Human Chorionic Gonadotropin (hCG)

Human Chorionic Gonadotropin – hCG examination is performed to verify and confirm the presence of hormone hCG in your blood or the urine. Certain hCG examinations quantify the precise amount and some merely confirm the presence of the hormone.

The hCG is produced by the placenta in your pregnancy. The hCG test may be utilized to know to know if a female is pregnant and ascertain the possibility of chromosomal or gene defects in the offspring. The hCG may also get generated by certain abnormal germ cell tumors, especially coming from sperm or eggs.

The hCG levels are generally examined in females who are suspected to be growing abnormal tissue in the uterus. The condition is known as a molar pregnancy or the cancerous growth in the uterus, called choriocarcinoma.

Certain hCG examinations are performed after the mishap of miscarriage to ensure that a molar pregnancy is not there in the uterus. In a male, hCG levels are quantified to ascertain the possibility of a cancer in the testicles.

hCG during pregnancy

An egg generally gets fertilized by a sperm cell of the semen in one of your Fallopian tubes. Within nine days after the fertilization takes place, the fertilized egg travels down the Fallopian tube to your uterus and gets implanted in the uterine lining. After the implantation of the fertilized egg, the growing placenta starts releasing hCG in your blood.

A little hCG may also get moved to be a part of the urine. The hCG may be traced in your blood before missing your first menstruation, and that could be as early as six days after the egg implantation. The hCG helps in maintaining your pregnancy and influences the growth of the fetus (one of the earliest stages of a developing baby).

The hCG levels increase gradually during the initial 14 to 16 weeks, subsequent to your last menstruation and begin declining gradually afterwards. The increasing hCG levels signify the existence of your pregnancy and the physical condition of your developing baby. Immediately after the delivery of your baby, the hCG levels go missing in your blood.

Compared to a single pregnancy, additional hCG gets released in you are carrying multiple pregnancies, like twins/triplets. The lesser amount of hCG gets released in case the implantation of the fertilized egg has taken place in one of your Fallopian tubes rather than happening in the uterus. The condition is known as an ectopic pregnancy.

hCG blood tests

The hCG blood test is used to know the presence of hCG.  It is also used to know the precise amount of hCG in your blood.

The blood test may be performed to know a female’s pregnancy status, to ascertain unusual pregnancies, or to examine the prevalence of some cancers related to hCG. The hCG levels in your blood are utilized as a part of the viewing the possibility of birth defects in a triple or quad screening examination.

Usually performed in between 15 & 20 weeks of your pregnancy, these examinations ascertain the levels of 3 or 4 materials in a pregnant female’s blood. In the triple screening, the levels of the following are examined:

  • Alpha-fetoprotein (AFP)
  • Human chorionic gonadotropin (hCG), and
  • uE3 or unconjugated estriol (a kind of estrogen)

In the quad screening, besides the examination of the levels of the above-mentioned three elements, hormone inhibin-A levels are also scrutinized. The levels of the above materials, the female’s age and some other factors help the doctor in determining the probability of the offspring having some problems or birth imperfections.

Shall I go in for screening for birth defects?    

In certain cases, the screening examination is performed during the first trimester to know the presence of Down syndrome.

During this screening, the ultrasound measurement of the skin thickness at the rear of the fetus’s neck, called nuchal translucency, besides a blood examination of the pregnancy hormone hCG levels and the pregnancy associated plasma protein-A (PAPP-A) is done.

This examination is believed to be nearly as accurate as the quad-screening during the second-trimester.

hCG urine examination

hCG urine examination is generally used for are usually used for conducting for regular pregnancy tests. This examination is not for measuring the precise amount of hCG, but it merely reveals the presence of hCG.

Pregnancy tests performed at home that show the presence of hCG in urine are commonly available.

Why is hCG Done?

The Human Chorionic Gonadotropin (hCG) is mainly done for:

  • Knowing your pregnancy status
  • Ascertaining the presence of ectopic pregnancy in you
  • Discovering and checking the molar pregnancy treatment
  • Observing whether there is a higher probability of birth defects, like Down syndrome. The test is performed in combination with certain other screening examinations.
  • Ascertaining and testing out the germ cell cancer treatment. Such cancers grow from an egg or sperm cell, such as the cancer in the ovaries or the testicles. In such a case, along with the hCG examination, an examination for alpha-fetoprotein is also done.

How to prepare for the test?

If a sample of your blood has been collected, you don’t require doing anything else before this examination. In a urine examination, the first urine in the morning hours is usually considered the best for the simple reason that it would have the highest level of hCG.

The urine sample taken at least four hours after the previous urination will also have an elevated quantity of hCG.

How Is the Test Done

Human Chorionic Gonadotropin (hCG) is generally measured in a blood or urine sample.

Collection of Blood sample

  • Bind an elastic band just around the upper region of your arm for stopping the blood flow. This helps in making the veins underneath the band bigger. This is done for facilitating the needle placement in the vein
  • Sanitize the needle area with alcohol to avoid any kind of infection
  • Place the needle in the vein. If the needle can’t be placed properly or in case the vein subsides, an additional needle stick may be required
  • Affix a suction tube with the needle for filling it with blood
  • Remove the elastic band from the arm when sufficient blood gets collected.
  • Place a cotton ball or gauze pad above the place of the needle as the needle is taken out
  • Exert little pressure on the needle site and then place a banded aid or a bandage

Urine collection

  • Try collecting the urine sample with the first urine in the morning hours. This urine will have the increased level of hCG.  Otherwise, a urine sample taken after a gap of minimum 4 hours from the last urination also will have higher amounts of hCG than taken after a lesser gap.
  • Place the collection vial in line with the stream of your urine for collecting about 60 Ml (4 tablespoons) of urine.
  • Keep the collection vial away from your genital region and avoid any contact with the toilet paper, pubic hair, feces (stool), blood or any other foreign substances that may contaminate the urine sample.
  • Finish your urinating in the urinal.
  • Place the lid on the collection vial carefully and give it to the lab for carrying out the examination.
  • In case you are doing the urine collection at home and it is not possible for you to reach the lab within an hour, you are advised to place the vial in a refrigerator.

How It Feels

  • Blood test

Since the blood sample is taken out from the vein of your arm and an elastic strap is draped around the upper region of your arm, you may feel the tightness. You may also feel a swift pinch or a sting from the needle or it may not bother you at all.

There may be anxiety in you while you await the outcome of an hCG examination to know your baby’s health.

  • Urine test

While collecting a urine sample, there is generally no sign of discomfort.

Risks

  • Risks of a blood examination

There is hardly any probability of a problem while taking out of a blood sample from your vein. But the needle may cause a bruise where it is placed in the vein through the skin. The probability of getting such a bruise can be reduced by exerting mild pressure on the place for some minutes.

In some unusual cases, the vein may get swollen after taking out the blood sample. Such a problem is known as phlebitis. It can be treated by using a warm compressing several times in a day. Bleeding constantly may be a problem for some people having bleeding disorders.

The probability of bleeding increases with the use of blood-thinning medications such as coumadin (warfarin), aspirin and other such medicines. It is of utmost importance to inform your doctor in case you have been suffering from clotting or bleeding problems, Or, you have been using blood-thinning medications.

  • Risks of Urine examinations

There is hardly any perceived issue in the process of urine sample collection.

Outcomes

The hCG examination is performed for measuring the quantity of hCG hormone in your blood or urine.  The hCG presence in your blood or urine signifies your positive pregnancy status. The hCG measurement is also performed to know the cancer in your ovaries or testicles.

Normal

The standard values listed below are for the purpose of a reference guide. These ranges may vary from laboratory to laboratory. While your laboratory may have different values what you deem as normal, another laboratory may find the values abnormal.

Your laboratory report should have the values that your lab has been using. Besides, your doctor may like evaluating your outcomes depending on your health conditions and some other factors.

The standard levels of hCG in the blood 
Status hCG levels
Males and non-pregnant females
Pregnant females with one-week of gestation (nearly three weeks after the last periods) >5 to 50 IU/L
Pregnant females with two weeks gestation (nearly four weeks after the last menstruation) >50 to 500 IU/L
Pregnant females with three weeks gestation (nearly five weeks to the after the last periods) >100 to 10,000 IU/L
Pregnant females with four weeks gestation (nearly six weeks after the last menstruation) >1080 to 30,000 IU/L
Pregnant females with six to eight gestation (nearly eight to ten weeks after the last menstruation) >3500 to 115,000 IU/L
Pregnant females with twelve weeks gestation (nearly fourteen weeks  after the last menstruation) >12,000 to 270,000 IU/L
Pregnant females between 13 and 16 weeks gestation (nearly between 15 and 18 weeks after the last menstruation) Nearly around  200,000 IU/L
The standard hCG levels in the urine
Status hCG level
Males None – negative test
Non-pregnant females None – negative test
Pregnant females Traceable  – positive test

High values

In case you happen to be pregnant, elevated levels of hCG may mean the presence of multiple pregnancies, like twins or triplets, Or, a Down syndrome, Or, a molar pregnancy. In males or non-pregnant females, a higher level of hCG indicates the presence of a cancerous or non-cancerous tumor(s) that may have developed from a germ cells (egg or sperm cells).  Such tumors usually develop in the testicles or the ovaries. The higher amount of hCG may also signify the presence of certain kinds of cancer, like pancrea, stomach, lung, liver or large intestine.

Low values

If you happen to pregnant, the low hCG levels indicate the possibility of an ectopic pregnancy, Or the demise of your baby, Or, that you are still in your early pregnancy and the estimation of your gestation may have wrongly been calculated from your last menstrual cycle. In case you happen to be pregnant and the hCG levels are abnormally decreasing, there is a likelihood of a miscarriage.

What may affect the examination?

The following may affect the outcomes of your examination:

  • Performing a urine examination for hCG during very early stage of your pregnancy (maybe in the initial stage of embryo implantation)
  • The examination may not indicate any sign of your early pregnancy in case the urine sample has been taken during the midday or after a gap of less than 4 hours.
  • Therapeutic abortion or the miscarriage. The hCG outcomes may be highly positive for nearly four weeks after the therapeutic abortion or the miscarriage.
  • Taking an hCG injection for treating infertility. This may cause test results to appear high for several days after the injection.
  • In case there are traces of blood or soap in the collection vial, the hCG level outcome may not be correct.
  • The medications such as promethazine and diuretics may give falsely low levels of hCG in the urine examination results.
  • Inform your doctor beforeyourhCG examination in case you have been using any kind of medications, such as:
    • Heparin (the medication prevents blood clotting)
    • Hypnotics, like Ambien
    • Antipsychotics
    • Antinausea medications like Promethazine and Prochlorperazine

Points to ponder

The blood examination for hCG is usually considered more accurate than the urine test. If you are suspecting pregnancy in you and the urine test results are showing a negative result, you are advised to go in for a blood examination or yet another urine examination after a few days.

You cannot rule out the probability of an ovarian or uterine or any kind of tumor in the testicles if the hCG assessment results are normal. The hCG examination is by and large a part of the overall diagnosis when there is a suspicion of a tumor. The hCG levels in your blood are often utilized in the triple or quad screening tests.

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