Star News
Hcg deviation from the norm. HCG analysis: results. HCG (human chorionic gonadotropin) during pregnancy: transcript. Highest HCG value
Definition hCG levels This is a standard procedure for early diagnosis of pregnancy. Already on the 6-8th day after conception, you can determine if there is a pregnancy by donating blood for the content of hCG in any clinical diagnostic laboratory.
After registering a pregnant woman in women's consultation a blood test for hCG is carried out if necessary, therefore, in most cases, in city antenatal clinics, it is not included in the list of mandatory tests. However, in modern clinics, this analysis is mandatory in the first trimester of pregnancy, as this is the most convenient way to prevent the occurrence of negative consequences for the health of the fetus in time.
- Deciphering the result of a blood test for hCG during pregnancy:
Why donate blood for hCG during pregnancy?
Chorionic gonadotropin (or "pregnancy hormone") begins to be produced by the embryonic membrane as soon as the fetal egg is introduced into the wall of the uterus, and this happens somewhere on the 6-8th day after conception.
On early dates, when the test for diagnosing pregnancy at home does not yet show a clear second strip, it is the laboratory blood test for hCG that will help to confirm the “interesting situation”, because the concentration of the “pregnancy hormone” in the blood of a pregnant woman is higher than in the urine.
And after registration in the antenatal clinic, a study in the dynamics of blood for the hormone hCG (in combination with ultrasound) is able to determine whether the fetus develops normally inside the womb.
Usually, a blood test for hCG is given at 11-14 weeks of pregnancy (during the first comprehensive screening - "double test") and at 16-20 weeks (during the second screening - "triple test"). During prenatal screenings, the level of b-hCG is determined in ng / ml (see Tables 1-a and 1-b).
Table 1-a and 1-b respectively
Beta-hCG is a component of chorionic gonadotropin, the quantitative assessment of which is aimed at determining abnormalities in the development of the fetus.
It is especially important to conduct a blood test for gonadotropin in the first trimester of pregnancy with the threat of miscarriage. Monitoring the condition of the fetus every week by doing an ultrasound of the pelvic organs is a risk for the baby, because excessive ultrasound exposure can adversely affect the course of pregnancy, since the harmlessness of ultrasound has not yet been proven. But a blood test for hCG is considered a harmless way to monitor the development of pregnancy.
A blood test for hCG is also prescribed if a frozen and / or ectopic pregnancy is suspected.
How to donate blood for hCG? When to submit?
To determine the level of hCG, blood is taken from a vein. For the purity of the results obtained, it is recommended to donate blood for analysis in the morning on an empty stomach (provided that the last meal was at least 8 hours ago).
Remember that tea / coffee and juice / fruit drink are also food, so you can only drink mineral water in the morning. And the day before the test, it is advisable not to eat fatty fried foods.
To test blood for changes in the level of hCG in dynamics, you should donate blood at the same time of day, preferably in the morning.
But if in the morning it is not possible to visit the laboratory, then you can carry out the analysis every day, at about the same time, but the last meal should be at least 4-5 hours before the test.
Immediately before the blood sampling itself, you need to calm down and sit quietly for 5-10 minutes.
Taking a synthetic progestogen can increase the level of hCG, so warn the laboratory assistant about this in advance.
It is necessary to undergo an ultrasound scan and donate blood during a comprehensive screening of the 1st and 2nd trimester on the same day or at least this way: undergo an ultrasound scan, and the next morning donate blood for hCG, but no later than 3 days after the ultrasound .
If before collecting a blood test you feel weak, dizzy and other pre-fainting sensations, warn the nurse about this in advance and then the blood will be taken from you in the supine position.
HCG levels by week of pregnancy
Throughout the entire period of pregnancy, the level of hCG changes: first it grows progressively, reaches its peak, the level of hCG slows down slightly, remaining practically unchanged, and then gradually decreases.
So in the first weeks of pregnancy, the level of hCG doubles every 2-3 days. At a period of 8-9 obstetric weeks (or 6-7 weeks from conception), it stops growing and then begins to slowly decrease.
For diagnostic value, the level of hCG in the blood of a woman is important only up to the 20th week of pregnancy.
HCG levels vary depending on the method of analysis in a particular laboratory. Therefore, it is important to carry out blood tests always in the same laboratory. Ask the laboratory assistant or doctor who wrote you a referral for a blood test to find out the acceptable limits for the level of hCG in your week of pregnancy.
Below are the standard values of hCG from different medical institutions, including the independent laboratory "Invitro", which has branches in many cities of Russia, Belarus, Kazakhstan and Ukraine (see Table 2-4).
table 2
Table 3
Table 4
Deciphering the result of a blood test for hCG during pregnancy
Having received the result of a blood test, it is necessary to compare the obtained value of the hCG level with the standard value according to the gestational age.
Decreased hCG level
A decrease in the concentration of hCG in the blood of a pregnant woman occurs for the following reasons:
- the threat of spontaneous abortion (in other words, with the threat of miscarriage), when there is a deviation from the norm by more than 50%;
- ectopic or missed pregnancy (hCG levels increase very slowly or stop growing for up to 9 weeks of pregnancy);
- chronic placental insufficiency.
Increasing hCG levels
An increase in the concentration of the hormone in the blood of a pregnant woman leads to:
- multiple pregnancy (hCG level increases in proportion to the number of fetuses);
- early toxicosis or gestosis;
- intrauterine infection;
- diabetes mellitus in a pregnant woman;
- cystic skid;
- chorionepithelioma;
- fetal pathology at the chromosomal level (for example, with Down syndrome and other malformations);
- taking synthetic progestogen.
Usually in women with irregular menstrual cycles or with late ovulation, the date of conception may differ significantly from the date expected by doctors. And such a discrepancy between the established gestational age and the real one is displayed in a blood test by an increase in the level of hCG.
Simply put, the gynecologist calculated that the gestational age, for example, 5 obstetric weeks, starting her report from the first day of the last menstruation. But in fact, ovulation occurred later than the due date (not 14 days before the start of the next menstruation, but a few days before the end of the menstrual cycle), then the real gestational age from conception (ovulation) is 1 week and several days.
Therefore, hCG should also comply with the norm not for the 5th obstetric week, and for 1-2 weeks from conception or 3-4 obstetric weeks. An ultrasound will set a more accurate gestational age according to the size of the fetus, and the level of hCG should correspond to this period.
A high level of hCG only in combination with a decrease in the level of AFP can indicate the likelihood of a Down syndrome in the fetus (see table 5).
Table 5
HCG with anembryony
The level of hCG can continue to rise even with a pathological course of pregnancy. The main way to make sure that the baby is alive and well is to undergo an ultrasound "plus" to hear the fetal heartbeat. The heart begins to be heard from 3 weeks from conception (or from 5 obstetric weeks of pregnancy).
HCG helps to determine the general condition of the pregnant woman and find out if the baby is developing correctly. This is an important analysis that needs to be done several times.
HCG is human chorionic gonadotropin, it is often called the main factor in pregnancy. The chorion produces it immediately after fertilization occurs. Usually, this analysis plays a significant role, as it helps to determine the presence or absence of disorders, as well as to identify possible negative symptoms of diseases in time and begin their treatment.
Why and when is it done?
To determine any pathological conditions for hCG, it is enough to compare its level with the weekly table, since any deviations from the norm may indicate the presence of deviations in the development of the baby. You can take it to check for pregnancy, and then every week to monitor the condition of the baby.
How is HCG made?
To check the concentration of hCG, you can use a special pregnancy test, and this indicator is also easily distinguished from a routine urine or blood test. To ensure reliability in measuring this indicator, it is necessary to use a blood test. If pregnancy occurs or you want to check this fact, you can notice changes in hCG already on the fifth day after fertilization. An analysis for it can help to reveal the fact of pregnancy not only earlier than the test indicators, but sometimes even faster than the delay in menstruation.
During a woman's pregnancy, the level of hCG is at least 15 mU / ml.
A urinalysis cannot always give an accurate answer whether a woman is pregnant or not, and also reveal the pathology of the indicator in a particular case. Also, a pregnancy test cannot give accurate indicators, but it can be quickly and easily used. To determine the most accurate level on a pregnancy test, you need to wait for the first missed period. More advanced tests help determine hCG with maximum accuracy even earlier, a few days before the onset of menstruation.
When the pregnancy is proceeding normally, the level of hCG rises every day, however, to track its exact dynamics, it is enough to measure this indicator once a week. The first trimester is characterized by the most frequent and significant increase in hCG. It slows down at about week 12, when the development of almost all organs has already taken place, and the fetus will only grow and improve in the future.
HCG norm by week: table decoding
The norms in the table are indicated not from the date of the last menstruation, but from the conception itself. For any deviations from the norm, it is necessary to calculate the age of the fetus using ultrasound and start from this when comparing hCG with standard indicators.
weeks hCG level
1-2
25-300
2-3
1500-5000
3-4
10000-30000
4-5
20000-100000
5-6
50000-200000
6-7
50000-200000
7-8
20000-200000
8-9
20000-100000
9-10
200000-95000
11-12
20000-90000
13-14
15000-60000
15-25
10000-35000
26-37
10000-60000
The numerical values in the table can be considered the most optimal indicator. With each method for determining hCG, the indicators may differ. If there is a slight deviation of hCG from the norm, this often does not indicate the presence of pathologies or any abnormalities in the health of the child. Of great importance is not only the compliance of hCG with the norm, but also the dynamics of its increase.
If you come to any laboratory, you can take a table with the norms from them. Many are surprised that the parameters are slightly different. Each organization uses the most optimal research methods in the opinion of their leaders, which may differ from traditional ones in accuracy. To be sure to see the full picture of possible deviations, you need to consult with your doctor. Self-interpretation of information can be a cause for frustration, as numbers are often misinterpreted.
What does an increase or decrease in hCG mean?
The level of hCG is used to determine the duration or possible pathologies during pregnancy, but it changes not only when it is present. When it fluctuates greatly, the formation of pathologies in the woman herself is possible, which are in no way connected with the course of pregnancy. This analysis is one of the main ones in gynecological practice, therefore it is prescribed to patients not only during pregnancy, but also when diseases are suspected.
Low level
Usually, a constant reduced dynamics indicates the presence of pathologies associated with the process of gestation. If the level of hCG does not increase, then there is a miscarriage. This pathology needs to be urgently treated. To do this, apply surgery, completely clean the uterine cavity.
An analysis of hCG helps to quickly identify this disorder, since with late recognition, not only infectious complications are possible, but also loss of reproductive function. Before curettage of the uterus, ultrasound is used to confirm the accuracy of the study.
If the pregnancy is ectopic, then the level of hCG can behave differently. In some cases, in the early stages, it is absolutely normal, no different from the standard indicators for a healthy pregnancy. Then it gradually decreases. It is important not to miss this dangerous pathology, for this you need to take the level of hCG in deadlines, and not be content with those indicators that were obtained at the very beginning of bearing a child. With an ectopic pregnancy, low hCG has its own reasons. Changes in this indicator indicate an incorrect localization of the fetus, and also begins to actively slow down with detachment of the chorion. They are insignificant, but the analysis immediately indicates this pathology.
A slowdown in the dynamics of hCG can tell not only that a woman is about to have an operation due to an ectopic pregnancy, but also when there is a risk spontaneous miscarriage due to lack of hormones. This negative factor can be moderated if the right actions are taken. To do this, you should immediately consult a doctor and take drugs that replace the natural production of the hormone. Usually not enough progesterone. For internal diagnosis and selection of the correct treatment, additional tests are taken so that hormonal therapy does not harm the child.
High level
Usually, the excess of normal indicators occurs due to the fact that a woman will have two babies at once. If a woman has severe toxicosis, then there is no need to be surprised at the increased rates. Also, such disorders are also manifested in diabetes mellitus, including in its previously undiagnosed form, so you need to check for this disease by passing tests.
If elevated values appear after the 12th week of pregnancy, this indicates one of the genetic disorders in the child, such as Down syndrome, but does not clearly signal this. Too much long pregnancy also manifested by elevated levels of hCG.
An overestimated hCG on the plate can also be detected with an incorrectly set period. Sometimes there is no delay in menstruation for a short period of pregnancy due to the presence of violations. You can once again undergo an examination with the help of ultrasound, revise the indicated terms so that there are no fears for the health of the child. Sometimes a constant elevated level of hCG does not indicate developmental pathologies, but only indicates that the mother regularly takes synthetic progestogens during pregnancy. If it is impossible to refuse their use, you should not worry when receiving the results of this test.
HCG levels if the pregnancy is ectopic
Sometimes this tragedy, like an ectopic pregnancy, has the ability to be determined by hCG, which will help to identify it in time. There is no chance for the development of the child, so the decision is always made to eliminate the pregnancy. If you do not pay attention to this pathology ahead of time, serious problems with the health of the mother are possible. If you miss the time when you can eliminate the fetus almost painlessly, the possibility of a second normal pregnancy is estimated at 50%.
A normal pregnancy involves the fertilization of an egg, which travels down the fallopian tube and into the uterus, where the fetus begins to develop. Sometimes this transition takes too long, then the egg does not reach the uterus, but is fixed where possible.
It's not always a fallopian tube. Sometimes the egg is attached to the ovaries and other nearby organs, which also indicates an ectopic pregnancy of the corresponding etiology.
The fallopian tubes are not able to serve as a reservoir for the development of the child, therefore, before causing defects to these organs, it is necessary to perform surgical intervention.
If you do not have time to make it on time, a rupture of the fallopian tube is possible, followed by the release of all the contents and severe internal bleeding, which can only be stopped in a hospital. With inaction or improper assistance in this situation, high mortality is possible.
Ectopic pregnancy sensations and appearance practically does not differ from the norm. Sometimes there is a delay in the menstrual cycle, while the periodic formation of blood in the discharge, which can be regarded as a failure of the cycle. Possible toxicosis, and weakness, and partial loss of orientation in space. All these signs indicate both normal and pathological conditions during pregnancy. Ectopic pregnancy is best shown by hCG analysis. With this pathology, this indicator is below optimal.
HCG during ectopic pregnancy
The level of hCG during an ectopic pregnancy rises, but not as much as during a normal pregnancy, when the fetal egg is fixed in the optimal place in the uterus. If the indicators are greatly reduced, it is highly likely to talk about an ectopic pregnancy.
The level of hCG during a normal pregnancy should not only immediately be normal, but also constantly increase. In a short time, it doubles, despite the fact that a pathological ectopic pregnancy does not allow the fetus to function as strongly. The dynamics of growth is very different from normal indicators. There are suspicions about the presence of pathologies that can only be confirmed by ultrasound.
Conclusion
To diagnose any abnormalities during pregnancy, an hCG test is used. This method helps to initially signal that additional examinations are needed to diagnose disorders in the development of the fetus. With hCG values that deviate from the norm, there is no need to panic. It is recommended to consult a competent doctor.
Video - blood test for hCG
We will try to improve!
Tell us how we can improve this information?
Laboratory tests have long been an integral part of the diagnosis of all known diseases. They acquire special significance at such an exciting and pleasant moment in a woman's life as the expectation of a child. During preventive (screening) examinations conducted in the first and second trimesters, each pregnant woman is tested for hCG. Let's discuss why the doctor prescribes it and in what cases it makes sense to pass such a test on your own.
HCG: what lies behind the mysterious abbreviation
HCG is chorionic gonadotropin, a hormone that is produced in the body of every pregnant woman, as well as in some pathologies. In terms of chemical composition, this substance is very close to those reproductive hormones (they are called "gonadotropic") that are produced in people regardless of gender in the brain - the pituitary gland. Their purpose in the normal state of the body is to stimulate the secretion of sex hormones. HCG, on the other hand, is needed in order to “adapt” a woman’s body to an atypical process for it - pregnancy - from the moment of fertilization to the start of the full-fledged work of the placenta.
Pregnancy in terms of endocrinology
While every woman's normal menstrual cycle ends with the shedding of the inner layer of the uterus and the "unused" egg, after successful fertilization, this process should be blocked. Menstruation occurs against the background of a drop in the concentration of the hormone progesterone in the blood, produced in the ovary by the corpus luteum (it resolves within two weeks after ovulation). How to make sure that the rejection of a fertilized egg does not occur? When pregnancy occurs, the tissues surrounding the fetus secrete hCG, which “prolongs the life” of the corpus luteum, so that the concentration of progesterone in the blood remains consistently high. A few months later, when the placenta takes over the functions of secreting progesterone, the level of hCG decreases: now the fetus is no longer in danger of being prematurely rejected by the mother's body.
From a chemical point of view, hCG consists of two "halves" - alpha and beta subunits. One of them (alpha) completely coincides in structure with the same subunits of other gonadotropic hormones, and the second (beta) is unique in composition, which makes it possible to accurately determine the concentration of hCG in the blood.
All hCG tests performed during pregnancy are divided into two types - qualitative and quantitative. The first ones give an unambiguous answer about whether an increase in the concentration of this hormone in the blood is recorded or not, which indirectly suggests the presence or absence of pregnancy (this is the basis of a rapid urine test, which every adult woman must have encountered). The second are quantitative tests that determine the exact concentration of hCG in the blood, thanks to which the doctor can monitor changes in the hormonal background in dynamics, as well as suspect some abnormalities in the development of the fetus.
This is interesting
Another property of hCG is the stimulation of ovulation, therefore, a drug based on this hormone is prescribed to women in preparation for in vitro fertilization (IVF).
In addition to reproduction issues, there is another reason why hCG appears in the blood of women and men - we are talking about hormone-producing tumors, oncological diseases that change the hormonal background of the body. Therefore, sometimes such an analysis is prescribed for the diagnosis of a pathological neoplasm.
Analysis for hCG: from total to ... free
Pregnancy tests, which can be bought at any pharmacy, are undoubtedly a convenient invention, but do not forget that they are not very accurate and are able to show the correct result only a few days after a missed period. In addition, they are not applicable for screening diagnostics of possible fetal developmental disorders, which is required in the first and second trimesters of pregnancy, and are not applicable for diagnostics in oncology. Therefore, a blood test for hCG is an extremely informative and sought-after medical service.
Total hCG
This analysis is the most reliable laboratory method to confirm or deny the presence of pregnancy, as well as to make sure that it is progressing. Even in the very early stages, when test systems for home use show one strip (as a rule, they do not respond to hCG levels of less than 20 mU / ml), a blood test will show an increase in the hormone concentration, indicating successful fertilization.
However, the use of hCG analysis to confirm pregnancy is not the only or main application of this study. The fact is that as the embryo develops, the level of hCG in the blood of the mother should increase - up to 12-13 weeks from the date of the last menstruation. If there is no growth from analysis to analysis or the hormone levels do not correspond to generally accepted standards, then this may indicate a high probability of miscarriage, missed or ectopic (ectopic) pregnancy. For more later dates deviation of hCG from reference values may indicate the presence of a genetic pathology in the fetus (such as Down syndrome or Edwards syndrome).
Free b-hCG
An analysis for free beta-hCG is a clarifying type of diagnosis, since it takes into account only that subunit of the hormone that distinguishes it from other gonadotropic substances in the blood. This means that the likelihood of distortion of the result due to general hormonal disorders will be minimal. This is relevant in situations where the purpose of diagnostics is to search for hormone-producing tumors (some of them increase the level of b-hCG in isolation), which, with a clinically confirmed absence of pregnancy in a woman, as well as in men, clearly indicates a neoplasm.
In addition, such an accurate diagnosis is useful in screening for congenital malformations, so many doctors consider it appropriate to prescribe a free beta-hCG test to the patient. This is especially important if the expectant mother has an increased risk of having a child with genetic abnormalities (this is determined by her age, heredity and history of previous pregnancies).
How accurate is a blood test for hCG
An analysis for chorionic gonadotropin is classified as a highly accurate laboratory diagnostic method. Determination of the concentration of the hormone in the blood is carried out by enzyme immunoassay (ELISA), during which human blood serum is mixed with standard antibodies to hCG and a dye. Without a chemical reaction to combine these substances into a single complex, the solution does not stain, so the test allows you to reliably confirm the presence of the hormone in the blood of the patient, as well as to assess its concentration.
Why the doctor may prescribe a study
For women with delayed menstruation, the doctor prescribes an hCG test in the following cases:
- to confirm or refute early pregnancy;
- to exclude ectopic pregnancy;
- to control the quality of the abortion performed (in case the artificial termination of pregnancy was not completed to the end, the remains of the fetal egg in the uterus continue to secrete the hormone into the blood);
- to diagnose a threatened miscarriage or miscarriage.
For women with an established and normally developing pregnancy, the determination of hCG is prescribed in the following cases:
- to monitor the progress of pregnancy;
- as part of a screening examination in the first trimester (together with an analysis for PAPP-A - plasma pregnancy-associated protein-A);
- as part of a screening examination in the second trimester (together with an analysis of alpha-fetoprotein and free estriol - the so-called triple test).
For men, as well as women outside of pregnancy, an hCG test can be prescribed to diagnose trophoblastic diseases and hormone-producing tumors.
How to donate blood for hCG analysis
One of the undeniable advantages of hCG analysis is the lack of special preparation for the study. Blood from a vein is given if possible - in the morning and on an empty stomach (after eating, at least 4 hours should pass).
If the test for hCG is carried out to confirm pregnancy, it is advisable to donate blood no earlier than 3-5 days after a missed period, so the likelihood of a false negative result will be minimal.
What does the result mean: we read the study form
The patient receives the results of the analysis for hCG within a week, but some private laboratories are able to conduct a study in one day or in emergency cases- in a few hours.
The received form will indicate the name and surname of the patient, as well as the type of analysis (total hCG or free b-hCG). Reference values for your case are also given here (norms for men and for non-pregnant women, norms for expectant mothers indicating the gestational age in weeks).
Table 1
|
Patient's condition |
The level of total hCG, honey / ml |
Free level b - hCG, ng/ml |
|
Men and non-pregnant women |
||
|
4 weeks pregnant |
no analysis |
|
|
5 weeks pregnant |
no analysis |
|
|
6 weeks pregnant |
no analysis |
|
|
7 weeks pregnant |
20000 – 100000 |
no analysis |
|
8 weeks pregnant |
20000 – > 225000 |
|
|
9 weeks pregnant |
20000 – > 225000 |
|
|
10 weeks pregnant |
20000 –> 225000 |
|
|
11 weeks pregnant |
20000 – > 225000 |
|
|
12 weeks pregnant |
20000 – > 225000 |
|
|
13 weeks pregnant |
20000 – > 225000 |
|
|
14 weeks pregnant |
19000 – 135000 |
|
|
15 weeks pregnant |
18000 – 110000 |
|
|
16 weeks pregnant |
||
|
17 weeks pregnant |
||
|
18 weeks pregnant |
||
|
19 weeks pregnant |
no analysis |
|
|
20 weeks pregnant |
no analysis |
|
|
21 weeks pregnant |
no analysis |
A blood test for hCG is just one of the stages of medical diagnosis. Regardless of its results - do not rush to make independent conclusions, be sure to consult a doctor and in no case do not panic ahead of time - the human body is complex, and conclusions about the processes taking place in it can only be made on the basis of a comprehensive medical assessment of the state of health.
Wednesday, 03/28/2018
Editorial opinion
As already mentioned in the article, an increase in hCG can be caused not only by pregnancy, but also by the development of various pathologies, even diabetes or malignant neoplasms. Therefore, do not belittle the importance of this analysis, pay attention to deviations from the norms and consult a doctor in a timely manner.
Obvious symptoms of pregnancy appear already at 7-8 weeks and it is not difficult for a woman to guess her interesting position. In the early stages, it is possible to diagnose the emergence of a new life by assessing the chorionic gonadotropin in the blood. What is hCG and what is its rate for weeks of pregnancy can be seen in the table.
What does hcg mean
Chorionic gonadotropin is a substance related to hormones. It is synthesized by the chorioallantoic membrane after the implantation of the embryo into the uterine wall. The production of the hormone begins already 6-8 days after the fusion of the female and male cell. By its nature, hCG is a glycoprotein substance that includes more than 200 amino acids.
Chorionic gonadotropin consists of two subunits (a and β). The alpha component is of the utmost importance, it is an analogue of a number of other hormones in the body. The beta subunit is used to diagnose pregnancy, and various pathologies can also be detected.
The role of the hormone
Undoubtedly, the most important function of human chorionic gonadotropin is to determine the onset of pregnancy. According to this principle, most pharmacy rapid tests work to determine the conception of a child. The convenience of such a diagnosis lies in the fact that it is possible to learn about pregnancy using this technique from the very first days of the delay. We have already found out that free hCG in a woman's body begins to rise 6-8 days after the fertilization of the egg.
In the absence of pregnancy in a woman and various pathologies that can affect hCG in the body, the level of chorionic gonadotropin is zero, only in extremely rare cases in non-pregnant girls can it be about four international units per liter (hereinafter IU / l). With each day of fetal development, the concentration of the hormone increases significantly. Only by the end of 11 weeks begins to gradually decline.
Functions of gonadotropin in the body
In addition to diagnostic significance, human chorionic gonadotropin performs several important functions. These include:
- Pregnancy is a kind of stress for the female body. HCG helps to stimulate the production of other hormones needed for the body to adapt to this new state.
- Chorionic gonadotropin is necessary for the female body to maintain the normal functioning of the corpus luteum. During the menstrual cycle, this body disappears. When it comes hCG pregnancy helps to maintain its function, contributes to a constant increase in the concentration of progesterone.
- In a successful pregnancy, hCG is also essential for keeping the placenta healthy. Increasing the level of hCG has a positive effect on the chorion, namely nutrition and an increase in the number of its villi.
An increase in hCG in the body may indicate not only the onset of pregnancy. We will talk about this and its other features later in the article.
Why analyze
Most women believe that the role of human chorionic gonadotropin is limited to determining pregnancy. This is not entirely true. Such an analysis can be prescribed to patients with the following purpose:
- diagnosis of pregnancy;
- control of its course;
- detection of defects in the fetus;
- for the purpose of quality control of artificial termination of pregnancy;
- to find out the reasons for the absence of menstruation;
- to identify various formations capable of releasing chorionic gonadotropin.
As mentioned earlier, in non-pregnant women, the concentration of hCG is zero, rarely reaches 4-5 IU / l.
Analysis for hCG can be carried out even in men. Such a study is indicated for suspected testicular neoplasia and some other pathologies.
HCG norms in the table
So, as already mentioned, chorionic gonadotropin is not normally observed in men and non-pregnant women. That is why we will consider hCG indicators, which should normally be observed precisely during the period of bearing a baby. In the first table, you can see how hCG readings change by week of pregnancy.
In the second table, the concentration of the hormone is indicated in the first 42 days after ovulation in a woman.
It should be noted that the table indicates the weeks to obstetric term. If we consider the features of changes in the concentration of hCG, it is necessary to highlight several characteristic patterns:
- It is not necessary to determine the chorionic gonadotropin earlier than 7-8 days after the onset of ovulation. Most likely, the analysis will not show an increase in the amount of this substance, since its concentration at this stage is still too low.
- Until the period of 11 weeks, the amount of hCG increases rapidly, then begins to decline. It doubles every three days. That is, if we talk about when the growth of the hormone slows down, we can say that its intensive increase stops by the end of 11-12 weeks.
- After 11-12 weeks, the level of hCG decreases and is almost at the same place until the very birth.
If any deviations from the norm and these principles are found, the doctor prescribes an additional examination to the woman. Deciphering certain values when obtaining laboratory results makes it possible to judge the normal development of the embryo or various deviations from the norm.
Most simple method determining the increase in chorionic gonadotropin in the body is a pregnancy test. It helps in a few minutes to detect an increase in the concentration of hCG using the patient's urine. This method is quite fast, but it is not uncommon for rapid tests to be wrong and may give false positive or false negative results.
In addition, it is worth noting that urinalysis does not always give accurate results and it is quite difficult to determine this or that pathology in a woman, for example, an ectopic pregnancy.
To obtain reliable data, the analysis must be carried out in a laboratory using the patient's blood. If a woman wishes, it is possible to check hCG in order to determine pregnancy as early as 6-8 days after the expected date of conception.
In order to track the dynamics of changes in this indicator after pregnancy, a girl is recommended to donate blood for hCG once a week. In the first weeks, the growth of the hormone is very high. A slowdown in the increase in its concentration in the body is noted at 11-12 weeks.
Why indicators may be higher than normal
There are average data that chorionic gonadotropin should correspond to at various stages of pregnancy. If the patient has deviations in a big direction, the doctor may suggest the following pathological conditions:
- multiple pregnancy - twins, triplets (often this happens with artificial insemination using IVF);
- fluctuations in the level of hCG during treatment with hormonal drugs;
- the presence of defects in the development of the embryo;
- endocrine diseases in women;
- late toxicosis in a pregnant woman;
- prolonged (term) pregnancy.
In the event that a woman is not pregnant, an increased level of this hormone may indicate an artificial termination of pregnancy no more than five days ago, the use of medications that include hCG in its composition, and the formation of a tumor in various parts of the body.
Jumps in human chorionic gonadotropin are noted in some women during the onset of menopause, as well as in people on hemodialysis.
Causes of a decrease in chorionic gonadotropin
Pathological conditions can be indicated not only by the deviation of hCG from the norm upwards, but also by those situations where the concentration of this substance is lower. During pregnancy low level HCG is a rather dangerous condition, because it can lead to a delay in fetal development, insufficient maturation of the placenta, impaired oxygen supply to the fetus, and others. negative consequences.
A reduced concentration of the pregnancy hormone is noted in such situations:
- ectopic attachment of the embryo;
- abnormal (slow) development of the fetus;
- fading of pregnancy or death of the child;
- placental insufficiency;
- threat of interruption;
- delayed pregnancy.
A very dangerous condition, which is often indicated by a low concentration of hCG, is an ectopic pregnancy. In this case, the implantation of a fertilized egg occurs in the pathological area (in the fallopian tube, ovary, and even in the abdominal cavity). This condition often ends with rupture of the fallopian tube, internal bleeding and other complications. You can read more about ectopic pregnancy at.
How long does hCG appear in the urine
To determine the onset of conception at home, you can use a pharmacy test. Such tests are carried out using a large number urine and a special indicator strip. Whether a test will show pregnancy before a missed period is a moot point. Most manufacturers in the instructions for use indicate that this diagnostic method should be used from the first days of the delay.
If you look better, it turns out that according to the female cycle, conception can occur within 14 days after ovulation. Therefore, if the egg was fertilized immediately after ovulation, then after 7-8 days the production of chorionic gonadotropin will begin. That is, the test can show the onset of pregnancy 2-3 days before the start of the delay.
MoM norm
The norm of human chorionic gonadotropin depends on the duration of pregnancy. However, different laboratories may use values that differ from each other. If the results obtained are indicated in MoM, then this rate is the same for all clinics and analyzes and is 0.5-2 MoM.
If a woman has deviations from the norm upwards, there is a threat of Down syndrome or Klinefelter's syndrome in a child. If the indicators are lower, it is customary to talk about the risk of having a baby with Edwards syndrome.
Chorionic gonadotropin in ectopic attachment of the fetal egg
In an ectopic pregnancy, as in a normal pregnancy, a blood test for hCG will show an increase in the concentration of this hormone. At the same time, it will not increase as rapidly as during a normal pregnancy. Such results give the gynecologist a reason to suspect an ectopic location of the fetal egg. In the table you can see the growth of hCG in pathology.
| Pregnancy time by week | The level of chorionic gonadotropin IU / l |
| Patients without pregnancy | 0-4 |
| Questionable results | 4-25 |
| 3-4 | 25-150 |
| 4-5 | 150-4800 |
| 5-6 | 1100-31000 |
| 6-7 | 2500-82000 |
| 7-8 | 23000-151000 |
| 8-9 | 27000-230000 |
| 9-14 | 20000-290000 |
| 14-18 | 6100-100000 |
| 18-25 | 4650-80000 |
| 25-41 | 2500-78000 |
The table shows that despite the fact that the concentration of hCG is still increasing, the numbers strongly deviate from the norm and they are much lower. Ultrasound and some other tests help to identify an ectopic pregnancy.
Does hCG increase during a missed pregnancy
The question of whether an increase in hCG is observed during a missed pregnancy should be given special attention. The fact is that it is rather difficult to determine the fading of the fetus in the initial stages. This is due to the fact that the first signs indicating the death of the embryo are found in a woman only after 10-14 days. And the heartbeat of the fetus is still impossible to listen to.
You can determine the fading of pregnancy using a test or a laboratory blood test. At the same time, it is necessary to conduct such studies two or more times. The dynamics of the concentration of hCG when the fetus fades will be negative, that is, chorionic gonadotropin will decrease. If the hormone levels correspond to the norms at a certain time, then we can talk about the normal development of pregnancy. Summing up, we note that with a non-developing pregnancy, hCG does not increase. His performance, on the contrary, is declining.
So, as we found out, when the embryo freezes, hCG begins to fall. In addition to assessing the level of the hormone, you can suspect the fading of pregnancy in the first trimester by the following signs:
- bloody issues;
- the appearance of weakness, chills;
- internal trembling;
- increase in thermometer readings;
- abrupt cessation of manifestations of toxicosis;
- during ultrasound examination, the heartbeat is not heard;
- the uterus of a woman does not correspond to the size at a particular time.
Therefore, if hCG has decreased at an early stage, there is every reason to believe that the fetus has died and the baby is not developing.
At later dates, for example, in the second and third trimester, the woman stops feeling the fetal movements, the baby's heartbeat is not audible.
The causes of fading can be such provoking factors as genetic failure, infections, hormonal changes in the body, and so on.
Is pregnancy possible with low rates
Sometimes during a laboratory blood test for chorionic gonadotropin, its indicators in the body do not exceed 1-2 mmu / ml. Can such numbers indicate the onset of conception? It is impossible to answer this question exactly. The patient will need to take the test after a while. Dynamics hCG changes in the blood will help confirm or refute the interesting position of a woman. Too slow growth may indicate the presence of an ectopic pregnancy or other pathologies. In this case, the patient will need a biochemical blood test and other types of diagnostics.
When a pregnancy test shows the correct result after an hCG injection
First of all, let's figure out what injections with human chorionic gonadotropin are for. A doctor may prescribe this type of treatment to a woman with irregular ovulation or its complete absence. In addition, an hCG injection is used in case of a threatened miscarriage, miscarriage, and in some other situations.
Complete excretion of the hormone from the body occurs after 10-14 days. Therefore, at this time it is better to refuse to use the test. Another option is to donate blood for hCG in a hospital setting, to monitor these indicators in dynamics.
In addition to chorionic gonadotropin, during pregnancy, a woman may be prescribed an ACE analysis. What it is? AFP is a specific protein called alpha-fetoprotein and is produced by the liver of the fetus, starting from the fifth week of formation. With the help of its assessment, it is possible to identify various deviations in the formation of the neural tube of the fetus, the genitourinary system, and the development of the heart. In the table you can see the normal level of AFP at different periods of bearing a child.
It can be seen from the table that the AFP indicators, in accordance with the development of pregnancy, are constantly increasing and reach 100-250 Ad/ml by the end of the third trimester. Any deviations from the upper and lower limits should be the reason for an additional examination of the woman.
Can hCG drop early
Sometimes, when re-donating blood for hCG, a woman notes that the level of the hormone has fallen. The doctor should pay attention to this, since a drop in the hormone often indicates a fading pregnancy. But what does this mean when hCG has dropped and the pregnancy has persisted?
In this case, we will most likely talk about an error in the primary study. Here, a laboratory assistant could make an error, or the woman herself neglected the rules for donating blood. In any case, an additional examination and re-donation of blood for the concentration of chorionic gonadotropin will be required. Sometimes with a successful pregnancy, the hormone is found initially in low concentrations.
How to donate blood
In order for the result of a laboratory test to be the most accurate, you should remember a few rules for preparing for blood donation:
- blood is taken from the cubital vein;
- pick-up is carried out in the morning;
- before the procedure, you should refuse to eat and drink a lot;
- if the woman takes any medications, you should definitely inform the doctor about it;
- a few days before the study, fatty, smoked, sour foods, alcohol should be excluded from the diet;
- it is important to limit physical activity and strong emotional upheavals;
- one hour before the analysis, you can not smoke.
These simple rules will help increase the chances of obtaining a reliable research result. How long does the analysis take? As a rule, a woman can receive the results the next day.
The effect of Duphaston on hCG
Duphaston is a drug prescribed to women with a deficiency in the body of the hormone progesterone. Initially, the remedy is used to help the onset of conception, and later in order to endure the baby. Due to the fact that progesterone is partially controlled by chorionic gonadotropin, when donating blood for hCG, an increase in the amount of this hormone is sometimes observed.
Dufastn and other hormonal drugs during pregnancy should be taken strictly according to the doctor's prescription.
How much does the analysis cost
A blood test for hCG should be done exclusively in a laboratory. This service is provided by most modern gynecological clinics. The price of the procedure will depend on the clinic. As a rule, it ranges from 300 to 800 rubles. In this case, the patient can independently choose the laboratory. To date, the choice is huge - Invitro, Hemotest, Helix and others. You can choose the option that suits you on the forums, based on patient reviews.
Video
This video will help you better understand the concept of human chorionic gonadotropin and its norms.
Having become pregnant, a woman takes a lot of tests, some even several times. This can be a cause for concern: maybe something is wrong? One of these tests, which may have to be taken repeatedly, is the analysis of hCG during pregnancy.
HCG (human chorionic gonadotropin) is a hormone secreted by the chorion after the attachment of a fertilized egg to the uterine wall. This happens almost from the moment of conception, therefore it is hCG that is a reliable indicator for the early diagnosis of pregnancy, provided that the result of the analysis is reliable.
Then why is the level of hCG measured during pregnancy, not only in the 1st, but also in the 2nd, and even the 3rd trimester? The fact is that there are certain norms for hCG indicators at different periods of pregnancy, which allow you to find out if it is normal and if the fetus has any pathologies.
HCG contains alpha and beta particles. It is the beta unit that has a unique structure, so it is precisely b-hCG during pregnancy. This laboratory test can be carried out as early as 2-3 days of delayed menstruation, if conception has occurred, and 6-10 days have passed since then, the hCG level will certainly be elevated. If higher accuracy is required, repeat analysis and ultravaginal ultrasonography are recommended.
By the way, home express pregnancy tests (what would we do without them?) Are also based on the detection of hCG during pregnancy, however, for a hormone that is not in the blood, but in the urine, where its concentration is half as low, and therefore the accuracy of this method inferior to laboratory examination, but still quite reliable.
HCG levels during pregnancy
After fertilization of the egg, its outer membrane (chorion) begins to actively release gonadotropin, and at a very fast pace: in the 1st trimester, the level of hCG during pregnancy doubles every 2 days. At 7-10 weeks, this indicator reaches its peak, and then gradually decreases, without changing significantly in the 2nd half of pregnancy. That is why, according to the growth rate of hCG during pregnancy, doctors can judge its normal development or lag. At 14-18 weeks, this indicator may signal the development of pathology. Therefore, when prescribing this analysis again, your doctor is simply playing it safe, so do not be alarmed.
As for the norms of hCG, this is a very relative concept. The fact is that almost every laboratory has its own standards. For example, we give a table of hCG norms, it will help you approximately navigate this issue. However, remember that only a qualified specialist can say the decisive word about the compliance or deviations from the norm of your analyzes.
| WEEKS | HCG LEVEL |
|---|---|
| 1-2 | 25-300 |
| 2-3 | 1500-5000 |
| 3-4 | 10000-30000 |
| 4-5 | 20000-100000 |
| 5-6 | 50000-200000 |
| 6-7 | 50000-200000 |
| 7-8 | 20000-200000 |
| 8-9 | 20000-100000 |
| 9-10 | 20000-95000 |
| 11-12 | 20000-90000 |
| 13-14 | 15000-60000 |
| 15-25 | 10000-35000 |
| 26-37 | 10000-60000 |
HCG levels by day after ovulation
| day after ovulation | HCG LEVEL | day after ovulation | HCG LEVEL | ||||
|---|---|---|---|---|---|---|---|
| min | average | max | min | average | max | ||
| 7 | 2 | 4 | 10 | 25 | 2400 | 6150 | 9800 |
| 8 | 3 | 7 | 18 | 26 | 4200 | 8160 | 15600 |
| 9 | 5 | 11 | 21 | 27 | 5400 | 10200 | 79500 |
| 10 | 8 | 18 | 26 | 28 | 7100 | 11300 | 27300 |
| 11 | 11 | 28 | 45 | 29 | 8800 | 13600 | 33000 |
| 12 | 17 | 45 | 65 | 30 | 10500 | 16500 | 40000 |
| 13 | 22 | 73 | 105 | 31 | 11500 | 19500 | 60000 |
| 14 | 29 | 105 | 170 | 32 | 12800 | 22600 | 63000 |
| 15 | 39 | 160 | 270 | 33 | 14000 | 24000 | 68000 |
| 16 | 68 | 260 | 400 | 34 | 15500 | 27200 | 70000 |
| 17 | 120 | 410 | 580 | 35 | 17000 | 31000 | 74000 |
| 18 | 220 | 650 | 840 | 36 | 19000 | 36000 | 78000 |
| 19 | 370 | 980 | 1300 | 37 | 20500 | 39500 | 83000 |
| 20 | 520 | 1380 | 2000 | 38 | 22000 | 45000 | 87000 |
| 21 | 750 | 1960 | 3100 | 39 | 23000 | 51000 | 93000 |
| 22 | 1050 | 2680 | 4900 | 40 | 25000 | 58000 | 108000 |
| 23 | 1400 | 3550 | 6200 | 41 | 26500 | 62000 | 117000 |
| 24 | 1830 | 4650 | 7800 | 42 | 28000 | 65000 | 128000 |
Deviations from the norm of hCG during pregnancy
But what if the analysis of hCG during pregnancy showed some deviation from the norm in one direction or another? Of course, this is not too good - both an increased and a lowered indicator should alert, because all this indicates some problems and complications in the woman's body. The main thing is to make sure that the gestational age is set correctly, otherwise the comparison with the norm will lose all meaning.
Too much high hCG levels during pregnancy- this, in best case, index multiple pregnancy: Usually the level of the hormone in the blood increases in proportion to the number of embryos.
In addition, the level of hCG above normal may indicate the following pathologies:
- anomalies in the development of the fetus, for example, Down's syndrome;
- prolongation of pregnancy.
The level of hCG may increase if the expectant mother suffers from diabetes and takes synthetic gestagens.
False positive hCG test result
If it turns out that you are not pregnant and your hCG level is high (false positive test result), one of the following factors may have influenced it:
- taking certain hormonal drugs, including oral contraceptives;
- residual effect after a previous pregnancy or abortion;
- chorioncarcinoma;
- cystic drift or its recurrence;
- tumor of the ovaries, uterus, kidneys, lungs.
In any case, this is a reason to see a doctor.
Decreased hCG during pregnancy may indicate an ectopic pregnancy, the threat of miscarriage, overdose. It can also be a symptom of such an unpleasant phenomenon as chronic placental insufficiency.
HCG with a frozen pregnancy
Also, the level of hCG drops during a frozen pregnancy. A frozen or regressing pregnancy is a case when the fetus died for one reason or another. The hormone ceases to be produced, and the analysis shows a drop in the level of hCG. Usually, if a missed pregnancy is suspected, studies are carried out in dynamics, that is, tests are taken several times, and the doctor can clearly determine how the level of the hormone in the blood changes.
However, do not rush to panic - perhaps the hCG levels are outside the normal range for your gestational age just because it was set incorrectly. This happens, therefore, an ultrasound scan is prescribed to determine a regressing pregnancy, but not on its basis, a final conclusion is made. In addition, there are cases when hCG rises during a missed pregnancy, although other signs have already disappeared.
Sometimes the results of the analysis show hCG 0 (negative) during pregnancy, most likely - this is also a mistake and you will need to do the analysis again.
