Human chorionic gonadotropin (hCG) is far from the most well-known component of the human body. Moreover, even every hundredth man is unlikely to know this term, and among girls who have not yet been pregnant, knowledge about this hormone is not much wider. But, despite this, hCG is one of the most important factors in the existence of the human race. No wonder it is called the "hormone of pregnancy." About him, as well as about the functions of this hormone, we will talk in as much detail as possible.

To begin with, without certain pathologies, chorionic gonadotropin is found only in the female body for a nine-month period, which is called pregnancy. Chorionic gonadotropin is synthesized at various stages of pregnancy by two different organs: in the first part of the nine-month period, synthesis is carried out by a fertilized egg, and in the second - by the trophoblast (the outer ball of blastocyst cells, which later serve as the basis for the outer shell of the embryo). Moreover, these stages are distinguished by the formation of the trophoblast, which, in fact, is the precursor of the placenta.

According to its structure, hCG is a glycoprotein, which consists of 237 amino acids. The basis of chorionic gonadotropin is two subunits - "α" and "β". This nuance is the most important in terms of the characteristics of this hormone. The alpha subunit of hCG is a component that completely repeats similar subunits of a number of other hormones. A specific element of the human hormone is the beta subunit. It is for her that the level of the substance is diagnosed and it is she who shows the regular course of pregnancy, or the presence of some pathologies.

Functions of chorionic gonadotropin

The most significant function of hCG is the diagnosis of pregnancy. This hormone is the basis for constructing pharmacy tests to determine pregnancy. The effectiveness of the testing method is determined by the fact that the hormone index in the female body changes dramatically almost immediately after the fertilization of the egg has passed.

If a woman without certain pathologies and not in a state of pregnancy, the level of hCG in the blood is zero and only in rare cases can reach four international units per liter (IU / l) with individual characteristics, then already seven days after fertilization it grows to 50 IU/l. At the same time, this diagnostic method is specific - it determines only pregnancy, and is very sensitive, demonstrating high rates of accuracy in determining pregnancy.

As for the functions of chorionic gonadotropin in the human body, there are three of them:

• 1. Stimulation of the synthesis of glucocorticoids - hormones that contribute to the adaptation of the female body to pregnancy, which is a chronic immune stress.
• 2. In the first six weeks of gestation, the "pregnancy hormone" is the key to the normal functioning of the corpus luteum. It also synthesizes progesterone - another important hormone in the body of a woman in position.
• 3. Assistance in the regular performance of the placenta. In particular, a sufficient level of hCG has a positive effect on the chorionic villi.

Laboratory measurements of hCG levels in the body

Modern medicine offers several methods for determining the amount of hCG at once, among which the most popular are the so-called "rapid tests" for pregnancy. Their action is based on measuring the level of hCG in the urine. At the same time, the study of urine to determine the level of this hormone is considered not the most sensitive method, but sufficient to confirm or deny the fact of pregnancy.

Measure chorionic gonadotropin in the urine and in the laboratory, but even in this case, the accuracy is not high enough. The most sensitive method is a laboratory blood test. In addition to the fact that the result will be the closest to the truth, the laboratory will also provide data on hCG standards at certain stages of pregnancy and will be able to guarantee the quality of the study through the control schemes used.

The nuances of laboratory studies of the level of hCG in the body

Quite interesting is the fact that, in addition to determining the fact of pregnancy, the analysis of hCG in the blood is practically no good for anything else. And this, despite the fact that in medicine there is an official table that indicates the level of hCG by weeks of pregnancy and the first days after fertilization of the egg.
Why, for example, is it impossible to determine the gestational age by the level of hCG? The fact is that in the normative tables, which we present below, fairly wide ranges of values ​​\u200b\u200bare given for each period. But even they are not those figures, deviation from which indicates the development of pathologies. Regarding hCG, only two facts are certain:

• it appears after fertilization of the egg,
• its level rises and falls in a certain pattern.

But the indicators of changes in the level of the hormone in absolute terms are individual for each woman. Moreover, they can differ significantly during the normal course of pregnancy. And hCG 1000 IU / l, for example, even at a certain time, one woman will have a normal indicator, the second one will be overestimated, and the third one will be low.
Therefore, regarding studies of the amount of hCG, two theses are the most important:

By adhering to these rules, you, firstly, will avoid unnecessary negative emotions, seeing in the analysis numbers that fall outside the normal ranges. And, secondly, do not make mistakes when determining the gestational age. For this task, ultrasound diagnostics and counting from the date of the last menstruation are best suited.

Another interesting nuance in diagnosing the volume of a hormone in a woman in position is the units of its measurement. In particular, two options can be found in laboratory results: IU / l and mIU / ml. The first of them means, as already indicated above, "international units per liter", the second is "million international units per milliliter". In this case, there is, in principle, no confusion. These concepts are compared one to one. That is, regardless of which unit of measurement a particular laboratory uses, the results will be exactly the same. We, for convenience, in this material will operate with the abbreviation "IU / l".

Norms of human chorionic gonadotropin

As we have already noted, hCG is the “hormone of pregnancy”, it practically does not occur in men and women who do not bear a child, therefore we will consider the norms for the period of bearing a child. In medicine, there are two tables of values ​​for this component:

• hCG table by week of pregnancy;
• hCG table by day from the second to the sixth week after ovulation.

By the day, in the first 42 days after ovulation, the hCG norms look like this:

day after ovulation		day after ovulation	HCG level (average and normal range)
7	4 IU/L, 2-10 IU/L	25	6150 IU/L, 2400-9800 IU/L
8	7 IU/L, 3-18 IU/L	26	8160 IU/L, 4200-15600 IU/L
9	11 IU/L, 5-21 IU/L	27	10200 IU/L, 5400-19500 IU/L
10	18 IU/L, 8-26 IU/L	28	11300 IU/L, 7100-27300 IU/L
11	28 IU/L, 11-45 IU/L	29	13600 IU/L, 8800-33000 IU/L
12	45 IU/L, 17-65 IU/L	30	16500 IU/l, 10500-40000 IU/l
13	73 IU/L, 22-105 IU/L	31	19500 IU/l, 11500-60000 IU/l
14	105 IU/L, 29-170 IU/L	32	22600 IU/L, 12800-63000 IU/L
15	160 IU/L, 39-270 IU/L	33	24000 IU/L, 14000-68000 IU/L
16	260 IU/L, 68-400 IU/L	34	27200 IU/l, 15500-70000 IU/l
17	410 IU/L, 120-580 IU/L	35	31000 IU/l, 17000-74000 IU/l
18	650 IU/L, 220-840 IU/L	36	36000 IU/L, 19000-78000 IU/L
19	980 IU/L, 370-1300 IU/L	37	39500 IU/l, 20500-83000 IU/l
20	1380 IU/L, 520-2000 IU/L	38	45000 IU/L, 22000-87000 IU/L
21	1960 IU/L, 750-3100 IU/L	39	51000 IU/l, 23000-93000 IU/l
22	2680 IU/L, 1050-4900 IU/L	40	58000 IU/l, 25000-108000 IU/l
23	3550 IU/L, 1400-6200 IU/L	41	62000 IU/l, 26500-117000 IU/l
24	4650 IU/L, 1830-7800 IU/L	42	65000 IU/l, 28000-128000 IU/l

Regarding the trend of changes in the level of hCG during pregnancy, three patterns should be noted:

• it makes sense to determine the level of the hormone from 6-9 days after ovulation. Prior to this, its concentration is insufficient for qualitative analysis;
• from the beginning of pregnancy to ten weeks, with a normal course, the level of chorionic gonadotropin doubles every two to three days;
• during the peak period, which falls on the tenth week of pregnancy and up to the 20th week, the level of this hormonal component decreases by about half and the resulting figure remains almost unchanged until the moment of delivery.

Deviations from these three points are a reason for in-depth research and consultation with a doctor. Absolute norms are not very indicative figures and it is not worth taking them as an axiom.

Causes of deviations in the level of hCG from the normative indicators

It has already been noted that the norms of chorionic gonadotropin in the body of a pregnant woman are not a paradigm. Deviation from them can be not only pathological, but also natural. Only a doctor should draw any conclusions regarding the hCG indicator at a certain gestational age.
At the same time, there are well-defined lists of pathological causes that cause the level of the “pregnancy hormone” to deviate in one direction or another. Let's consider them in separate groups.

Causes of Low HCG

• ectopic development of pregnancy,
• risk of miscarriage,
• extended pregnancy,
• frozen fruit,
• delays in fetal development.

In addition to these reasons, a reduced (as well as increased) level of human chorionic gonadotropin can be recorded due to an incorrect determination of the gestational age by a doctor. This situation is dangerous because in the normal course of the process of bearing a child, a woman is assigned additional diagnostics, and sometimes treatment, which she absolutely does not need. Such situations are quite rare, but it is impossible not to mention them. In addition, an incorrect determination of the gestational age and, consequently, an incorrect diagnosis of a reduced level of hCG can cause not the most pleasant emotional burden for the expectant mother. The above reasons for insufficient concentration of the hormone will not add positive emotions to anyone, which are extremely important during the period of gestation.

Causes of High HCG Levels

• toxicosis and late toxicosis (gestosis),
• cystic drift (conception without normal development of the embryo),
• multiple pregnancy (CHR level increases in proportion to the number of fetuses),
• diabetes,
• taking hCG-containing medications.

In addition, it is necessary to separately highlight the causes of high levels of chorionic gonadotropin in men and women who are not bearing a child. In principle, any indicator other than zero is considered elevated. The following reasons may lead to this:

• tumor formations of the gastrointestinal tract and testicles,
• malignant and benign formations of a number of organs (kidneys, lungs, uterus),
• Chorionic carcinoma is a malignant oncological disease, the development of which begins from embryonic structures.

Finishing the consideration of the characteristics of human chorionic gonadotropin, one cannot but mention a number of features of this hormone and its functioning in the body.
Firstly, medicine knows cases when women developed immunological resistance to hCG. Natural antibodies inhibited the process of hormone synthesis, leading to spontaneous early abortions. The nature of this phenomenon remains unknown (it is assumed that intracellular infections, disruptions in the hormonal background, or weak immunity lead to this), but it is not intractable. When the presence of antibodies to chorionic gonadotropin is confirmed, the woman is prescribed drug therapy based on low molecular weight heparins and glucocorticoids. The action of these drugs is quite effective in order to stop the work of the immune system, aimed at suppressing hCG.

Secondly, there are two options in which pregnancy is not confirmed by the presence of hCG. This can happen when a pregnancy test is taken earlier than the ninth day after ovulation, and also when the pregnancy is ectopic. Therefore, compliance with the rules for analyzing the level of hCG, as well as consultation with a specialist in all problematic cases, is extremely important.

Thirdly, sometimes chorionic gonadotropin in the form of a medication is used in the treatment of a number of pathologies. There are three prerequisites for this:

• threatened early abortion
• preparation for artificial insemination,
• infertility treatment.

It is impossible to talk about the stable effectiveness of the use of exogenous chorionic gonadotropin. Nevertheless, the practice of its use, even in these cases, is not widespread enough and there is simply no reliable sample of the results of a statistical analysis of the use.

Fourthly, recently a number of medical and near-medical resources, as well as a number of specialized specialists, argue that in men and women outside the time period of gestation, the level of hCG is in the range from zero to five international units per liter. At the same time, no research papers or statistical samples that confirm this statement are given, which does not allow us to accept this thesis as reliable. So official medicine continues to believe that, with the exception of pregnant women, the level of hCG in humans is zero.

And the last thing: human chorionic gonadotropin of exogenous origin is quite common in the form of a doping drug in sports. Its alpha subunits are identical to those of luteinizing hormone, which in the human body is produced by the pituitary gland. By stimulating the sex cells in the ovaries, hCG in the body of a male athlete promotes the production of testosterone, increasing the body's resource in terms of maintaining strength and mass.

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HCG: table of norms by week of pregnancy. Possible errors and pathologies

Thoughts of pregnancy occur in a woman after a few days of delay in menstruation. By that time, the embryo is already several weeks old. HCG was not without reason dubbed the hormone of pregnant women, it is actively produced only by "ladies in position" and is determined by the most.

The table of hCG indicators is guided not only in the diagnosis of early pregnancy. It is needed for:

• comparisons when observing the correct formation of the fetus;
• timely detection of developmental anomalies.

Normally, the hormone is found in the body of both sexes, but its concentration does not exceed 5 U / ml.

• What is hCG and why is it important during pregnancy
• Normal level outside of gestation
• Period of active hormone synthesis
  • When to take an analysis
  • Why HCG is out of date
• Reasons for deviations
• When to donate blood for research
• How often do you get tested in the 1st trimester?
  • Indications
  • Mistakes
  • Is it possible to take hCG in the evening
• Preparation for analysis
• HCG growth table during pregnancy by week
• Dynamics of hCG by day from conception (table)
• Characteristic changes in hormone levels in genetic pathologies
• When does a natural decrease in hCG occur during pregnancy

Chorionic gonadotropin and its role

Chorionic gonadotropin is a glycoprotein consisting of a pair of components:

• alpha particles or alpha subunits;
• beta particles or beta subunits.

Actually, the beta component of the hormone is a kind of marker of the onset and successful course of pregnancy. HCG is produced by the primary embryonic membrane - the chorion, from the first days of conception.

The main role is to block the menstrual cycle, prevent bleeding and spontaneous rejection of the embryo. It activates the production of estradiol - hormones responsible for retaining a fertilized egg in the body of the uterus, as well as the proper formation and nutrition of the placenta.

The concentration of the hormone in the blood outside of pregnancy

In a non-pregnant woman, the level of gonadotropin is low - from 0 to 5 IU / ml. The increase in indicators is fixed:

• some time after ;
• in menopause (up to 9 U / ml);
• against the background of long-term therapy with hormonal drugs;
• in the presence of tumor-like formations of the genitourinary system.

In men, an increased amount of the hormone in the blood indicates the development of a tumor process in the reproductive sphere.

The period of active production of hCG

Active production of gonadotropin begins on the 5-7th day from conception, during this period the increased level is diagnosed only in the venous blood. On days 8-10, the concentration of the hormone is such that it is freely excreted in the urine. Not everyone knows what it is - hCG, but it is on the principle of detecting a hormone in urine that the work of test strips is built.

The quantitative peak of gonadotropin is fixed on - I trimester. Further, its indicators gradually decrease and increase in accordance with the gestational age.

When is the first test scheduled?

If the planned term of conception is known, you can take an analysis on the 7th - 9th day. If there are doubts about the day, blood is given after 4 days of delayed menstruation. For the accuracy of the result, the analysis is repeated after 2 days.

With successful fertilization, the indicator increases every day by one and a half to two times. If the concentration of hCG remains the same or fluctuates slightly, another reason should be sought. After a week of delay in menstruation, you can use a test strip for determining gonadotropin in the urine.

Why the increase in hCG does not correspond to the expected timing?

Often, the dynamic growth rates of the hormone go against the deadlines set by the gynecologist. This disturbs the woman, forcing her to think about pathology. Indeed, with some developmental anomalies, a lag in the level of gonadotropin is observed. But it is important to remember that hCG is used to judge the duration of pregnancy from the moment of conception, and the doctor counts the weeks from the last menstruation.

Note! An analysis of hCG reliably establishes the fact of pregnancy, but not its duration. To determine the age of the fetus, it is better to use the ultrasound method.

Factors of deviation from the norm

The obtained indicators during pregnancy may not correspond to the hCG standards from the table for various reasons.

When the level of gonadotropin is above normal:

1. With the wrong deadline. In the first trimester, a difference of 5-6 days gives significant deviations. Therefore, it is possible to compare the tabular data with your results, but it should be understood that the hCG table during pregnancy is only a guideline and it is important not the exact correspondence of the numbers, but the dynamics of their growth.
2. With multiple gestation. The concentration of gonadotropin is proportional to the number of embryos. So with a double, the norm is multiplied by two, and with a triple, by three.
3. After therapy with hormone-containing drugs based on progestogen.
4. At .
5. With a genetic abnormality in the fetus.

In addition, the result of the analysis is affected by an increase in blood sugar.

When a low concentration of hCG is determined:

1. With the wrong deadline.
2. . The amount of the hormone is increasing, but at a reduced pace.
3. . The level of hCG drops sharply down by 40 - 50%.
4. With reduced blood supply to the placenta and insufficient nutrition.

Any deviation from the norm requires a retake, to eliminate errors, and additional examination methods.

Self-determination of the fact of pregnancy, when to take the test?

In the average woman, fertilization occurs in the middle of the cycle - during the period of ovulation. The egg cell journey takes 5-7 days. Once in the uterine cavity, it attaches to the wall, it is during this period that the production of hCG begins in the pregnant woman (this is clearly seen in the table).

The first analysis can be carried out on the 8-10th day after intercourse, but it should be remembered that the level of the hormone is not yet high. A result of 25 IU/mL and below is considered controversial. The optimal delivery time is 3-4 days of delayed menstruation. The amount of gonadotropin increases daily by about half. For the purity of the result, it is recommended to retake two days later in the same laboratory.

Important! HCG table standards have a wide range. With a healthy pregnancy, the outcome will vary from woman to woman.

Frequency of examination in the first trimester

Twice with a break of several days, blood is donated for primary diagnosis and establishment of the fact. If the course of pregnancy does not inspire concern, the study is repeated at 11 - at the end of the first trimester. This study includes the detection of the level of three hormones, the change of which gives an idea of ​​the development of abnormalities in the fetus.

If it is necessary to follow the dynamics of growth, the doctor may prescribe a study of the amount of gonadotropin for 2 to 4 weeks with a break of 4 to 5 days. This approach is used for women at risk. The next one is being held.

Indications for analysis

In what cases does the detection of the “hormone of pregnancy” become an important part of the diagnosis:

• first-time amenorrhea;
• tracking the dynamics of the course of pregnancy;
• indication of ectopic development of the embryo;
• the threat of intrauterine death of the fetus;
• the threat of spontaneous abortion;
• identification of anomalies in the formation of the child's anatomical and genetic;
• suspicion of the development of a malignant tumor process.

Are there errors in reading hCG?

HCG, like any medical analysis, can give false readings, although the error rate is not high.

Reasons for a false positive response:

1. hormone therapy with progestin preparations;
2. increased synthesis of gonadotropin as a result of a malfunction of the controlling organ - the pituitary gland;
3. development of neoplasms of the reproductive sphere;
4. endocrine diseases.

In these cases, the test results show pregnancy in its actual absence.

The reverse situation is a false-negative test in the presence of a fertilized egg, which develops with insufficient production of gonadotropin:

1. too early analysis;
2. and the exit of the fetal egg into the uterine cavity;
3. ectopic development of the embryo.

Is it possible to take a hormone test in the afternoon?

The maximum amount of hCG in the blood and urine is fixed in the morning after sleep. Therefore, all studies are carried out before 10 am on an empty stomach. This condition is especially important in the early stages, when the concentration of the hormone is not yet high. By evening, the level of gonadotropin decreases several times, which provokes a false result.

Rules for passing the analysis

The delivery of hCG does not require special preparation. The rules common to all blood tests apply here:

• a light dinner the day before, the exclusion of food on the day of delivery;
• it is recommended to drink a glass of clean water;
• reduce physical activity;
• do not smoke 7 - 8 hours before the study;
• all medications taken must be reported to the attending physician.

For research, venous blood is taken, which is then subjected to separation using a centrifuge. The term for decoding the data obtained in different laboratories is not the same, from 4 hours to a week.

Change in indicators by week of gestation

For clarity, consider the growth of hCG in the table by week of pregnancy.

Table 1: HCG by weeks of pregnancy from conception

Estimated age	Bottom line	Upper limit
Before conception	0	5
controversial result	5,2	25,5
1 – 2	50	480
3 – 4	1 500	4850
5	11 000	31 000
6	25 000	98 000
7	32 500	152 000
8	37 300	235 000
9	35 500	152 000
10	32 000	135 000
11	29 000	123 000
12	27 500	110 000
13	24 300	100 500
14	22 300	90 500
15	20 000	81 000
16	18 500	80 100
up to 21	5 200	73 300

There is another calculation system - according to the days of the cycle from the moment of ovulation.

Table 2: HCG rate during pregnancy by day

day from fertilization	Permissible limits	day from fertilization	Permissible limits
7th (period of embryo attachment)	2,1 – 10	25th	2400,1 – 9800
8th	3,1 – 18	26th	4200,1 – 15600
9th	5,1 – 21	27th	5400,1 – 19500
10th	8,1 – 26	28th	7100,1 – 27300
11th	11,1 – 45	29th	8800,1 – 33000
12th	17,1 – 65	30th	10500,1 – 40000
13th	25,1 – 105	31st	11500,1 – 60000
14th	29,1 – 170	32nd	12800,1 – 63000
15th	39,1 – 240	33rd	14000,1 – 68000
16th	68,1 – 400	34th	15500,1 – 7000
17th	120,1 – 580	35th	17000,1 – 74000
18th	220,1 – 840	36th	19000,1 – 78000
19th	370,1 – 1300	37th	20500,1 – 83000
20th	520,1 – 2000	38th	22000,1 – 87000
21st	750,1 – 3100	39th	23000,1 – 93000
22nd	1050,1 – 4900	40th	25000,1 – 100000
23rd	1400,1 – 6200	41st	26500,1 – 117000
24th	1850,1 – 7800	42nd	28000,1 – 130000

The described norm for the days of ovulation shows the upper and lower limits, based on the average menstrual cycle.

HCG changes in genetic abnormalities

Gonadotropin is a kind of marker of genetic and anatomical abnormalities in the development of the fetus.

• almost twice the norm may indicate the risk of Down syndrome;
• persistently low levels of gonadotropin - suspicion of Edwards or Patau syndrome;
• subtle dynamics may indicate the development of Turner's syndrome.

The discrepancy between the indicators of the gestational age is recorded during the formation of heart defects or underdevelopment of the neural tube in the embryo.

Attention! The hCG indicator only raises suspicion of the possible development of anomalies. To establish the fact of a genetic abnormality, an additional examination is prescribed.

Natural decrease in hCG

The peak of blood saturation with gonadotropin is observed at -e, after which there is a slight uniform decrease to approximately. The level stabilization period continues until the 40th week, until the moment of resolution. A week and a half after childbirth, the concentration of hCG returns to the norm inherent in the pre-pregnancy state.

In some cases, a sharp jump in the tested hormone is observed in the third trimester, and is considered as the result of the occurrence of pathological conditions, for example,.

A woman can check her blood for hCG on her own, which does not require a doctor's referral. But only a specialist is able to correctly interpret the result with a positive answer. Tables are presented for reference.

Actual video

Preparation for analysis for hCG during pregnancy and decoding

HCG (human chorionic gonadotropin) or hCG (human chorionic gonadotropin) is a special pregnancy hormone. The level of hCG can be overestimated not only during pregnancy and not only in women. An analysis of the level of free b-hCG is used in the screening of intrauterine development and the presence of fetal pathologies in the first trimester of gestation. Please note that although hCG standards for weeks of pregnancy begin from the first week of embryonic development, at this time the results practically do not differ from hCG indicators in non-pregnant women.

The norms of hCG levels during pregnancy at different times can be seen in the table below. But when evaluating 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 for hCG!

HCG is human chorionic gonadotropin, a hormone that is actively produced by the cells of the chorion (fetal membrane) immediately after it attaches to the wall of the uterus. The "production" of this hormone is vital for the preservation and maintenance of pregnancy! It is hCG that controls the production of the main pregnancy hormones - estrogen and progesterone. With a serious lack of hCG, the fertilized egg is detached from the uterus, and menstruation occurs again - in other words, a spontaneous miscarriage occurs. Normally, the concentration of hCG in the blood of the expectant mother is constantly growing, reaching a maximum by the 10-11th week of pregnancy, then the concentration of hCG gradually decreases to remain unchanged until the very birth.

What are the norms of hCG during a normal pregnancy, and what is the level of hCG during an ectopic pregnancy? Pregnant women receive special tables in laboratories that show what the level of hCG should be at different stages of pregnancy.

When deciphering the obtained analysis for hCG, follow the following rules:

1. In most laboratories, the gestational age is indicated "from conception", and not from the date of the last menstrual period.
2. When evaluating the results of the analyzes, always check the standards of the laboratory that performed your analysis. Since different laboratories may have different levels of hCG during pregnancy
3. If your hCG level differs from the norm of the laboratory - do not panic! It is best to decipher the analyzes in dynamics. Retake the analysis in 3-4 days and only then draw conclusions.
4. If you suspect an ectopic pregnancy, be sure to undergo an ultrasound scan to make an accurate diagnosis.

NORM HCG IN THE BLOOD IN WOMEN DURING PREGNANCY

HCG levels during pregnancy honey/ml (INVITRO laboratory standards)

HCG values ​​ranging from 5 to 25 mU / ml do not allow confirming or disproving pregnancy and require re-examination after 2 days.

For the first time, an increase in hCG levels can be detected using a blood test approximately 11 days after conception and 12-14 days after conception using a urinalysis. Since the content of the hormone in the blood is several times higher than in the urine, therefore, a blood test is much more reliable. In a normal pregnancy, in 85% of cases, the level of beta-hCG doubles every 48-72 hours. With increasing gestational age, the time it takes for it to double can increase to 96 hours. HCG levels reach their peak in the first 8-11 weeks of pregnancy, and then starts to decrease and stabilizes during the remaining period.

HCG norms during pregnancy

The human chorionic gonadotropin hormone is measured in milli-international units per milliliter (mIU/mL).

An hCG level of less than 5 mIU / ml indicates the absence of pregnancy, and a value above 25 mIU / ml is considered a confirmation of pregnancy.

As soon as the level reaches 1000-2000 mIU / ml, transvaginal ultrasound should show at least the fetal sac. Since during pregnancy, normal levels of hCG in different women can vary significantly and the date of conception can be calculated erroneously, the diagnosis should not be based on ultrasound results until the hormone level reaches at least 2000 mIU / ml. The result of one analysis for hCG is not enough for most diagnoses. To determine a healthy pregnancy, multiple measurements of human chorionic gonadotropin are needed with a difference of a couple of days.

It is worth noting that these figures should not be used to determine the duration of pregnancy, as these numbers can vary greatly.

To date, there are two types of routine blood tests for hCG. A qualitative test determines the presence of hCG in the blood. A quantitative hCG test (or beta-hCG, b-hCG) measures exactly how much of the hormone is present in the blood.

HCG levels by week

HCG levels by week from the start of the last menstrual period*

3 weeks: 5 - 50 mIU/ml

4 weeks: 5 - 426 mIU/ml

5 weeks: 18 - 7340 mIU/ml

6 weeks: 1080 - 56500 mIU/ml

7-8 weeks: 7650 - 229000 mIU/ml

9-12 weeks: 25700 - 288000 mIU/ml

13-16 weeks: 13300 - 254000 mIU/ml

17-24 weeks: 4060 - 165400 mIU/ml

25-40 weeks: 3640 - 117000 mIU/ml

Non pregnant women:<5 мМЕ/мл

After menopause:<9,5 мМЕ/мл

* These figures are only a guideline - the level of hCG by week for each woman can rise in different ways. It is not so much the numbers that are important, but the trend in the level change.

Is your hCG pregnancy normal?

To determine if your pregnancy is going well, you can use hcg calculator below on this page

By entering two hCG values ​​and the number of days that have passed between tests, as a result, you will find out how long it takes for your beta hCG to double. If the value corresponds to the normal rate at your gestational age, then everything is going well, and if not, you should be alert and conduct additional checks on the condition of the fetus.

HCG doubling rate calculator

At the beginning of pregnancy (the first 4 weeks), the hCG value doubles approximately every two days. During this time, beta-hCG usually manages to rise to 1200 mIU / ml. By 6-7 weeks, the doubling rate slows down to about 72-96 hours. When beta-hCG rises to 6000 mIU / ml, its growth slows down even more. At the tenth week of pregnancy, the maximum is usually reached. On average, it is about 60,000 mIU / ml. Over the next 10 weeks of pregnancy, hCG decreases by about 4 times (to 15,000 mIU / ml) and remains at this value until childbirth. 4-6 weeks after delivery, the level will be less than 5 mIU / ml.

Increasing hCG levels

Men and non-pregnant women:

1. chorioncarcinoma, recurrence of chorioncarcinoma;
2. hydatidiform drift, recurrence of hydatidiform drift;
3. seminoma;
4. testicular teratoma;
5. neoplasms of the gastrointestinal tract (including colorectal cancer);
6. neoplasms of the lungs, kidneys, uterus, etc.;
7. the study was conducted within 4 - 5 days after the abortion;
8. taking hCG drugs.

Pregnant women:

1. multiple pregnancy (the level of the indicator increases in proportion to the number of fetuses);
2. prolonged pregnancy;
3. discrepancy between the real and the established gestational age;
4. early toxicosis of pregnant women, preeclampsia;
5. maternal diabetes;
6. fetal chromosomal pathology (most often with Down syndrome, multiple fetal malformations, etc.);
7. taking synthetic gestagens.

Decreased hCG levels

Pregnant women. Alarming level changes: inconsistency with the gestational age, an extremely slow increase or no increase in concentration, a progressive decrease in the level, more than by more than 50% of the norm:

1. ectopic pregnancy;
2. non-developing pregnancy;
3. the threat of interruption (the level of the hormone decreases progressively, by more than 50% of the norm);
4. true prolongation of pregnancy;
5. antenatal fetal death (in II - III trimesters).

False negative results (non-detection of hCG during pregnancy):

1. the test was performed too early;
2. ectopic pregnancy.

Attention! The test has not been specifically validated for use as a tumor marker. HCG molecules secreted by tumors can have both normal and altered structure, which is not always detected by the test system. The results of the test should be interpreted with caution, in comparison with clinical data and the results of other types of examination, they cannot be considered as absolute evidence of the presence or absence of the disease.

Level HCG in ectopic pregnancy will be significantly lower than the specified standards and this will allow you to respond in time to the current situation.

An analysis of the level of free b-hCG is used in the screening of intrauterine development and the presence of fetal pathologies in the first trimester of gestation. This test is carried out between 11 and 14 weeks of embryonic development. Its purpose is to identify possible pathological changes in development in the form of trisomy 18 or 13 pairs of chromosomes. Thus, you can find out the child's tendency to ailments such as Down's disease, Patau and Edwards syndromes.

This test is carried out not as a determination of the predisposition of the fetus to the above ailments, but in order to exclude them, therefore, special indications for the analysis are not required. It is as planned as an ultrasound at week 12.

Increasing hCG levels during pregnancy may occur when:

• multiple pregnancy;
• toxicosis, gestosis;
• maternal diabetes;
• fetal pathologies, Down syndrome, multiple malformations;
• incorrectly established gestational age;
• taking synthetic gestagens, etc.

Elevated values ​​can also be seen within a week when taking an analysis after the abortion procedure. A high level of the hormone after a mini-abortion indicates a progressive pregnancy.

Low hCG levels during pregnancy may indicate a miscalculation of the gestational age or be a sign of serious disorders, such as:

• ectopic pregnancy;
• non-developing pregnancy;
• delay in fetal development;
• the threat of spontaneous abortion;
• chronic placental insufficiency;
• fetal death (in the II-III trimester of pregnancy).

Rules for preparing for a blood test for hCG during pregnancy

1. Blood donation should take place in the morning (from 8 to 10 days). Before taking the test, it is better not to eat fatty foods, do not have breakfast in the morning.
2. The day before blood sampling, it is strictly forbidden to drink alcohol, drugs and engage in physical activity.
3. A couple of hours before the test, do not smoke, do not drink anything other than plain water; eliminate stress and emotional instability. It is better to rest and calm down before the test.
4. It is not recommended to donate blood after physical procedures, examinations, massage, ultrasound and radiography.
5. If it is necessary to retake the test in order to control the indicators, it is recommended not to change the conditions for donating blood (time of day, meals).

HCG test during pregnancy - meaning

Firstly, an analysis of the level of hCG in the blood can confirm that you will become a mother already 5-6 days after conception. This is much earlier and, most importantly, much more reliable than using conventional rapid tests.

Secondly, a test is needed to determine the exact gestational age. Very often, the expectant mother cannot give the exact date of conception, or she calls it, but incorrectly. At the same time, certain indicators of growth and development correspond to each period, deviations from the norm may indicate the occurrence of complications.

Thirdly, the level of hCG in the blood can quite accurately “tell” whether your baby is developing correctly.

An unplanned increase in the level of hCG usually occurs with multiple pregnancy, preeclampsia, taking synthetic progestogens, diabetes in the expectant mother, and can also indicate some hereditary diseases in the baby (for example, Down syndrome) and multiple malformations. An abnormally low level of hCG can be a sign of an ectopic and non-developing pregnancy, fetal growth retardation, the threat of spontaneous abortion, and chronic placental insufficiency.

However, do not rush to sound the alarm: increased or decreased values ​​\u200b\u200bmay also indicate that the gestational age was initially set incorrectly. Your doctor will help you interpret the test results correctly.

The chemical structure of hCG and its role in the body

Glycoprotein is a dimer with a molecular weight of about 46 kDa, synthesized in the placental syncytiotrophoblast. HCG is made up of two subunits: alpha and beta. The alpha subunit is identical to the alpha subunits of the pituitary hormones TSH, FSH, and LH. The beta subunit (β-hCG) used for the immunometric determination of the hormone is unique.

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).

In the first trimester of pregnancy, hCG provides the synthesis of progesterone and estrogens, necessary to maintain pregnancy, by the corpus luteum of the ovary. HCG acts on the corpus luteum like a luteinizing hormone, that is, it supports its existence. This happens until the "fetus-placenta" complex acquires the ability to independently form the necessary hormonal background. In the male fetus, hCG stimulates the Leydig cells that synthesize testosterone, which is necessary for the formation of male reproductive organs.

The synthesis of hCG is carried out by trophoblast cells after implantation of the embryo and continues throughout pregnancy. In the normal course of pregnancy, between 2 - 5 weeks of pregnancy, the content of β-hCG doubles every 1.5 days. The peak concentration of hCG falls on the 10th - 11th week of pregnancy, then its concentration begins to slowly decrease. With multiple pregnancies, the content of hCG increases in proportion to the number of fetuses.

Decreased concentrations of hCG may indicate an ectopic pregnancy or threatened abortion. Determining the content of hCG in combination with other tests (alpha-fetoprotein and free estriol at 15-20 weeks of pregnancy, the so-called "triple test") is used in prenatal diagnosis to identify the risk of fetal abnormalities.

In addition to pregnancy, hCG is used in laboratory diagnostics as a tumor marker for tumors of trophoblastic tissue and germ cells of the ovaries and testes that secrete chorionic gonadotropin.

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The main indications for the test for chorionic gonadotropin:

• early diagnosis of pregnancy - a reliable result can be obtained within a week after the expected date of fertilization;
• suspected ectopic pregnancy;
• as part of tests to identify possible pathologies of fetal development;
• abortive procedures (a blood test for hCG helps to track the fact of the complete removal of the fetal egg);
• suspicion of an oncological process in the body of not only women, but also men.

On a note! The reliability of the test for hCG in the diagnosis of early pregnancy is 98%.

Types of laboratory diagnostics

The hCG hormone molecule is a dimer based on a- and b-subparticles. The a-part is related to the structure of the luteotropic and thyroid-stimulating hormones of the pituitary gland, and the second is unique. Therefore, for medical diagnosis, 2 types of analysis are used:

• total hCG;
• specific b-hCG.

The total level of the hormone is used in a blood test for pregnancy - an elevated hCG in this case confirms the fact of conception as early as 6-8 days after the fertilization of the egg. In the first time after the fusion of germ cells, the concentration of beta particles is too low for accurate diagnosis, but the total number of hormone fractions is quite enough for accurate analysis. In the second trimester, the level of total hCG is analyzed as part of prenatal screening during triple and quadruple tests.

Free b-hCG

B-hCG is used to control pregnancy. The first b-particles appear in the blood plasma a week after the fertilization of the egg, and doubles every 48 hours, reaching a maximum by 7-11 weeks. During this period, with the help of a hormone (I and II trimesters), the quality of egg implantation is checked, followed by the formation of the “fetus-placenta” system, and screening for genetic diseases of the embryo is done.

In addition, the level of specific beta particles helps to detect hormone-dependent tumors, namely:

• trophoblastic neoplasms in women - hydatidiform mole, choriocarcinoma;
• embryonic tumors in men and women - teratomas, seminomas;
• neoplasms of other tissues and organs - lymphomas, neoplasia of the lung tissue, cancers of the gastrointestinal tract.

This is interesting! With regard to hCG, scientists are still unraveling the chicken-or-egg mystery. There is no consensus on what is primary: a high level of human chorionic gonadotropin caused the oncological diseases or the appearance of a tumor led to an increase in the hormone. Therefore, in many Western countries, the over-the-counter sale of products that include this substance is prohibited.

Rules for preparing for the study

For analysis, venous blood taken on an empty stomach is used. When preparing for the procedure, try to adhere to the following requirements:

• For a few days, if possible, refuse to take hormonal drugs, especially those based on hCG.
• For 3 days, exclude the use of alcohol, limit the amount of smoked, fatty and spicy foods.
• The day before the test, try to reduce your stress levels; prescribe any other instrumental studies after the analysis for hCG.
• Try not to smoke for a couple of hours before taking blood.
• Drink half a glass of pure non-carbonated water 20 minutes before the procedure.

On a note! Pregnancy test strips measure the level of hCG in the urine. But the sensitivity of such an express test is much lower - reliable results are possible only a few days after the menstruation failed on schedule.

Reference indicators

The level of the norm is different and depends on gender, age and functional state of the body:

• In young non-pregnant women, the norm of total hCG should not exceed the level of 5 mU / ml.
• In older women, during menopause and after, the minimum rate can be increased to 9 mU / ml.
• In healthy active men, the maximum limit is 2.5 mU/ml.
• In a normal singleton pregnancy, the level of the hormone rises every 2 days by 2 times, and reaches peak levels around the beginning of the 3rd month. After that, the values ​​begin to gradually decrease. The initial level of 5 mU/ml is restored 3-5 days after delivery.

Blood test for hCG: what does an increase in levels mean in non-pregnant women

A critical level of 5-10 mU / ml may indicate a precancerous condition. Higher values ​​are a sign of an obvious tumor process:

• embryonic neoplasms of the sex glands in children and adults (teratomas, seminomas);
• hormone-dependent tumors of organs outside the reproductive system (lungs, gastrointestinal tract).

A constant increase in the level of the hormone indicates the growth of the neoplasm and / or the presence of metastases.

Causes of an increase in pregnant women

A natural excess of reference values ​​for pregnant women may be the result of:

• multiple pregnancy - this is due to a multiple increase in the volume of trophoblastic tissue producing hCG;
• individual features of the female cycle.

In all other cases, an excess of values ​​indicates the presence of a pathological process. Among them:

• toxicosis of the first trimester;
• preeclampsia (late toxicosis);
• the risk of chromosomal abnormalities in the development of the fetus;
• trophoblastic diseases - cystic mole or choriocarcinoma; in this case, the fetus dies in the early stages of development, and its place is replaced by pathologically overgrown trophoblastic tissue; a characteristic feature is the absence of a decrease in hCG after 10-11 weeks.

What will the decrease in hCG tell about

A decrease in the level of the hormone during pregnancy causes the immune system to show aggression towards the tissues of the fetus. Chorionic gonadotropin adapts the female body to the antigenic composition of the new embryo and prevents its rejection during implantation. A drop in choriotropic gonadotropin levels poses a high risk, and may contribute to:

• ectopic implantation of the embryo;
• miscarriage or fetal death;
• missed pregnancy, when the fetus stops its development, stops growing and subsequently dies;
• disruption of the "fetus-placenta" system;
• true overgestation (pregnancy lasts more than 42 weeks).

False positive analysis

The analysis is highly accurate, but the error may be associated with third-party pathological processes or hormonal abnormalities.

A false positive result is possible in the following cases:

• internal hormonal disruptions;
• taking drugs based on hCG;
• undiagnosed cancers.

False-negative results may occur with late ovulation, ectopic implantation, miscarriage.

The danger of deviations for the fetus

HCG is the most sensitive marker for trisomy on chromosome 21, therefore, an increase in chorionic gonadotropin by 2 or more times automatically records a pregnant woman at risk for the development of Down syndrome in the fetus. A similar increase in the hormone is observed in Edwards, Turner, Patau syndromes, as well as in pathologies of the development of the heart and nervous system.

Attention! In 4-5% of pregnant women, the hCG level shows the presence of possible abnormalities, but only in 0.1-0.2% of cases a child with genetic abnormalities is born. The data of the analysis is only a reason for further examination.

What is HCG

The abbreviation stands for human chorionic gonadotropin. This hormone is produced from the first days of pregnancy. After fertilization, the embryo is attached to the wall of the uterus and immediately begins to secrete hCG. Gonadotropin is produced by the substance chorion, which subsequently turns into the placenta.

When pregnancy occurs, a woman's body experiences severe stress. HCG acts like corticosteroid drugs. Hormone weakens a woman's immune system. This is necessary so that the body does not reject the fetus. Thanks to the action of hCG, the embryo begins its development, and the woman normally bears the baby.

HCG also affects the genitals of the expectant mother. The uterus and ovaries begin to work in such a way as to support the development of a new life. Gonadotropin acts on the corpus luteum of the ovary, in parallel it begins to produce a hormone necessary for the normal course of pregnancy. HCG affects the gonads in male embryos. Under its influence, the reproductive system of future boys develops without pathologies.

Gonadotropin starts actively excrete immediately after conception. Already on the 6th - 7th day from the moment of conception, the level of the hormone will be significantly higher than normal. Based on the concentration of hCG, all blood tests for pregnancy also work.

Doctors advise take tests for hCG on the 5th - 7th day of delayed menstruation. The hormone level rises every forty-eight hours. The normal index of chorionic gonadotropin varies from 0 to 5 units. In 1 - 2 weeks after implantation, it increases to 25 - 300 units.

In what cases are they tested for hCG

The main reason for taking an analysis that determines the hCG level in the blood is the presence of pregnancy. In addition to this, there are other indications for the determination of the hormone:

• amenorrhea - a condition for which is characteristic;
• diagnosis of fetal malformations;
• suspicion of a poor-quality abortion;
• diagnosing pathologies of pregnancy - or multiple pregnancy, the threat of miscarriage;
• monitoring the normal course of pregnancy;
• suspicion of malignancy.

HCG norms in pregnant women

As we already wrote, the normal rate of chorionic gonadotropin varies from 0 to 5 units in non-pregnant women. In the first trimester the level of the hormone rises 2 times every two days. The indicator becomes maximum to , then gradually decreases.

In the second half of pregnancy HCG does not change significantly, is in the same range. An increase or decrease in the indicator indicates any pathologies in development. But the level of hCG should be considered in dynamics. It is unprofessional to judge the condition of the fetus based on the results of a single analysis.

The norms of the hormone level are a conditional concept, since most laboratories have their own indicators. Only a qualified doctor can resolve the issue of discrepancy with the norm, find out the causes and prescribe treatment. In these cases, it is forbidden to self-medicate.

Preparation for analysis for hCG

How to take a blood test for hCG? Blood sampling is done in the morning from a vein only on an empty stomach. Before passing the analysis, it is recommended to observe the following rules:

• a day before blood sampling, you need to follow a special diet - exclude fatty and fried foods, alcohol;
• on the day of the test, it is allowed to drink a glass of clean non-carbonated water;
• an hour before the test, it is recommended to refrain from smoking,
• for a day it is necessary to limit the physical and emotional stress on the body;
• if a woman takes any medications, then it is worth notifying the doctor about this.

If there was urgent need to take tests for hCG, then it is necessary to refrain from eating for 5-6 hours. The analysis can be taken independently at any medical institution, such a procedure will be paid. You can find out the hCG indicator for free, but in the direction of a gynecologist.

A high rate may indicate the following reasons:

• multiple pregnancy - the level of the hormone is proportional to the number of embryos;
• preeclampsia;
• gestation of the fetus;
• anomalies in the development of the child (for example: Down syndrome);
• if a pregnant woman is sick,
• when taking synthetic gestagens.

If the scores are down

Low levels of hCG indicate the following:

• the likelihood of non-drug abortion;
• gestation of the fetus;
• chronic placental insufficiency.

False positive result for hCG

There are cases when the level of hCG is high, but there is no pregnancy. This is called a false positive result. It may occur in the following situations:

• the use of certain hormonal drugs, including oral contraceptives;
• chorioncarcinoma - a tumor that has developed as a result of a malignant transformation of the chorion;
• tumor of the ovaries or uterus;
• cystic skid;
• a consequence of a previous pregnancy or abortion.

In case of a false positive result should consult a doctor.

HCG with a frozen pregnancy

Such a pathology as a missed pregnancy indicates that the embryo died for some reason. In this case, hCG ceases to be produced and its level drops sharply. To determine a missed pregnancy, an hCG analysis is performed several times. The doctor visually examines the dynamics of the hormone.

If the hCG level is below normal, then don't panic right now. Perhaps the gestational age was set incorrectly. The final verdict is made after the ultrasound examination.

Video about hCG analysis

Those who want to know more detailed information about the analysis of hCG can watch the video. In this video, the doctor will talk about chorionic gonadotropin. He will explain the nuances of preparing for analysis, the advantages of hCG analysis over express tests, the reasons for deviations from the norm, and much more.