  Usually, human chorionic gonadotropin is elevated if the test was performed 4–5 days after an abortion or due to taking hCG drugs.

  Low hCG in pregnant women, it may mean incorrect timing of pregnancy or be a sign of serious disorders:

  • ectopic pregnancy
  • non-developing pregnancy
  • delayed fetal development
  • threat of spontaneous abortion (reduced by more than 50%)
  • chronic placental insufficiency
  • true post-term pregnancy
  • fetal death (in the II-III trimester of pregnancy).
  It happens that the test results show the absence of the hormone in the blood. This result may occur if the test was performed too early or during an ectopic pregnancy.

  Whatever the result of the test for hormones during pregnancy, remember that only a qualified doctor can give the correct interpretation, determining which hCG norm is for you in combination with data obtained by other examination methods.

Video. Prenatal screening - hCG

Chorionic gonadotropin: instructions for use and reviews

Latin name: Gonadotrophin chorionic

ATX code: G03GA01

Active substance: Chorionic Gonadotropin

Manufacturer: Moscow Endocrine Plant (Russia)

Updating the description and photo: 22.10.2018

Chorionic gonadotropin is a drug with gonadotropic, follicle-stimulating and luteinizing effects.

Release form and composition

Dosage form of chorionic gonadotropin is a lyophilisate for the preparation of a solution for intramuscular (i.m.) administration: lyophilized almost white or white powder (in glass tube bottles, in blister packs, 5 bottles complete with 5 ampoules of solvent, 1 ml each, in a cardboard 1 pack per pack).

Composition of 1 bottle:

• active substance: human chorionic gonadotropin – 500, 1000, 1500 or 5000 IU (international units);
• auxiliary component: mannitol (mannitol) – 20 mg.

Solvent: 0.9% sodium chloride injection solution – 1 ml.

Pharmacological properties

Pharmacodynamics

Chorionic gonadotropin has a luteinizing, follicle-stimulating and gonadotropic effect, while the luteinizing activity is higher than the follicle-stimulating one.

The active substance of the drug, human chorionic gonadotropin (hCG), is a gonadotropic hormone produced by the placenta during pregnancy (excreted unchanged by the kidneys). The method of obtaining the substance for the drug is extraction from urine followed by purification.

HCG is necessary for women and men for normal growth and maturation of gametes, as well as for the production of sex hormones.

The drug stimulates the development of the genital organs and secondary sexual characteristics. In addition, it promotes ovulation and stimulates the synthesis of estrogens (estradiol) and progesterone in women, and also stimulates spermatogenesis, the production of dihydrotestosterone and testosterone in men.

Pharmacokinetics

After intramuscular administration it is well absorbed. The half-life is 8 hours.

Achieving the maximum plasma concentration of hCG in the blood is observed after 4–12 hours. The half-life of human chorionic gonadotropin is approximately 29–30 hours; with daily use, accumulation of the drug may be observed.

Chorionic gonadotropin is excreted by the kidneys. Approximately 10–20% of the administered dose is found unchanged in the urine, the main part being excreted as β-chain fragments.

Indications for use

Chorionic gonadotropin 1500, 1000 and 500 IU

• maintaining the corpus luteum phase;
• amenorrhea, anovulatory ovarian dysfunction.

Men and boys:

• delayed puberty associated with insufficiency of the gonadotropic function of the pituitary gland;
• oligoasthenospermia, spermatogenesis deficiency, azoospermia;
• cryptorchidism, which is not associated with anatomical obstruction;
• conducting a functional Leydig test to assess testicular function in hypogonadotropic hypogonadism before prescribing long-term stimulating therapy;
• conducting a differential diagnostic test for cryptorchidism/anorchidism in boys.

• induction of ovulation in case of infertility, which is caused by anovulation or impaired follicle maturation;
• preparation of follicles for puncture in programs of controlled ovarian hyperstimulation (for methods of additional reproduction);
• maintaining the corpus luteum phase.

• hypogonadotropic hypogonadism;
• conducting a functional Leydig test to assess testicular function in hypogonadotropic hypogonadism before prescribing long-term stimulating therapy.

Contraindications

Absolute:

• hormone-dependent malignant tumors of the genital organs and breast (diagnosed or suspected), including ovarian cancer, breast cancer, uterine cancer in women, and prostate cancer, breast carcinoma in men;
• organic lesions of the central nervous system (tumors of the hypothalamus, pituitary gland);
• deep vein thrombophlebitis;
• hypothyroidism;
• adrenal insufficiency;
• hyperprolactinemia;
• premature puberty in boys (for 500, 1000 and 1500 IU);
• infertility that is not associated with hypogonadotropic hypogonadism in men;
• children under 3 years of age (for 500, 1000 and 1500 IU);
• individual intolerance to the components of the drug.

Additional absolute contraindications for the use of the drug in women:

• bleeding or spotting from the vagina of unknown origin;
• abnormal formation of the genital organs, which is incompatible with pregnancy;
• primary ovarian failure;
• fibrous tumor of the uterus, which is incompatible with pregnancy;
• indications in the anamnesis of ovarian hyperstimulation syndrome (OHSS) (for 5000 IU);
• infertility that is not associated with anovulation (for example, tubal or cervical origin, for 500, 1000 and 1500 IU);
• polycystic ovary syndrome (PCOS) (for 5000 IU);
• pregnancy and breastfeeding period.

Relative (diseases/conditions in the presence of which the use of human chorionic gonadotropin requires caution):

• risk factors for thrombosis (complicated personal/family history, severe obesity with a body mass index > 30 kg/m2, thrombophilia, etc.);
• prepubertal age in boys - for doses of 500, 1000 and 15000 IU;
• latent or obvious heart failure, renal dysfunction, arterial hypertension, epilepsy, migraine, including indications of these diseases/conditions in the anamnesis - for men;
• bronchial asthma.

Instructions for use of human chorionic gonadotropin: method and dosage

The drug is administered intramuscularly slowly, after first adding a solvent to the lyophilisate.

The dosage regimen can be adjusted individually by your doctor.

Chorionic gonadotropin 1000, 500 or 1500 IU

• anovulatory cycles: 2-3 times with an interval of 2-3 days, 3000 IU, from 10-12 days of the menstrual cycle, or 6-7 injections - every other day, 1500 IU;

Men and boys:

• hypogonadotropic hypogonadism: 2–3 times a week, 1000–2000 IU. In cases of infertility, a drug containing follitropin (follicle-stimulating hormone) may be additionally prescribed. The duration of the course during which any improvement in spermatogenesis can be expected is at least 3 months. During the period of use of the drug, testosterone replacement therapy should be suspended. After improvement, in order to maintain the result, sufficiently isolated use of human chorionic gonadotropin;
• delayed puberty due to insufficiency of the gonadotropic function of the pituitary gland: 2–3 times a week, 1500 IU for a course of at least 6 months;
• cryptorchidism not caused by anatomical obstruction: 2 times a week, 500–1000 IU for children 3–6 years old or 1500 IU for children over 6 years old; if necessary, therapy is repeated;
• insufficiency of spermatogenesis, oligoasthenospermia, azoospermia: daily 500 IU in combination with menotropin (75 IU of follicle-stimulating and luteinizing hormone) or every 5 days 2000 IU in combination with menotropin (150 IU of follicle-stimulating and luteinizing hormone) 3 times a week in a course of 3 month. In cases of insufficient effect or its absence, the drug is prescribed 2-3 times a week, 2000 IU in combination with menotropin (150 IU of follicle-stimulating and luteinizing hormone) 3 times a week for a course of 3-12 months. After spermatogenesis improves, in some cases maintenance doses of human chorionic gonadotropin can be administered;
• differential diagnosis of anorchism/cryptorchidism in boys: a single dose of 100 IU/kg, the serum concentration of testosterone in the blood is determined before the test and 72–96 hours after the injection. With anorchism, the test will be negative, which is evidence of the absence of testicular tissue; with cryptorchidism, even if only one testicle is present, positive (5-10-fold increase in testosterone concentration). If the test is weakly positive, a search for the gonad (laparoscopy or abdominal ultrasound) is required, since there is a high risk of malignancy.

Chorionic gonadotropin 5000 IU

• induction of ovulation in case of infertility, which is caused by anovulation or impaired maturation of follicles, preparation of follicles for puncture in programs of controlled ovarian hyperstimulation: a single dose of 5000–10,000 IU to complete therapy with follicle-stimulating hormone drugs;
• maintaining the corpus luteum phase: 2–3 injections of 1500–5000 IU for 9 days after ovulation or embryo transfer (for example, once every three days).

• hypogonadotropic hypogonadism: 1500–6000 IU once a week. In cases of infertility, hCG can be administered with a drug containing follitropin 2-3 times a week. The duration of the course during which any improvement in spermatogenesis can be expected is at least 3 months. Testosterone replacement therapy should be suspended during this period. After improvement, in order to maintain the result, in some cases, human chorionic gonadotropin is used in isolation;
• Leydig functional test: 5000 IU daily for 3 days (at the same time). After the last injection, the next day blood is drawn and testosterone levels are examined. The sample is assessed as positive in cases where there is an increase of 30–50% or more from the initial values. It is preferable to combine this test with another spermogram on the same day.

Side effects

• immune system: in rare cases – fever, generalized rash;
• local reactions at the injection site and general disorders: pain, bruising, redness, itching, swelling; in some cases - allergic reactions (rash/pain at the injection site), increased fatigue.

Chorionic gonadotropin 500, 1000 and 1500 IU

• nervous system: dizziness, headache;
• metabolism and nutrition: edema.

Men and boys:

• subcutaneous tissues and skin: acne;
• endocrine system: premature puberty;
• genitals and mammary gland: gynecomastia, enlarged penis, prostatic hyperplasia, increased sensitivity of the nipples of the mammary glands in men, with cryptorchidism - enlargement of the testicles in the inguinal canal.

Chorionic gonadotropin 5000 IU

• nervous system: headache;
• respiratory system: hydrothorax in severe OHSS;
• vessels: in rare cases - thromboembolic complications that are associated with combination therapy for anovulatory infertility (in combination with follicle-stimulating hormone), complicated by severe OHSS;
• genitals and breast: breast tenderness, moderate to severe OHSS (ovarian diameter > 5 cm or large ovarian cysts > 12 cm in diameter, prone to rupture). Clinical manifestations of OHSS are bursting abdominal pain, hemoperitoneum, diarrhea, a feeling of heaviness in the lower abdomen, tachycardia, decreased hemostasis, blood pressure, increased activity of liver transaminases, acute renal failure, oliguria, respiratory failure, shortness of breath;
• digestive system: ascites in severe OHSS, abdominal pain and dyspepsia symptoms, including nausea and diarrhea associated with moderate OHSS;
• psyche: anxiety, irritability, depression;
• metabolism and nutrition: weight gain (a sign of severe OHSS), edema.

• subcutaneous tissues and skin: acne;
• genitals and mammary gland: gynecomastia, penis enlargement, prostatic hyperplasia, hypersensitivity of the nipples of the mammary glands.

Long-term therapy may cause increased side effects.

Overdose

The drug is characterized by very low toxicity.

Against the background of an overdose, women may experience OHSS. Depending on the severity, there are several types of this complication:

• light: the size of the ovaries usually does not exceed 8 cm; symptoms – abdominal discomfort, minor abdominal pain;
• medium: the average size of the ovaries is 8–12 cm; symptoms – moderate/small enlargement of ovarian cysts, breast tenderness, moderate abdominal pain, diarrhea, vomiting and/or nausea, ultrasound signs of ascites;
• severe: the size of the ovaries usually exceeds 12 cm; symptoms - weight gain, clinical signs of ascites (sometimes hydrothorax), in rare cases - thromboembolism; oliguria, hemoconcentration, hematocrit > 45%, hypoproteinemia, large ovarian cysts prone to rupture.

Basic principles of therapy for OHSS in case of overdose (depending on the severity):

• easy: bed rest, monitoring the patient’s condition, drinking plenty of mineral water;
• moderate and severe (only in hospital settings): control of hematocrit level, function of the respiratory and cardiovascular systems, kidneys, liver, water/electrolyte balance (diuresis, changes in abdominal circumference, weight dynamics); intravenous drip crystalloid solutions (in order to maintain/restore circulating blood volume); intravenous drip colloidal solutions of 1.5–3 liters per day (with persistent oliguria and preservation of hemoconcentration); hemodialysis (in cases of renal failure); antihistamines, antiprostaglandins and corticosteroid drugs (to reduce capillary permeability); low molecular weight heparins, including clexane, fraxiparine (for thromboembolism); 1–4 sessions of plasmapheresis with an interval of 1–2 days (to improve the rheological properties of blood, reduce the size of the ovaries, normalize the acid-base state and gas composition of the blood); transvaginal puncture of the abdominal cavity and paracentesis (for ascites).

Symptoms of overdose in men and boys:

• gynecomastia;
• degeneration of the gonads (in cases of unreasonably long-term therapy for cryptorchidism);
• behavioral changes in boys similar to those observed during the first phase of puberty;
• reduction in the number of sperm in the ejaculate in men (in cases of drug abuse);
• atrophy of the seminiferous tubules (associated with inhibition of the production of follicle-stimulating hormone due to stimulation of the production of estrogens and androgens).

special instructions

During therapy, the likelihood of arterial/venous thromboembolism increases, and therefore patients classified as at risk should evaluate the benefits of in vitro fertilization therapy before prescribing the drug. It should also be noted that pregnancy itself is accompanied by an increased risk of thrombosis.

The use of human chorionic gonadotropin increases the risk of developing multiple pregnancies. During therapy and for 10 days after stopping treatment, the drug can affect the values ​​of immunological tests, the concentration of hCG in plasma, urine and blood, which can cause a false-positive pregnancy test result.

In male patients, human chorionic gonadotropin can lead to an increase in androgen production, and therefore patients at risk require strict medical supervision.

Because hCG promotes precocious puberty or premature closure of the epiphyses, regular monitoring of skeletal development is required.

With high levels of follicle-stimulating hormone in men, treatment is not effective.

Long-term therapy may lead to the formation of antibodies to the drug.

An unreasonably long course for cryptorchidism, especially if there are indications for surgical intervention, can lead to degeneration of the gonads.

Impact on the ability to drive vehicles and complex mechanisms

It is recommended to refrain from driving vehicles during the treatment course.

Use during pregnancy and lactation

According to the instructions, human chorionic gonadotropin is contraindicated for use during pregnancy and lactation.

Use in childhood

HCG therapy is not prescribed for children under 3 years of age.

Drug interactions

When combined with human menopausal gonadotropin (HMG) drugs in cases of infertility treatment, it is possible to increase the symptoms of ovarian hyperstimulation, which occurred due to the use of MGH.

Combination with high doses of glucocorticosteroids is not recommended.

No other interactions noted.

Analogs

Analogs of human chorionic gonadotropin are: Choral, Ecostimulin, Horagon, Pregnil.

Terms and conditions of storage

Store in a place protected from light at temperatures up to 20 °C. Keep away from children.

Shelf life (depending on dose): 500, 1000 and 1500 IU – 4 years; 5000 IU – 3 years.

Today, the hCG hormone is of great interest: what it is, what the normal indicators are and when drugs based on it are needed.

Contrary to popular belief, not only pregnant women should know about it, because its production in certain situations means the development of tumors and other abnormalities in the body.

Human chorionic gonadotropin is a unique hormone with special functions.

It is produced in pregnant women, since the process of bearing a child is a unique condition that involves additional regulatory mechanisms and restructuring in the functioning of the body.

To briefly answer the question of what is hCG, we can say that it is a hormone that is produced by fetal tissues, supports its growth and influences the course of the pregnancy process.

For reference!

It is this hormone that first notifies a woman about her condition. It serves as the basis for pregnancy tests.

Since human chorionic gonadotropin is synthesized by the membranes of the embryo, there is no way to detect it outside the pregnancy process.

Thus, if this hormone is detected not during pregnancy or in a man, this indicates a pathological condition, in particular the presence of a tumor.

Functions of hCG

At the end of the first week after the union of the egg with the sperm, the embryo can be attached to the uterine wall, although at this stage it is only a small bubble.

Already at this time, its cells are actively producing human chorionic gonadotropin, which is aimed at ensuring its normal growth.

The main part of the placenta is the chorion, formed by the endometrium, to which the outer part of the embryo is attached.

It is the chorion that synthesizes hCG during all 9 months for the development of the unborn child and maintaining a certain condition in its mother.

After conception, the main regulatory hormone in the body becomes progesterone, initially produced by the corpus luteum.

To ensure the function of the last and continuous increase in progesterone levels during pregnancy, hCG is required.

Thus, it becomes clear why the corpus luteum does not disappear during pregnancy, as in the presence of menstruation.

The chemical structure of this hormone is represented by alpha and beta units. Alpha is absolutely identical to a similar unit in some gonadotropins, while beta is unique.

This determines the peculiarities of the functions that hCG performs, as well as the possibility of its detection in urine and blood.

Human chorionic gonadotropin performs the following main functions:

1. Provides normal adaptation of a pregnant woman to the period of bearing a child.
2. Supports corpus luteum and is responsible for the production of the hormone progesterone.
3. Helps the chorionic membrane to form correctly.
4. Promotes an increase in the number of chorionic villi.
5. Provides nutrition of villi.

Under the influence of human chorionic gonadotropin, the production of adrenal hormones increases, which allows the pregnant woman to adapt to her new condition.

Glucocorticoids help suppress her immune responses to fetal tissue (at the genetic level, the embryo is partly considered a foreign body).

For reference!

When hCG drugs are administered to a woman, ovulation is stimulated and. At the same time, the production of endogenous sex hormones also increases. When such drugs are administered to males, there will be an increase in spermatogenesis and increased testosterone production.

HCG norm

The following main factors influence the human chorionic gonadotropin level:

• gestational age;
• presence of neoplasms.

Moreover, in cases of absence of pregnancy and for men, its optimal indicator is a figure not higher than 5 mU/ml.

In a pregnant woman, the substance begins to be produced approximately 7 days after conception.

Average hCG levels during pregnancy can be seen in the table.

Minor deviations from these data are usually not dangerous, but a significant difference requires urgent action.

Week of pregnancy	Average value, honey/ml	HCG norm, honey/ml
1 — 2	150	50-300
3 — 4	2 000	1 500 — 5 000
4 — 5	20 000	10 000 — 30 000
5 — 6	50 000	20 000 — 100 000
6 — 7	100 000	50 000 — 200 000
7 — 8	70 000	20 000 — 200 000
8 — 9	65 000	20 000 — 100 000
9 — 10	60 000	20 000 — 95 000
10 — 11	55 000	20 000 — 95 000
11 — 12	45 000	20 000 — 90 000
13 — 14	35 000	15 000 — 60 000
15 — 25	22 000	10 000 — 35 000
26 — 37	28 000	10 000 — 60 000

It is noteworthy that the greatest increase in hCG or human chorionic gonadotropin in the body of a pregnant woman is observed before the beginning of the 2nd trimester.

This means that the hormone is most necessary during the development of the placenta, which from the 2nd trimester begins to independently produce the necessary hormones.

However, the importance of hCG in this period is to activate testosterone production for optimal development of the gonads and to provide nutrition.

Why do you need an hCG test?

It may be necessary to determine the level of human chorionic gonadotropin in the following situations:

• for the purpose of establishing pregnancy;
• with the likelihood of fetal defects and pathological changes in placental tissue;
• to control the course of pregnancy;
• for the purpose of establishing the quality of abortion;
• in the absence of menstruation for an unknown reason;
• when identifying tumors that produce hCG.

Chorionic gonadotropin in males and non-pregnant women is either not detected after the test or is present in low levels.

If the indicator is high in a woman, we can assume she is pregnant, and at least five days old.

When conception is excluded and in males, detection of hCG levels may be required if neoplasia or certain trophoblastic pathologies are suspected.

For a woman, motherhood is not only nine months of anxious anticipation and the joy of a long-awaited meeting with the baby. For the expectant mother, the entire period of pregnancy is a big burden for the body. Many functions and some organs undergo changes. The psycho-emotional background of the expectant mother is also not stable.

As a rule, a gynecologist who monitors the course of a woman’s pregnancy periodically prescribes tests for her. This is done in order to adequately assess whether everything is normal. Among the numerous laboratory tests, there is one test called hCG. It is very informative. For the expectant mother and for the gynecologist at the beginning of pregnancy, the hCG level is a key indicator of the presence of fertilization, and it can also be used to quite accurately determine the date of the expected birth.

What is hCG?

First, you need to say how this mysterious abbreviation stands for. HCG is human choriotic gonadotropin.

This is a hormone that is produced by the cells of the embryonic germinal membrane after the fertilized egg attaches to the uterine lining.

There are two substances of this hormone: alpha-hCG and beta-hCG. The first of the substances is very similar to other human hormones. Beta-hCG is unique in nature and is released only during pregnancy. This hormone allows a woman to preserve the fetus in the earliest stages. During this period, the immune system does everything possible to eliminate the foreign body. This is how a woman’s body’s defenses perceive the unborn baby. It is human chorionic gonadotropin that suppresses the immune response and maintains pregnancy. When determining the content of beta-hCG, a blood test will be more informative, since all pharmacy rapid tests react to both fractions of the hormone.

There are certain statistics about the onset of production of this hormone. In the vast majority of cases, the formation of hCG in the body of a pregnant woman begins 7-10 days after fertilization. The concentration of this hormone reaches its peak levels at 11-12 weeks. After this period, the hCG level begins to gradually decrease and stabilizes by mid-pregnancy. Further, its concentration remains stable and decreases slightly immediately at the time of birth.

How is hCG content determined?

Determination of the presence of hCG and its concentration can be carried out in the blood or urine of a pregnant woman. It is these biological fluids that are subject to laboratory testing.

There is some evidence that the release of this hormone into the blood occurs faster by several weeks. By taking this test, you will be able to find out about the fact and duration of pregnancy earlier.

In order to determine the level of hCG in urine, it is not at all necessary to contact a laboratory. The pharmacy sells a variety of pregnancy tests. These modern miniature devices can not only confirm the fact of fertilization, but also provide information about the concentration of hCG in a woman’s urine. Every representative of the fair sex knows perfectly well what two stripes on such a test indicate. The objectivity of this verification method, according to its manufacturer, is 98-99%. However, in order to make sure exactly what the level of hCG is, a woman should entrust a laboratory analysis.

When is the best time to donate blood for hCG?

It is known that the concentration of human choriotic gonadotropin begins to increase already in the first days after fertilization of the egg. According to statistics, in 5% of women the level of hCG increases already on the 8th day after conception.

In the vast majority of pregnant women, the concentration of this hormone begins to increase by the 11th day from the moment of fertilization of the egg. If a woman does not know the exact date of conception, then she should donate blood for an hCG test 3-4 weeks after the start of her last menstruation. In this case, the expectant mother usually detects a delay of several days.

Quite often, gynecologists recommend that a woman be tested for choriotic gonadotropin twice with a time interval of a couple of days. If a repeat analysis shows an increased level of hCG relative to the first result, the doctor will note the dynamics of growth and confirm the presence of pregnancy.
Usually within a few days the concentration of gonadotropin increases by 1.5-2 times. If the opposite picture is observed, that is, the level of the hormone is stably low or has decreased, then fertilization of the egg has not occurred.

When taking an analysis, it is very important to find out the standards adopted in this particular laboratory. The fact is that these indicators may differ in different institutions.

How to prepare for the hCG test?

There is no need for any special preparation. If a woman is taking a drug containing hormones, she must inform the doctor and laboratory assistant about this. Some medications, especially with progesterones, can affect the results of the study. It is best to take a blood test in the morning on an empty stomach.

What is the normal hCG level for a non-pregnant woman?

Often women undergo this test, regardless of whether they are pregnant or not. Sometimes a gynecologist recommends checking your hCG level if you suspect certain diseases, such as fibroids or ovarian cancer. The concentration of this hormone, along with other examination methods, can directly indicate the presence of the disease.

Normally, the hCG level in a non-pregnant woman should be 0-5 mU/ml. In women during menopause, due to changes in the body, the content of this hormone reaches 9.5 mIU/ml. If the analysis reveals a high level of hCG, this may be caused by the following reasons:

• A reaction to substances in a woman’s blood similar to hCG.
• This hormone is produced by the patient's pituitary gland.
• A woman is taking medications containing hCG.
• The hormone is produced by a tumor of an organ.

In cases where hCG is elevated and pregnancy is not detected, the patient undergoes a full diagnosis and receives appropriate treatment.

HCG levels during pregnancy

As mentioned earlier, after implantation of the fertilized egg has occurred, the chorion begins to produce hCG. This is how the embryo tries to survive in this still hostile world.

A woman's hormonal background begins to change. The hCG level begins to rise quite quickly in the days following conception. But immediately after conception it is not advisable to rush to get tested in the laboratory. During this period, as a rule, the result will not show an increase in hCG concentration. In order for laboratory diagnostics to detect pregnancy, at least 7-8 days must pass from the moment of fertilization. But gynecologists do not recommend forcing things and performing an analysis after a delay in menstruation.

• A result of up to 5 mU/ml is accepted in international medical practice as negative.
• An indicator of 5-25 mU/ml is considered doubtful; after a few days it is necessary to take a second test to monitor the dynamics.
• A deviation from the norm is considered to be a difference of more than 20%. If the result differs from the standard indicators for this period by 50% or more, then we are talking about a pathological phenomenon. If the deviation from the norm is 20%, then the patient is sent for a repeat test. If it showed an increase in the indicator of difference from the standards, then they talk about the development of pathology. If a deviation of 20% was confirmed, or a lower result was obtained, then this is considered a variant of the norm.

A single laboratory test of the level of choriotic gonadotropin is practiced very rarely. This may only be relevant at the beginning of pregnancy. Basically, a series of periodic tests are prescribed at a certain time interval. In this way, the dynamics of changes in the level of hCG are observed and pathological conditions are identified, such as the threat of interruption, fetoplacental insufficiency and others.

How does hCG change by day of pregnancy?

In order to assess how the hCG level changes by day of pregnancy, you need to carefully consider the table provided below.

Age of the embryo by days after conception	HCG level, honey/ml
	Average	Minimum	Maximum
7	4	2	10
8	7	3	18
9	11	5	21
10	18	8	26
11	28	11	45
12	45	17	65
13	73	22	105
14	105	29	170
15	160	39	240
16	260	68	400
17	410	120	580
18	650	220	840
19	980	370	1300
20	1380	520	2000
21	1960	750	3100
22	2680	1050	4900
23	3550	1400	6200
24	4650	1830	7800
25	6150	2400	9800
26	8160	4200	15 600
27	10 200	5400	19 500
28	11 300	7100	27 300
29	13 600	8800	33 000
30	16 500	10 500	40 000
31	19 500	11 500	60 000
32	22 600	12 800	63 000
33	24 000	14 000	38 000
34	27 200	15 500	70 000
35	31 000	17 000	74 000
36	36 000	19 000	78 000
37	39 500	20 500	83 000
38	45 000	22 000	87 000
39	51 000	23 000	93 000
40	58 000	58 000	108 000
41	62 000	62 000	117 000

From this table we can conclude that the hCG level by day of pregnancy changes quite dynamically in the first weeks after ovulation, then the rate decreases slightly and the level reaches stable levels.

At first, it takes 2 days for gonadotropin levels to double. Further, from the 5th-6th period, it takes 3 days for the concentration of hCG to double. At 7-8 weeks this figure is 4 days.

When pregnancy reaches a period of 9-10 seven-day periods, the hCG level reaches its peak values. By the 16th week, this factor is close to the concentration of the hormone in the 6-7 period. Thus, the level of hCG in the early stages changes quite dynamically.

After the 20th week of pregnancy, the concentration of hCG does not change so dramatically. Once every 10 seven-day calendar periods, the hormone level increases by approximately 10%. Only on the eve of birth does the hCG level increase slightly.

Experts explain this uneven growth of human chorionic gonadotropin to the physiological characteristics of a pregnant woman. The initial increase in hCG levels is due to the intensive development of the size of the fetus, placenta and hormonal changes in the body of the expectant mother. During this period, the chorion produces a large amount of gonadotropin to prepare a place for the baby and provide optimal conditions for its development. After the 10th week, the placenta changes significantly. From this moment on, her hormonal function fades away. The placenta is transformed into the main organ of nutrition and respiration in the mother-fetus system. It is thanks to this important element that the baby receives all the substances necessary for growth and development, as well as vital oxygen. Therefore, during this period there is a decline in the dynamics of hCG concentration.

What are the hCG levels by week?

It is very convenient to see how hCG levels change during pregnancy week by week. At the 3-4th seven-day period it is 25-156 mU/ml. Already at 4-5 weeks, the concentration of the hormone increases: 101-4870 mU/ml. By the 5th-6th period, the hCG content becomes equal to 1110-31,500 mU/ml. At 6-7 weeks, the hormone concentration changes to 2560-82,300 mU/ml. The hCG level after the 7th seven-day period rises to 23,100-151,000 mU/ml. In the 8th-9th period, the hormone content falls within the range of 27,300 - 233,000 mU/ml. For a period of 9-13 weeks, indicators of 20,900-291,000 mU/ml are considered normal. By period 13-18, the hCG level decreases to 6140-103,000 mU/ml. From the 18th to the 23rd week, the hormone concentration remains at the level of 4720-80 100 mU/ml. Further, the hCG content decreases slightly. From the 23rd to the 41st week it remains at the level of 2700-78,100 mU/ml.

How to compare laboratory data with standards?

Having received laboratory test data, expectant mothers rush to find out whether they correspond to the norm. When comparing your results with the above indicators, you should take into account one very important circumstance. The text indicates obstetric weeks, which doctors count from the date of the start of the last menstruation.

The hCG level during pregnancy at 2 weeks is equal to that of a woman in normal physical condition. Conception occurs only towards the end of the second or the beginning of the third seven-day calendar period.

It is necessary to remember the fact that when comparing obstetric and embryonic stages of pregnancy, the first lags behind the second by two weeks.

If the analysis results in a result slightly higher than 5 mU/ml, the gynecologist will send you for a repeat test in a few days. Until the hCG level (from conception) reaches 25 mU/ml, it is considered doubtful and requires confirmation. Remember that you should always compare the results of a study with the standards of the laboratory where they were carried out. Only a doctor can make a comparison in the most accurate way.

If the result is below normal

If the concentration of human chorionic gonadotropin obtained as a result of the analysis does not meet the standard and the deviation is more than 20%, then this is a very alarming sign. First, the doctor prescribes a repeat test. If the low level of hCG is confirmed, then this may be a consequence of the following conditions:

• Incorrectly calculated gestational age.
• Regressive pregnancy (frozen pregnancy or fetal death).
• Ectopic pregnancy.
• Delayed embryo development.
• Threat of spontaneous miscarriage.
• Post-term pregnancy (over 40 weeks).
• Chronic placental insufficiency.

To make a more accurate diagnosis, the patient undergoes a mandatory ultrasound examination.

The level of hCG during an ectopic pregnancy is initially slightly below normal, and then the dynamics drop sharply. But tubal or ovarian attachment of the embryo can only be determined with greater accuracy by ultrasound. It is very important to promptly detect an ectopic pregnancy, since this condition directly threatens the health and life of a woman. Modern methods of eliminating this condition make it possible to completely preserve reproductive function. Laparoscopic operations are seamless and as gentle as possible. The rehabilitation period with this method of treatment is minimal.

During a frozen pregnancy, the fetus dies, but for some reason it is not excreted from the body. The hCG level initially remains at a certain level, then begins to decrease. In this case, the doctor observes thickening of the uterus, since spontaneous abortion does not occur.

Regressive pregnancy can occur both in the early stages and in a later period. The reasons may be varied, but no clear dependence of this condition on specific factors has been identified.

If the indicator is higher than normal

Most often, an elevated hCG level during a generally normal pregnancy is not a dangerous sign. It is often a companion to multiple births or severe toxicosis.

However, if other tests also differ significantly from the norm, then an elevated hCG level may indicate gestosis or diabetes mellitus. This factor is also observed in women taking hormonal medications.

In addition, an upward difference in the concentration of human chorionic gonadotropin in combination with reduced estriol and ACE (triple extensive test) may indicate the risk of having a child with Down syndrome.

A pregnant woman undergoes two screenings. The first of them is carried out from 11 to 14 weeks after conception. The level of hCG in the mother's blood is measured and if it is elevated, then we are talking about chromosomal mutations. Based on the data obtained, the doctor calculates the likelihood of having a child with Down syndrome or other chromosomal diseases. Typically, children with trisomy have elevated hCG levels. To confirm the blood test, an ultrasound is performed, and then repeated screening at 16-17 weeks. Sometimes it happens that an elevated level of hCG is detected in a completely healthy baby. Then the amniotic fluid is analyzed for high accuracy of the result.

One of the main tests during pregnancy is to study the level of the pregnancy hormone - hCG or human chorionic gonadotropin.

HCG is a protein with hormonal activity that begins to be produced when the embryo is formed and is produced throughout pregnancy.

It is thanks to hCG and simple methods for its determination that pregnancy tests appeared - they are sensitive precisely to the appearance of this hormone in the urine (the test strip, when the hormone is present in the urine, gives color; the more hormone there is, the brighter the test strip will be).

Total information

HCG is necessary for the development and maintenance of pregnancy, it blocks the menstrual cycle and activates the production of other hormones necessary to maintain pregnancy - estrogen and progesterone.

The pituitary gland produces a minimum amount of hCG even in the absence of pregnancy, but its concentration is so low that it is not detected by pregnancy tests.

The level of the hCG hormone in men and women outside of pregnancy is 0-5 IU; during menopause, up to 9 IU is permissible.

HCG during pregnancy may increase from the moment the fertilized egg is introduced into the uterine cavity. Therefore, by the level of the hormone, you can determine the presence or absence of pregnancy almost from the first weeks, even before the delay of menstruation. HCG can be detected in urine and blood, but its level in the blood increases faster and more actively than in the urine.

In the first 2 weeks of pregnancy, the level of the hormone is still low for it to be detected by a pregnancy test in the urine, but determining the level of hCG in the blood is already possible.

In the future, hCG monitoring is necessary for doctors to detect certain pathologies in the development of the fetus or the normal course of pregnancy.

The level of hCG increases not only during normal pregnancy, but also during ectopic pregnancy, as well as within a few days after an abortion, and with some hormonally active tumors.

Preparing for analysis

A blood test is taken from a vein on an empty stomach; you must first not eat or drink for about 4-6 hours.

It is worth excluding sexual contacts and physical activity on the eve of the study.

When taking an hCG test, you must warn your doctor about taking hormonal medications - duphaston or utrozhestan, other hormones and insulin.

The timing of the first test may vary - laboratories determine the level of hCG in the blood already from 2-3 weeks of pregnancy, but a single test is not indicative and a repeat test is necessary after 2-3 weeks.

Additionally, an analysis for hCG is carried out at 14-18 weeks of pregnancy as part of a triple test (with estriol and AFP).

Values ​​during pregnancy

An increase in hCG levels that is significant for diagnosis occurs already from the 10th day of implantation, and 2-3 days after the delay of menstruation, pregnancy can be confidently diagnosed by the level of hCG in urine and blood.

It is worth remembering that the level of hCG in the blood is 2-3 times higher than the level in the urine - if there is a slight delay, pregnancy tests may still be negative. While the level of hCG in the blood is already high.

The amount of the hormone doubles daily, and after 1-2 weeks from the start of the delay, any pregnancy test will show a clear positive result.

The level of hCG reaches its maximum values ​​at approximately 7-8 weeks of pregnancy; subsequently, its level remains stably elevated, decreasing slightly as the placenta develops and the duration of pregnancy.

Decoding hCG

This table shows the dates by week from CONCEPTION. If you calculate hCG by obstetric weeks (from the date of the last menstruation), then add 2 weeks.

• At 1-2 weeks it is up to 300IU,
• At 3 weeks - up to 5000IU,
• At 4 weeks up to 30,000IU,
• At 5 weeks - 100,000 IU,
• At 6 weeks - 150000IU,
• At 7 weeks up to 200,000 IU,
• At 10 weeks 150-200000IU,
• At 12 weeks - about 90,000IU,
• At 14 weeks - 60000IU,
• At 25 - 40000 IU,
• At 35 weeks - 40,000-60,000IU.

Low hCG levels

A low hCG level that does not correspond to the gestational age can occur with certain pregnancy problems:

• with ectopic pregnancy, when the hormone level decreases by almost half of normal,
• in case of fetal death and frozen pregnancy,
• with delayed fetal development,
• if there is a threat of miscarriage,
• with chronic placental insufficiency and postmaturity.

However, the interpretation of the result must be made by a doctor, taking into account laboratory standards and examination data of ultrasound results.

An ectopic pregnancy is the implantation of a fertilized egg in the tubes or abdominal cavity, which leads to abnormal development of the pregnancy and serious abnormalities.

Usually, with this condition, the hCG level first rises, but not as much as with intrauterine pregnancy; it is usually 2/3 lower than standard levels. And from 5-6 weeks, hCG levels begin to decrease progressively. However, the data must be confirmed by examination using ultrasound and detection of an ectopic embryo in the tube or abdominal cavity.

During a frozen pregnancy, the level of hCG begins to decrease progressively from the moment of fetal death and the cessation of pregnancy development. Usually, with a decrease in hCG levels, toxicosis gradually disappears.

High hCG levels

An increase in hCG in men and non-pregnant women may indicate the development of malignancy.

For the most part, a high level of hCG is not a pathology during pregnancy; it can be a sign of multiple pregnancy, toxicosis, but when an increased level of the hormone is combined with other indicators, it can be a harbinger of gestosis or diabetes.

The combination of high hCG with low levels of AFP and estriol may indicate an increased risk of having a child with a genetic pathology.

Reliability of results

Laboratory tests are accurate and errors are rare. A false positive response may occur when taking hCG drugs for the treatment of infertility, for some tumors and diseases. False negative - due to collection or reagent defects.