Positive level of human chorionic gonadotropin in the blood. HCG analysis: results

home

CCTV

Every woman will certainly be worried about the fact that her period is delayed. For some, this is a glimpse of such a long-awaited pregnancy and maternal happiness, for others it is an alarming signal that a malfunction in the well-coordinated functioning of the body may be a consequence of some disease. In both cases, before contacting a specialist, it is advisable to confirm or rule out a possible pregnancy.

At home, you can independently get a preliminary answer to this question using pregnancy tests, which are sold at any pharmacy.

Conducting a rapid analysis using such a test is based on identifying a specific “pregnancy hormone” in a woman’s urine – hCG. The test strip contains special reagents that are colored by the presence of hCG in the urine sample.

What is hCG, what role does it play in realizing the main purpose of the female body and what important information can be obtained by studying the indicators of its value in the blood, you will learn from this article.

What it is?

The abbreviation hCG means human chorionic gonadotropin - a specific hormonal substance that begins to be produced by a fertilized egg from the very moment it attaches to the endothelium of the uterus (approximately the sixth to eighth day from conception). Human gonadotropin is produced first by the cells of the outer membrane of the embryo, which is called the chorion (hence the definition of this specific gonadotropin - chorionic).

With the help of chorionic villi, which penetrate the wall of the uterus, the embryo receives all the necessary substances. Over time, as the embryo grows, the chorion is transformed into the placenta - a kind of organ on the wall of the uterus through which the fetus receives oxygen and nutrients. The placenta continues to produce hCG throughout pregnancy until delivery.

The structure of hCG is protein in nature - it is a glycoprotein consisting of 237 amino acids. The hCG molecule consists of two parts (subunits) - alpha and beta, connected to each other. And if the alpha part has a similar structure to the alpha subunits of other pituitary hormones (follicle-stimulating, luteinizing), then the beta subunit has a structure characteristic exclusively of this hormone and it is this that determines its uniqueness, specific properties and effect on the body. Therefore, the presence and amount of this hormone in the blood can be determined using methods using antibodies specific to the beta subunit (this explains the origin of the term beta-hCG).

The formation of two different gonadotropin subunits occurs independently, therefore, both bound into one molecule (intact) and separate free subunits are present in the blood. In gynecology, the term hCG refers to beta-hCG, both total and free.

Meaning

Without human chorionic gonadotropin, the preservation and normal bearing of a fetus by a woman would become impossible. After ovulation, instead of the destroyed follicle, the so-called corpus luteum is formed - a temporary gland that produces the hormones estrogen and progesterone. Under their influence, the endometrium of the mucous wall of the uterine body thickens, its glands begin to actively produce a special secretion that fills the endometrial cells with all the components necessary for the further active and full development of the fertilized egg.

Progesterone, produced by the corpus luteum, not only creates conditions for the attachment of a fertilized egg to the wall of the uterus, its division and development of the fertilized egg, but also reduces uterine tone, thus eliminating the possibility of miscarriage, and also helps the mammary glands adapt to the process of lactation.

To maintain pregnancy and its normal course, a constant high level of progesterone is necessary, however, the corpus luteum under normal conditions stops producing hormones after about 10-14 days. But thanks to hCG, which large quantities secreted by the chorion and then by the placenta, the corpus luteum in the body of a pregnant woman not only does not dissolve, but also produces a much larger amount of progesterone, which it is unable to produce in a non-pregnant body.

Human chorionic gonadotropin supports the function of the corpus luteum until the fetal placenta is sufficiently formed to begin to independently produce progesterone and estrogen (at about 10-12 weeks).

HCG has a positive effect on the development of the placenta, improves cellular nutrition processes and supports its functional activity. HCG also increases the production of hormones from the adrenal cortex, and this, in turn, provides temporarily necessary immune suppression to prevent fetal rejection(half foreign genetically) by the maternal organism.

HCG is also believed to play a role in a woman's adaptation to pregnancy, which can be stressful for her.

In a male embryo, hCG is responsible for a group of cells that stimulate further production of testosterone, a special sex hormone necessary for the primary formation and further development of male characteristics. HCG is the earliest marker of pregnancy.

Determining the amount of hCG in the blood has great importance for diagnosis and assessment of the course of pregnancy, helps to identify pathology in time and prevent possible complications

A blood test for hCG in men and non-pregnant women, who normally do not have it, makes it possible to determine or exclude the presence of tumors that can produce this hormone.

How does the hormone grow?

HCG begins to be produced almost immediately from the moment the dividing egg is fixed on the wall of the uterus. Already on days 6-8 from the moment of fertilization, the level of chorionic gonadotropin in the blood can be in the range of 5-50 m IU/ml (in non-pregnant women 0-5 m IU/ml).

Since hCG is excreted from the body by the kidneys, it will be present in the urine of a pregnant woman. Already on the first day of a missed period, it can be detected in the urine using a pregnancy test with a sensitivity of 10 IU/ml or higher. In any case, such tests allow you to determine the presence of “pregnancy hormone” in the urine in general, and do not determine its exact amount. On the other hand, such test strips allow a woman to independently determine the onset of pregnancy, which is much more reliable than trying to calculate the “risk” by days of the cycle.

In order to find out the exact concentration of hCG in the blood or urine, it is necessary to perform a professional laboratory test. Such tests are carried out regularly for any type of pregnancy, since the dynamics of the growth of human chorionic gonadotropin is the most informative indicator of the condition of the unborn child, as well as the health of the mother herself, for the doctor.

Of course, any pregnant woman most looks forward to those moments when the embryo is visible or the fetal heartbeat is heard on an ultrasound, however It is precisely such biochemical analyzes that are more necessary.

If you wish, you can interpret the results yourself to assess the state of your baby's health.

Below is a list of hCG indicators in international units of measurement depending on the current week of gestation:

1-2 weeks – 20-125 mU/ml;
2-3 – 150-4000;
3-4 – 1100-25000;
4-5 – 2500-40000;
5-6 – 23000-100000;
6-7 – 27000-200000;
7-11 – 20000-250000;
11-17 – 6000-100000;
17-21 – 5000-50000;
21-39 – 2500-70000.

At the beginning of the first trimester, hCG levels increase slowly. This is due to the gradual increase in hormone production by the embryo membrane. However, these numbers can be highly correlated depending on the conditions of pregnancy and the method of conception. For example, if a woman is diagnosed with twins, then hCG levels by week can double, while still being the absolute norm for her.

Also, the “pregnancy hormone” may behave slightly differently in the case of IVF. Artificially inseminated women check the level of hCG much more often, since its faster growth is important for them until the 11th week, after which the peak concentration of the hormone is reached and its maintenance at the proper level over the next few weeks.

Immunity

In some cases, a woman’s body reacts with autoimmune processes to the appearance of human chorionic gonadotropin in the blood and urine. In response to the growth of hCG, specific antibodies are formed that neutralize the unique beta subunit of the hormone and thereby can prevent the normal attachment of the fertilized egg to the uterine mucosa, as well as the further development of the embryo.

Thus, the level of the “pregnancy hormone” before gestation, as well as the body’s sensitivity to its molecules, plays a very important role in family planning.

As a rule, the issue of an increased immune reaction is considered by doctors if a woman has a history of at least two pregnancies that ended in spontaneous miscarriage or some other complications.

If an autoimmune reaction to hCG is determined before gestation, then such a woman receives specialized treatment throughout the first trimester. In some cases, therapy can last much longer, and will be based on regular use of low molecular weight heparin and glucocorticoids.

It should be noted that such an autoimmune reaction is very rare, so the disorder is not always explained by a similar phenomenon.

Before planning a pregnancy, it is strongly recommended to undergo all additional studies, including the woman’s individual sensitivity to human chorionic gonadotropin.

Types of analyzes

Today, there are several options for analyzing the hCG content in the body, among which there are both rapid tests available to any woman and more professional laboratory diagnostics:

Express pregnancy test;
Analysis of hCG concentration in blood plasma;
Laboratory urine analysis.

Tests for diagnosing pregnancy today can be easily purchased at any pharmacy or even at the supermarket checkout. Such “strips” work on the principle of detecting specific beta subunits of hCG in a woman’s urine.

Rapid tests are easy to use at home, since for diagnosis it is enough to immerse the strip for a few seconds in a container with urine. Meanwhile, they are not very informative, since they only confirm or refute the presence of the hormone in the urine, and do not show its specific amount. That's why even a positive result is not an absolute indicator of pregnancy, just as a negative one does not completely refute it.

More accurate are professional laboratory tests of urine and blood, which are carried out in specialized centers or clinics. Among them, several diagnostic options can also be distinguished: general and free, the difference between which lies in their information content.

A general analysis of hCG content is most suitable for early diagnosis of a woman’s pregnancy condition. We are talking about those periods of gestation when even the most expensive test strips do not give an accurate result. In the case when the attachment and development of the embryo proceeds without any pathologies, the hCG level will increase every two days, reaching its peak at 10-11 weeks. After this, the amount of the hormone stabilizes and its growth stops.

The so-called analysis of free hCG involves diagnosing the content of beta subunits directly in the body. Typically, such studies are necessary to diagnose various neoplasms or pregnancy complications such as hydatidiform mole.

Also, determination of free pregnancy hormone is necessary in the second and third trimester. Its content is a very informative indicator for identifying various genetic diseases of the fetus, for example, Down syndrome or Edwards syndrome.

If a positive result is detected, the pregnant woman is identified as a risk group, however, this still does not provide 100% confirmation that the child has chromosomal abnormalities. In the next 8 weeks, it is necessary to carry out regular repeated tests in order to identify all possible abnormalities and the dynamics of specific hCG subunits, which in the end may turn out to be completely normal.

How and when to take it?

The preparation and process of taking tests largely depends on what kind of result you are interested in. For example, if you need to detect the presence of hCG in urine in general, then a standard pregnancy test is suitable for this.

You can do the test at home. For it, you only need a special test strip and a sterile container into which you need to collect a small amount of urine. The rapid test is immersed in urine for a few seconds and then shows a positive or negative result.

Any woman who suspects the possible onset of pregnancy, for example, in case of delayed menstruation, can conduct such an analysis at home.

For a more accurate diagnosis of human chorionic gonadotropin levels, professional laboratory tests should be carried out, for which blood or urine is taken, depending on the type of test. From a medical point of view, a more informative analysis is the blood and amniotic fluid that surrounds the fetus.

The last of them is performed in the later stages of pregnancy and is carried out, as a rule, only if there is a risk of developing pathology in the unborn baby, since it has important diagnostic value.

To test blood for hCG levels, it is necessary to take blood from a vein. The collection is carried out using a special sterile syringe. In general, the entire procedure for a pregnant woman is as follows:

The doctor sets a specific date for collecting the material and performing the analysis;
On the specified day, usually in the morning, the woman visits the laboratory. It is very important to donate blood on an empty stomach, since in some cases the intake of certain foods can affect the final result. Preparation for urine collection also includes basic intimate hygiene;
A laboratory doctor carries out a procedure for drawing blood from a vein, which will later be examined for the concentration of hCG in it.

A pregnant woman should pay special attention to preparing for donating blood for analysis. If certain points are not met, then It is very easy to get a false result, which can negatively affect your health in the future:

The optimal time to take the test is from 8 to 10 am. At the same time, it is important not to have breakfast at all, and in extreme cases, when this is impossible, to refuse fatty and spicy foods in the next few days;
About a day before the date of blood sampling, you should completely stop drinking alcoholic beverages, taking most medications (with the exception of insulin), and also not engage in sports or any type of physical activity;

Several hours before taking the hCG test, you should not smoke or drink anything other than ordinary water. Doctors also strongly recommend protecting yourself from possible emotional experiences and stress, try to relax and unwind;
It is not advisable to donate blood after any procedures or instrumental studies such as massage, ultrasound, fluorography or radiography.

If you have been scheduled for a repeat follow-up examination to clarify the result, then it is best to try not to change any conditions for taking the test: time of day, food intake and all other factors that could affect the test data.

As for the timing of the test, it depends entirely on the doctor who is caring for the pregnant woman. It is he who decides when to conduct a control test and determine the dynamics of hormone growth. Usually, a blood and urine test for free hCG subunits is carried out at approximately 13-14 weeks, since during these periods there is a high risk of developing various pathologies, and such examinations allow them to be suspected and identified in a timely manner.

If the indicators do not correspond to the norm for the current stage of pregnancy, this may imply not only pathology, but also the presence of other factors that affect the content of the hormone. These include certain foods, the constant use of certain medications by a pregnant woman, or even an incorrect laboratory test.

If we're talking about about the early diagnosis of pregnancy, the most appropriate time to conduct a blood and urine test in the laboratory is 13 days after ovulation.

Very often on thematic women's forums one can come across the erroneous opinion that a blood test for the “pregnancy hormone” is not informative, since in their case it was negative, but in the end the pregnancy was confirmed. Typically, such false results are the result of an error in the ovulation calendar and the wrong time for testing.

To clarify the gestational age, if the woman cannot calculate it herself, a blood test for hCG concentration is carried out no earlier than 5-6 days after the delay of menstruation. Since it will not be informative enough, it will need to be repeated 3-4 days after the first one.

The analysis is also carried out approximately 7-9 days after a medical abortion or curettage. The fact is that part of the fertilized egg can easily remain on the uterine mucosa, which will harm the woman in the future. An elevated level of hCG after a medical termination of pregnancy is one of the most reliable methods for diagnosing such complications.

Most pregnant women try to independently evaluate the results obtained, guided by the simplest decoding, consisting of the permissible norm of hCG for a certain stage of pregnancy. However, when obtaining and evaluating results, the following nuances should also be taken into account:

In most private laboratories and clinics, the gestational age is calculated from the expected date of conception, and not from the last day of menstruation. In the case of standards for hCG indicators, as a rule, the period from the MPD is taken into account;
If you want to evaluate the results yourself, always check the normal values with the laboratory in which you performed the diagnostics. The fact is that each medical institution may have its own standards, which largely depends on the reagents and equipment used;

If, nevertheless, your level of human chorionic gonadotropin differs from the permissible norm, then you should not immediately panic. It is best to diagnose deviations from the norm in dynamics. Take a follow-up test 4-5 days after the first;
The hCG level is not always an informative standard for diagnosis ectopic pregnancy, however, quite often you can encounter a situation where, during the initial examination, doctors may suspect this particular diagnosis.

How long to wait for the result?

How long it takes to prepare the result of an hCG blood test completely depends on the laboratory in which it is carried out. As a rule, a day is enough for a full diagnosis. That is, you can get the test result the next day after you donate blood or urine. Of course, a lot can be decided by both the professionalism of laboratory doctors and the workload of the laboratory, the availability of certain reagents and equipment.

If we are talking about late pregnancy, when the level of the “pregnancy hormone” is a very important indicator of the child’s condition, doctors may prescribe a test marked “cito! ", which means "urgently!". As a rule, such tests are carried out in an accelerated mode, so you can get the result within a few hours. Typically, such measures are necessary if the doctor suspects that you have a certain acute pathology, in which case a long wait is unacceptable.

Norm

Human chorionic gonadotropin performs the most important function in a pregnant woman’s body - it prepares the expectant mother for bearing a child, and also provides everything necessary for the normal development of the fetus. The fertilized egg begins to produce this hormone, due to which the launch and active preparation of all processes in the woman’s body for further bearing a child begins from the first days.

From approximately 9 or 10 days after ovulation, subunits of the “pregnancy hormone” can be detected in a woman’s blood plasma. This is explained by the fact that the active production of this substance normally begins immediately after the attachment of a fertilized egg to the endothelium of the uterine wall mucosa. Too low levels of hCG in the early stages of pregnancy are often considered acceptable, but only if the dynamics show subsequent rapid growth every two days. That is why the hormone content is measured quite often throughout gestation.

Typically, an increase in the concentration of human chorionic gonadotropin is observed until 8-10 weeks of pregnancy. We are talking about the weeks since the last day of menstruation. It is during this period that hCG reaches its peak of 50,000 - 100,000 mIU/ml. After this, as a rule, its concentration begins to gradually decrease until 18-20 weeks, and then stabilizes at a certain level.

Of course, as stated earlier, gonadotropin is also found in the urine. This is due to the fact that this hormone is excreted by the kidneys. Urine has its own standards for indicators, but they are considered not as important as the level of hCG in the blood plasma. The highest content of the “pregnancy hormone” in the urine is recorded approximately on the 60th day after the last menstrual period, which is also considered as one of the indicators of the normal course of pregnancy.

There have been cases where human chorionic gonadotropin reaches repeated peak levels in the later stages of gestation. Previously, this condition was considered as an acceptable norm, but modern medicine has evidence that such a picture is a possible harbinger of various pathologies. Most often, an increase in hCG in the third trimester is caused by a Rh conflict, which also causes a secondary reaction of the placenta to placental insufficiency, which is manifested by the active production of specific gonadotropin subunits.

With a normal pregnancy or after a medical abortion, after one week it is no longer possible to detect hCG in a woman’s body. Sometimes a control test is carried out much later, after 42 days, which is necessary to identify the risk of trophoblastic disease. Also, a blood test for the “pregnancy hormone” is carried out 7-10 days after delivery or abortive curettage. The presence of hCG subunits makes it possible to identify the remains of the fertilized egg or placenta.

Today, there are quite a lot of different tables that display the permissible hormone growth rates depending on the gestational age. They may differ from each other, since sometimes they imply different units of measurement, as well as taking into account or missing the possibility of multiple pregnancies. Most of them are designed to take into account the dynamics of hCG, starting from the day when the fertilized egg joined the endothelium of the uterus.

It is very important that not only the doctor, but also the pregnant woman herself has a correctly selected table. This way she can easily monitor her health and make sure that her baby is growing and developing normally.

However, it should be understood that the figures presented in such tables are not always reference figures.

Each laboratory that diagnoses the growth of hCG may have its own standards and indicators, which should always be consulted. The most convenient is a table that shows the acceptable average values of the “pregnancy hormone” depending on the so-called obstetric week of gestation. note that values may double depending on the presence of multiple pregnancies.

Below is a list-table that shows the duration of pregnancy by obstetric week, as well as The average permissible value of hCG in a woman’s blood plasma is:

2 weeks – 150 mIU/ml;
3-4 weeks – 2000 mIU/ml;
4-5 weeks – 20,000 mIU/ml;
5-6 weeks – 50,000 mIU/ml;
6-7 weeks – 100,000 mIU/ml;
7-8 weeks – 80,000 mIU/ml;
8-9 weeks – 70,000 mIU/ml;
9-10 weeks – 65,000 mIU/ml;
10-11 weeks – 60,000 mIU/ml;
11-12 weeks – 55,000 mIU/ml;
13-14 weeks – 50,000 mIU/ml;
15-16 weeks – 40,000 mIU/ml;
17-20 weeks – 30,000 mIU/ml.

If you use such tables, then do not forget that gonadotropin is produced quite quickly, so it has very high variability. So, for example, in the early stages - in two weeks of pregnancy, you may encounter readings of 100-150, or vice versa, 300 mIU / ml, which is a completely acceptable norm. The same can be said about other stages of pregnancy.

There is also a special table for determining the normal dynamics of hCG during IVF. Of course, in the case of artificial insemination, the growth rates of gonadotropin are somewhat different, although in many respects they coincide with normal pregnancy.

It is important to note that in the case of artificial insemination, the behavior of human chorionic gonadotropin in the first trimester should be especially carefully monitored, since it is an indicator of how well the implanted embryo is taking root.

In the case of IVF, the DPP of five days is taken into account. This term means every 5 days after the day of implantation of the fetus into a woman. Just like in the previous table, such tables show the ratio of the average acceptable hCG value to weeks of pregnancy and to the DPP of five days, respectively.

It should be noted that in IVF, the MoM coefficient is considered the most informative. MoM- this is the ratio of the actual gonadotropin indicator to its average permissible norm. The most optimal coefficient is considered to be from 0.5 to 2. Timely and competently carried out tests for the concentration of hCG in the blood plasma of a pregnant woman are the key to reliable monitoring of the health of the mother and child.

There are also various indications that require other related examinations. However, a deviation from the norm does not always imply a serious threat to pregnancy.

For example, hCG levels of 0 mmu/ml during obvious pregnancy may indicate a risk of anembryonia. This is a rather unpleasant diagnosis, which is also called “frozen pregnancy” and can threaten the complete death of the fetus. If these results occur, a follow-up ultrasound should be performed., since the fetus may simply be too small in the early stages of development, as a result of which specific gonadotropin subunits are not yet registered in the blood plasma.

There is a huge range of factors that can affect the results of a blood or urine test. If in the early stages of pregnancy you receive indicators that differ from the norm, this first of all means that you need to undergo a follow-up examination in a few days. This will allow you to track the behavior of the hormone over time and eliminate the possibility of error.

Also don't forget that Only a doctor can professionally decipher the results of the studies, That's why final decision should always be left to a specialist.

Do not panic prematurely if the numbers on paper are slightly different from those you saw in the tables.

Reasons for rejection

Most dangerous reasons changes in “pregnancy hormone” levels are pathological processes both in the woman’s body and in the embryo itself. However, there are situations where high or low hCG levels are an acceptable physiological response.

Most often, an increase in the hormone can be associated with the following conditions:

Multiple pregnancy. Twins can increase gonadotropin levels several times. This is due to the fact that the fertilized egg contains two or more embryos, and the outer membrane of each of them begins to produce the amount of hCG that it specifically needs. Thus, the concentration of detected subunits doubles or increases several times depending on the number of embryos;
Developmental defects or the presence of chromosomal pathologies. By tracking gonadotropin dynamics, doctors can promptly diagnose most birth defects, Down or Edwards syndrome. To do this, hCG is measured both in the pregnant woman’s blood and in the amniotic fluid (amniotic fluid) during screening in the third trimester;

Presence of diabetes mellitus type 1 or 2 in the pregnant woman's history. Changes in glucose levels in the blood and urine can not only affect test results, but also directly change the concentration of hormones in the body;
Elevated hCG levels may be directly related with the use of drugs, which contain synthetic analogues of gonadotropin subunits;
Can also cause changes trophoblastic neoplasms;
A sharp increase is often associated with the development hydatidiform mole.

As for the decrease in hormone levels in pregnant women, the most common causes of this condition are the following factors:

Ectopic pregnancy– the most common pathology with a similar laboratory picture. However, in order to confirm such a diagnosis, it is necessary to carry out a lot of control studies, including a detailed ultrasound of the uterus and its appendages;
Antenatal fetal death. The saddest reason for a sharp drop in hCG is the death of the fetus at a certain stage of pregnancy;
Frozen pregnancy, or the so-called anembryony - a pathological condition when the development of the embryo stops. Also, such data are considered as harbingers of spontaneous abortion;
As is the case with an increase in hCG, its decrease can serve as indicators of the presence of certain defects or chromosomal abnormalities.

In what cases does the level change?

The level of human gonadotropin is very sensitive to chromosomal changes in the structure of the embryo. This allows it to be used as a specific marker for identifying genetic diseases. Typically, such studies are carried out in the third trimester of pregnancy, when it becomes possible to study the amniotic fluid:

With Down syndrome, there is a sharp increase in hCG and a decrease in all other screening markers;
Edwards syndrome, on the contrary, is characterized by a decrease in gonadotropin concentration along with other markers. Patau syndrome also has a similar picture;
Turner syndrome is characterized by a laboratory picture when the average value of all screening markers has fallen and the normal hCG concentration has remained;
Deep defects of the heart or neural tube of the embryo can also provoke a sharp increase or decrease in the production of human chorionic gonadotropin.

We should also not forget that it is possible to obtain false-positive results, which often occur in the early stages and when pregnancy is suspected.

High hCG in the absence of conception can be observed in the following cases:

Some doctors have noted cases where regular use of contraceptive medications could increase gonadotropin levels in non-pregnant women. To date, evidence that such drugs affect the concentration of hCG in the blood plasma is considered unproven. However, many experts recognize this possibility, considering it as one of the side effects;
After childbirth or abortion for medical reasons, the level of the “pregnancy hormone” drops to a minimum level within one week. As a rule, women undergo a control test after this period to eliminate the risk of a residual fertilized egg or placenta. Most doctors wait 42 days before ordering hCG monitoring to monitor for possible development of trophoblastic disease;
Also, the hormone level may remain at a certain level after childbirth. This laboratory picture is a suspicion of the presence of metastases of a hydatidiform mole or chorionic carcinoma - a malignant neoplasm that is formed from the remains of chorion tissue.

Thus, the hCG level for a non-pregnant woman should not be higher than 5 units. Otherwise, we are talking about the possible development of pathology, among which neoplasms are most common.

In some cases, human chorionic gonadotropin is found in the urine of men, and this can also be a sign of a prostate tumor.

Medicines

Since gonadotropin plays an important role in the normal course of pregnancy, its analogs are used in medicine to correct the condition of the pregnant woman and the fetus. Today, quite a lot of different versions of drugs have been developed, the composition of which is based on natural or synthetically produced human gonadotropin.

Most often, such medications in the form of an injection or in tablet form are prescribed to women with infertility. They are also actively used for IVF, as they are excellent for preparing a woman for embryo transfer, increasing the level of hCG in her body in the shortest possible time.

Sometimes such drugs are used when there is a threat of miscarriage. Most women are interested in Duphaston because it is one of the most popular and easily tolerated options for this medication. The most pressing question related to it: does Duphaston affect hCG levels during testing?

Most doctors note the fact that Duphaston primarily affects progesterone, thereby stimulating the maintenance of normal gonadotropin levels. Therefore, changes in tests while taking this medication are usually insignificant. Serious deviations from the norm should not be attributed to taking such pills, and most likely they are the result of pathology.

Could the result be wrong?

Testing a pregnant woman's blood for hCG levels is a fairly accurate and very informative research method. However, as in every case, the laboratory doctor or diagnostician may make mistakes. Of course, this does not happen often, but a specialist can be confused by a lot of factors that affect the analysis data.

For example, women who have had long-term problems with the ability to become pregnant, have any pregnancy pathologies or a history of abortion, and also take certain medications for a long time are included in a specific “risk group” and should be sure to notify your doctor about such factors.

It is important to do this before the very first analysis, since such nuances of your health can seriously distort laboratory data.

Human chorionic gonadotropin (hCG) is practically the most important indicator of the existence of pregnancy and disorders in its development.

HCG begins to be produced by chorion tissue already 6-8 days after fertilization of the egg (immediately after implantation of the embryo). All first trimester pregnancy, hCG has a stimulating effect on the production of the hormones progesterone, estradiol and free estriol, which are necessary for the development of pregnancy, and also supports the corpus luteum. During the first weeks of a successful pregnancy, the hCG level doubles every two days. If the pregnancy is multiple, the hCG content increases in proportion to the number of fetuses.

"The maximum concentration of hCG is observed at 9 - 11 weeks of pregnancy, after which the level of hCG slowly decreases.

At the end of the first trimester, when the necessary hormones begin to be produced by the fetus-placenta system, the hCG level begins to decrease and the entire second trimester remains at approximately the same concentration.

HCG norms

The hCG hormone is a glycoprotein in structure and consists of two subunits - alpha and beta:

Alpha - subunit corresponds to the alpha subunits of pituitary hormones (TSH, FSH and LH);
Beta subunit(beta - hCG) hormone is exceptional.

Therefore, beta-hCG tests are used to determine the level of hCG. This hormone is excreted unchanged in the urine, and this makes it possible to use it to diagnose pregnancy at very early stages using home tests. But in order to get a true result, such a test is carried out no earlier than two weeks after fertilization of the egg or if menstruation is delayed by more than three days. It is advisable to use the morning portion of urine. However, it must be taken into account that the level of beta-hCG in the urine is 1.5 - 2 times lower than in the blood. After a few days, the level of hCG in the urine required to diagnose pregnancy will also reach the required amount.

Determination of hCG levels is used in prenatal diagnosis to identify the risk of fetal development disorders. It is recommended to take an analysis for hCG and PAPP-A protein from 8 to 12 weeks of pregnancy (double test), and from 16 to 18 weeks of pregnancy, along with hCG, you need to take the following markers: AFP (alpha fetoprotein) and E3 (free estriol). This is the so-called triple test.

Normal serum beta hCG levels	Unit of measurement: honey/ml, U/l
Men and non-pregnant women	0—5
Pregnant women:
1-2 weeks of pregnancy	25—156
2-3 weeks of pregnancy	101—4 870
3-4 weeks of pregnancy	1 110—31 500
4-5 weeks of pregnancy	2 560—82 300
5-6 weeks of pregnancy	23 100—151 000
6-7 weeks of pregnancy	27 300—233 000
7-11 weeks of pregnancy	20 900—291 000
11-16 weeks of pregnancy	6 140—103 000
16-21 weeks of pregnancy	4 720—80 100
21–39 weeks of pregnancy	2 700—78 100

An hCG level ranging from 5 to 25 mU/ml does not allow one to reliably confirm or refute pregnancy, so a repeat test is required after 2 days.

Need to know! These hCG norms are indicated as approximate for the duration of pregnancy “FROM CONCEPTION” (and not for the duration of the last menstruation). The above figures are not generally accepted standard! Each laboratory may have its own standards. To correctly evaluate the result of the analysis, rely on the standards of the laboratory where you performed this analysis!

If the hCG level is different from normal

HCG level is higher during pregnancystandards in the following cases:

if the pregnancy is multiple (the hCG level increases in proportion to the number of fetuses);
if the actual gestational age does not correspond to the expected one;
if a pregnant woman has early toxicosis or gestosis;
if the fetus has a chromosomal pathology (Down syndrome, serious fetal malformations, etc.);
if the pregnant woman has diabetes;
if a pregnant woman takes synthetic gestagens;
in case of post-term pregnancy.

It occurs that the hCG level turns out to be less than normal for a certain stage of pregnancy, or increases very slowly. There may also be a lack of increase in concentration, as well as a progressive drop in hCG levels, more than 50% of normal. A decrease in hCG levels may indicate:

ectopic pregnancy;
undeveloped pregnancy;
threat of interruption (in this case, the hCG level progressively decreases by more than 50% of normal);
intrauterine fetal death (in 2 - 3 trimesters);
discrepancy between the actual and expected gestational age (especially if the menstrual cycle is irregular);
chronic placental insufficiency;
true post-term pregnancy.

It also happens that hCG levels are undetectable in the blood of a pregnant woman. This result could be:

if the test turned out to be of poor quality;
if the hCG test was performed too early;
with pathological pregnancy (ectopic, frozen, threatened miscarriage);
if the urine sample was stale;
if the concentration of hCG in the urine due to high diuresis is low;
if urine is collected during the day.

Increased hCG levels in non-pregnant women and men may indicate:

chorionic carcinoma or its relapse;
hydatidiform mole or its recurrence;
seminoma;
testicular teratoma;
neoplasms of the gastrointestinal tract (including colorectal cancer);
neoplasms of the lungs, kidneys, uterus, etc.;
taking hCG drugs;
poor quality test.

The hCG level may also be higher than normal from a previous pregnancy or after an abortion if the analysis was performed within 4 to 5 days after it. A high level of hCG after a mini-abortion indicates an ongoing pregnancy.

" IMPORTANT! Only a competent doctor can give the correct interpretation of the hCG test. He will determine exactly your hCG level in combination with data obtained by other diagnostic methods.

Indications for the purpose of analysis

Among women:

amenorrhea;
diagnosis of early pregnancy;
eliminating the possibility of ectopic pregnancy;
to assess the quality of induced abortion;
if there is a threat of miscarriage and suspected non-developing pregnancy;
for the diagnosis of tumors - chorionepithelioma, hydatidiform mole;
during prenatal diagnostics (as part of a triple test together with AFP and free estriol).

For men:

Diagnosis of testicular tumors.

How to prepare for a blood test for the hCG hormone?

Blood for hCG analysis is taken from a vein. It is advisable to donate blood for hCG in the morning and strictly on an empty stomach. If you donate blood at other times, you must not eat for 4 to 6 hours before the test. Also tell your nurse or doctor if you are taking any hormonal medications.

Pharmacological group: gonadotropic hormones.
Pharmacological action: prevention and treatment of infertility, stimulation of ovulation in women and spermatogenesis in men.
Effect on receptors: luteinizing hormone receptor
In molecular biology, human chorionic gonadotropin (hCG) is a hormone produced by a fertilized egg after conception. Later in pregnancy, hCG is produced during the development of the placenta and then through the placental component syncytiotrophoblast. This hormone is produced by some cancers; Thus, elevated levels of the hormone in the absence of pregnancy may indicate a diagnosis of cancer. It is not known, however, whether hormone production is a cause or consequence of cancerous tumors. The pituitary analogue of hCG, known as luteinizing hormone (LH), is produced in the pituitary gland of men and women of all ages. On December 6, 2011, the FDA banned the sale of "homeopathic" and unlicensed hCG-containing dietary products, declaring them illegal.

Description

Human chorionic gonadotropin (hCG) is a prescription drug containing human chorionic gonadotropin of natural (human) origin. Human chorionic gonadotropin is a polypeptide hormone that is usually found in a woman’s body in the first months of pregnancy. It is synthesized in syncytiotrophoblast cells of the placenta, and is responsible for increasing the production of progesterone, a hormone important for maintaining pregnancy. Human chorionic gonadotropin is present in significant quantities in the body only during pregnancy, and is used as an indicator of pregnancy in a standard pregnancy test. The level of human chorionic gonadotropin in the blood becomes noticeable already on the seventh day after ovulation, and gradually reaches a peak at about 2-3 months of pregnancy. After this, it will gradually decrease until birth.
In molecular biology, human chorionic gonadotropin (hCG) is a hormone produced by a fertilized egg after conception. Later in pregnancy, this hormone is produced during the development of the placenta and then through the placental component syncytiotrophoblast. Some cancers produce this hormone; Thus, elevated levels of the hormone in the absence of pregnancy may indicate a diagnosis of cancer. It is not known, however, whether hormone production is a cause or consequence of cancerous tumors. The pituitary analogue of hCG, known as luteinizing hormone (LH), is produced in the pituitary gland of men and women of all ages. On December 6, 2011, the US FDA banned the sale of "homeopathic" and unlicensed hCG-containing dietary products, declaring them illegal.
Although the hormone has minor activity similar to FSH (follicle stimulating hormone), the physiological action of human chorionic gonadotropin is essentially similar to luteinizing hormone (LH). As a clinical drug, hCG is used as an exogenous form of LH. It is commonly used to support ovulation and pregnancy in women, especially those suffering from infertility due to low gonadotropin concentrations and inability to ovulate. Because of LH's ability to stimulate Leydig cells in the testes to produce testosterone, hCG is also used by men to treat hypogonadotropic hypogonadism, a disorder characterized by low testosterone levels and insufficient LH release. The drug is also used to treat prepubertal cryptorchidism (undescendency of one or both testicles into the scrotum). Male athletes use hCG for its ability to increase endogenous testosterone production, primarily during or at the end of a steroid cycle when natural production of the hormone is interrupted.

Structure

Human chorionic gonadotropin is a glycoprotein consisting of 237 amino acids with a molecular weight of 25.7 kDa.
It is a heterodimeric compound, with an alpha subunit identical to luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH) and a unique beta subunit.
The alpha subunit consists of 92 amino acids.
The beta subunit of hCG gonadotropin contains 145 amino acids, encoded by six highly homologous genes located in tandem and inverted pairs on chromosome 19q13.3 - CGB (1, 2, 3, 5, 7, 8).
These two subunits create a small hydrophobic core surrounded by an area with a high surface-to-volume ratio: 2.8 times larger than a sphere. The vast majority of external amino acids are hydrophilic.

Function

Human chorionic gonadotropin interacts with the luteinizing hormone/human chorionic gonadotropin receptor and contributes to the maintenance of the corpus luteum in early pregnancy. This allows the corpus luteum to produce progesterone during the first trimester of pregnancy. Progesterone enriches the uterus with a thick lining of blood vessels and capillaries so that it can support a growing fetus. Due to its highly negative charge, hCG can repel cells of the mother's immune system, protecting the fetus during the first trimester of pregnancy. It has also been suggested that hCG may act as a placental link for the development of local maternal immunological tolerance. For example, endometrial cells treated with hCG cause an increase in T cell apoptosis (dissolution of T cells). These results suggest that hCG may be a link in the development of immune tolerance and may promote trophoblast invasion, which is known to accelerate fetal development in the endometrium. It has also been suggested that hCG levels are associated with symptoms such as morning sickness in pregnant women.
Because of its similarity to LH, hCG can also be used clinically to induce ovulation in the ovaries as well as testosterone production in the testes. Some organizations collect the urine of pregnant women to extract hCG for further use in the treatment of infertility.
Human chorionic gonadotropin also plays an important role in cell differentiation/proliferation and can activate apoptosis.

Production

Like other gonadotropins, the substance can be extracted from the urine of pregnant women or from cultures of genetically modified microorganisms with recombinant DNA.
In laboratories such as Pregnyl, Follutein, Profasi, Choragon and Novarel, it is extracted from the urine of pregnant women. In the Ovidrel laboratory, the protein is produced by microbes with recombinant DNA.
It is produced naturally in the placenta in the syncytiotrophoblast.

Story

Human chorionic gonadotropin was first discovered in 1920 and approximately 8 years later it was identified as a hormone important in pregnancy. The first drug containing human chorionic gonadotropin came in the form of an animal extract of the pituitary gland, developed as a commercial product by Organon. In 1931, Organon introduced the extract to the market under the trade name Pregnon. However, disputes over the trademark forced the company to change the name to Pregnyl, which appeared on the market in 1932. Pregnyl is still sold by Organon today, however it is no longer available as a pituitary gland extract. Manufacturing techniques were improved in 1940, allowing the hormone to be produced by filtering and purifying the urine of pregnant women, and by the late 1960s this technology was adopted by all manufacturers previously using animal extracts. In subsequent years, the manufacturing process has become more refined, but in general, hCG is produced today in the same way as it was several decades ago. Since modern drugs are of biological origin, the risk of biological contamination is considered to be low (but cannot be completely excluded).
Previously, the indications for the use of human chorionic gonadotropin drugs were much wider than they are now.
Product literature dating back to the 1950s and 60s recommended the use of the drugs for, among other things, uterine bleeding and amenorrhea, Frohlich's syndrome, cryptorchidism, female infertility, obesity, depression and male impotence. A good example of the widespread use of human chorionic gonadotropin is illustrated in the drug Glukor, which was described in 1958 as “three times more effective drug than testosterone. Created for men suffering from menopause and older men. It is used for impotence, angina pectoris and coronary artery disease, neuropsychosis, prostatitis, [and] myocarditis.”
Such recommendations, however, reflect a time when drugs were less regulated by government agencies and their release to market was less dependent on the success of clinical trials than is the case today. Today, FDA-approved indications for the use of hCG are limited to the treatment of hypogonadotropic hypogonadism and cryptorchidism in men and anovulatory infertility in women.
HCG does not exhibit significant thyroid-stimulating activity and is not effective means for fat loss. This is especially noted because hCG was widely used in the past to treat obesity. This trend became popular in 1954, after the publication of an article by Dr. A.T.W. Simons, in which he stated that human chorionic gonadotropin is an effective addition to the diet. According to the results of the study, with a low-calorie diet and use of the drug, effective suppression of hunger was observed. Inspired by articles like these, people all over the world soon after began putting themselves through severe calorie restriction challenges (500 calories per day) while taking HCG injections. Soon the hormone itself begins to be considered the main component that promotes fat burning. In fact, by 1957, hCG was the most commonly prescribed weight loss drug by doctors. More recent and comprehensive studies, however, refute the existence of any anorexic or metabolic effects with the use of hCG, and the drug is no longer used for this purpose.
Back in 1962, the Journal of the American Medical Association issued a consumer warning about the Simon Diet, which included the use of hCG, and stated that severe calorie restrictions resulted in the muscles and tissues of the body not receiving the required amount of protein, which in itself is even more dangerous than obesity. By 1974, the FDA had received enough complaints about the use of hCG for fat loss that it issued an order requiring the following notice to be printed on the drug's prescribing information: “HCG HAS NOT BEEN DEMONSTRATED TO BE EFFECTIVE AS AN ADDITIONAL THERAPY FOR THE TREATMENT OF OBESITY. THERE IS NO SUFFICIENT EVIDENCE THAT THE DRUG INCREASES WEIGHT LOSS WITHOUT CALORIE RESTRICTION, OR THAT IT CAUSES A MORE DESIRED OR “NORMAL” FAT DISTRIBUTION, OR THAT IT REDUCES
FEELINGS OF HUNGER OR DISCOMFORT ASSOCIATED WITH CALORIE RESTRICTION.” This warning appears on all products currently sold in the United States.
Human chorionic gonadotropin is a very popular drug today, due to the fact that it remains an integral part of ovulation therapy in many cases of female infertility. Currently popular drugs in the United States include Pregnyl (Organon), Profasi (Serono), and Novarel (Ferring), although many other brand names of human chorionic gonadotropin drugs have been popular over the years. The drug is also widely sold outside the United States and can be found under many additional brand names, all of which cannot be listed here. Because the drug is not federally regulated, athletes and bodybuilders in the United States who are unable to find a local physician willing to prescribe the drug to treat steroid-induced hypogonadism often order the product from other international sources. Given that the drug is relatively cheap and rarely counterfeited, most international sources are fairly reliable. Although recombinant forms of human chorionic gonadotropin have been brought to market in recent years, the wide availability and low cost of biological hCG continues to make it a major product for both off- and off-label use.

HCG analysis

HCG is measured using blood or urine tests, such as during pregnancy tests. A positive result indicates blastocyst implantation and embryogenesis in mammals. This may aid in the diagnosis and monitoring of tumor germ cells and trophoblastic diseases.
In pregnancy tests, quantitative blood tests and the most accurate urine tests usually detect hCG between 6 and 12 days after ovulation. However, it must be taken into account that total hCG levels can vary over a very wide range during the first 4 weeks of pregnancy, which may lead to false results during this time period.
Trophoblastic diseases, such as choriodemona ("molar pregnancy") or choriocarcinoma, can lead to high levels of beta-hCG (due to the presence of syncytial trophoblasts - the villi that make up the placenta), despite the absence of an embryo. This, as well as some other conditions, can lead to elevated hCG levels in the absence of pregnancy.
HCG levels are also measured during the triple test, a screening test for certain fetal chromosomal abnormalities/birth defects.
Most tests use monoclonal antibodies specific for the beta subunits of hCG (beta-hCG). This procedure is carried out in order to ensure that during testing the similarity of hCG with LH and FSH (the latter two substances are always present in the body in varying quantities, while the presence of hCG almost always indicates pregnancy.)
Many hCG immunological tests are based on the sandwich principle, when antibodies labeled with an enzyme or a regular or fluorescent dye are attached to the hCG. Urine pregnancy tests are based on the lateral slide technique.
Urinalysis can be immunochromatographic or any other, and is carried out in home, office, clinical or laboratory settings. The threshold degree of detection ranges from 20 to 100 mIU/ml, depending on the brand of test. Early in pregnancy, more accurate results can be obtained by testing the first morning urine (when hCG levels are highest). When urine is dilute ( specific gravity less than 1.015), the hCG concentration cannot indicate the concentration in the blood, and the test may be false negative.
Serum tests, using 2 to 4 mL of venous blood, typically include a chemiluminescent or fluorimetric immunoassay, which can detect beta-hCG levels below 5 mIU/mL and provide quantitative beta-hCG concentrations. Quantitative analysis of beta-hCG levels is useful for monitoring embryos in cells and trophoblastic tumors, during follow-up therapy after miscarriage, and in the diagnosis and follow-up therapy after treatment of ectopic pregnancy. The absence of a visible fetus on vaginal ultrasound with beta-hCG levels reaching 150,000 mIU/ml indicates an ectopic pregnancy.
Concentrations are usually measured in thousand international units per milliliter (mIU/mL). The International Unit of HCG was created in 1938 and revised in 1964 and 1980. Currently, 1 international unit is equal to about 2.35x10−12 moles, or about 6x10−8 grams.

Use of hCG in medicine

Tumor marker

Human chorionic gonadotropin can be used as a cancer marker because its beta subunits are secreted in several types of cancer, including seminoma, choriocarcinoma, germ cell tumors, chorioadenoma, teratoma with choriocarcinoma elements, and islet cell tumors. For this reason, a positive result in men may indicate testicular cancer. The normal level for men is 0-5 mIU/ml. In combination with alpha-fetoprotein, beta-hCG is an excellent marker for monitoring germ cell tumors.

HCG and ovulation

Human chorionic gonadotropin is widely used parenterally in place of luteinizing hormone as an ovulation inducer. If one or more mature ovarian follicles are present, ovulation can be induced by the administration of hCG. If ovulation occurs between 38 and 40 hours after one hCG injection, procedures such as intrauterine insemination or intercourse may be planned. Additionally, patients who undergo IVF (in vitro fertilization) typically take hCG to trigger the ovulation process, but there is oocyte recovery between 34 and 36 hours after the injection, several hours before the testicles are released. released from the ovary.
Since hCG supports the corpus luteum, administration of hCG is used in certain circumstances to increase progesterone production.
In men, hCG injections are used to stimulate Leydig cells, which synthesize testosterone. Intratesticular testosterone is essential for spermatogenesis from Sertoli cells. Typically, hCG in men is used in cases of hypogonadism and in the treatment of infertility.
During the first few months of pregnancy, transmission of the HIV-1 virus from woman to fetus is extremely rare. It is believed that this is due to the high concentration of hCG and that the beta subunits of this protein are active against HIV-1.

Warning for women taking HCG drugs (HCG Pregnyl) for ovulation induction:

a) Infertile patients undergoing fertility treatments (especially those requiring in vitro fertilization), often suffering from tubal anomalies, may experience ectopic pregnancy after using this drug. This is why early ultrasound confirmation at the beginning of pregnancy (whether intrauterine pregnancy or not) is critical. Pregnancies occurring after treatment with this drug will present a higher risk of multiplets. Women suffering from thrombosis, obesity and thrombophilia should not be prescribed this medicine, as there is an increased risk of arterial or venous thromboembolism after or during the use of HCG Pregnyl.
b) Women tend to be more likely to have miscarriages after treatment with this drug.
In the case of male patients: Long-term use of HCG Pregnyl is known to generally lead to increased androgen production. Therefore: Patients suffering from overt or hidden heart failure, hypertension, renal dysfunction, migraine and epilepsy are not recommended to take this drug or are advised to take it in lower doses. In addition, the drug should be used with extreme caution in the treatment of sexually mature adolescents in order to reduce the risk of premature sexual development or premature closure of the epiphyseal growth plate. This type of skeletal maturation of patients must be closely and regularly monitored.
The drug should not be prescribed to either men or women suffering from: (1) hypersensitivity to the drug or to any of its main ingredients. (2) known or possible androgen-dependent tumors, such as male breast cancer or prostate carcinoma.

Chorionic gonadotropin in bodybuilding

Testosterone replacement therapy causes the hypothalamus to stop producing GnRH (gonadotropin-releasing hormone). Without GnRH, the pituitary gland stops releasing LH. Without LH, the testes (testes or gonads) stop producing testosterone. In men, hCG is closely similar to LH. If your testicles appear wrinkled after prolonged use of testosterone, it is likely that testosterone production will begin to increase again soon after hCG therapy. HCG promotes the testicles' own production of testosterone and increases their size.
HCG can be extracted from the urine of pregnant women or through genetic modification. The product is available by prescription under the brand names Pregnyl, Follutein, Profasi and Novarel. Novire is another brand that is a recombinant DNA product. Some pharmacies can also make prescription hCG in bottles of various sizes. Brand-name hCG drugs at a regular pharmacy cost more than $100 per 10,000 IU. The same amount of IU with a special prescription can be purchased for $50. Many insurance companies do not cover hCG because its use is necessary for testicular atrophy during testosterone replacement therapy, which is considered off-label use. And most men buy the drug from prescription pharmacies, which sell it much cheaper.
HCG is on the illegal drug list in some sports.
Professional athletes who test positive for hCG have been temporarily withdrawn from competition, including a 50-game ban from MLB for Manny Ramirez in 2009 and a 4-game ban from the NFL for Brian Cushing.

Human chorionic gonadotropin and testosterone

How long does it take to see an increase in testosterone levels after an HCG injection? Scientists have studied this question and tried to determine whether high doses are more effective in maintaining this surge. After administration of 6000 IU hCG, plasma levels of testosterone and hCG were studied in normal adult men at two various options applications. In the first option, seven patients received one intramuscular injection. There was a dramatic increase in plasma testosterone levels (1.6 ± 0.1-fold) within 4 hours. Testosterone levels then decreased slightly and remained unchanged for at least 24 hours. A delayed peak in testosterone levels (2.4 ± 0.3-fold increase) was observed between 72–96 hours. After this, testosterone levels decreased and reached the initial level within 144 hours.
In the second case, six patients received two intravenous injections of hCG (at doses 5-8 times higher than those administered to the first group) at 24-hour intervals. The initial increase in plasma testosterone after the first injection was the same as in the first case, despite the fact that plasma hCG levels in in this case were 5-8 times higher. Within 24 hours, testosterone levels were again lower than those observed 2 to 4 hours after injection, and a second intravenous injection of hCG did not cause a significant increase. A delayed peak in plasma testosterone levels (2.2 ± 0.2-fold increase) was seen approximately 24 hours later than in the first case. Thus, the study shows that when it comes to hCG dosing, more is not better. In fact, high doses may reduce the sensitivity of the Leydig cells in the testes. It has also been shown that testosterone levels in the blood peak not once, but twice after an HCG injection.

Human chorionic gonadotropin and Leydig cells

HCG can not only increase testosterone levels, but also increase the number of Leydig cells in the testicles. Leydig cell clusters in adult testes are known to increase significantly during hCG treatment. However, in the past it was unclear whether this increased the number of Leydig cells or all cells in the body. A study was conducted in which adult male Sprague-Dawley rats were administered 100 IU of hCG daily subcutaneously for 5 weeks. The volume of Leydig cell clusters increased 4.7-fold over 5 weeks of treatment. The number of Leydig cells (initially equal to an average of 18.6 x 106/cc testicle) increased 3 times.

Human chorionic gonadotropin and replacement therapy

There are currently no guidelines for prescribing hCG for men undergoing testosterone replacement therapy who wish to maintain normal testicular size. A study using 200 mg of testosterone enanthate injections per week with hCG at doses of 125, 250, or 500 IU every other day in healthy young men showed that at a dose of 250 IU every other day, normal testicular function was maintained (without changes in testicular size). It is not known whether this dose is effective for older men. Additionally, there are no long-term studies on the use of hCG for more than 2 years.
Because of its effect on testosterone levels, hCG use may also increase estradiol and estradiol levels, although there is no data demonstrating whether this increase is proportional to the dose used.
Thus, the best dose of hCG to maintain normal testicular function while maintaining minimal levels of estradiol conversion has not yet been established.
Some doctors recommend that men who are concerned about testicular size or who want to maintain fertility while on testosterone replacement therapy use 200-500 IU of hCG twice a week. Higher doses have also been used, such as 1,000-5,000 IU twice a week. It is believed that this dosage may cause side effects typically associated with estrogens and may reduce testicular sensitivity with long-term use of hCG. Scientists have begun to investigate whether the use of estrogen receptor modulators (brand name Nolvadex) or Anaztrozole (brand name Arimidex) is necessary to counteract the increase in estradiol levels. High levels of estradiol can cause breast enlargement and fluid retention in men, but in acceptable amounts it is an important link in maintaining bone and brain health.

Shippen human chorionic gonadotropin stimulation test (in men under 75 years of age)

Although the required doses of hCG have not been approved or clinically proven, Dr. Eugene Shippen (author of Testosterone Syndrome) developed his own method of using the drug based on his personal experience.
Dr. Shippen found that a typical three-week course of treatment worked best for patients who responded well to hCG. 500 units are administered daily by subcutaneous injection, Monday through Friday, for three weeks. The patient is taught to inject himself with 50-unit insulin syringes with 30-gauge needles into the anterior thigh while sitting with hands free. Levels of testosterone, total and free, plus E2 (estradiol) are measured before use and on the third Saturday after 3 weeks of use (the author states that saliva testing may be more accurate for dose adjustment). Studies have shown that subcutaneous injections are equally effective as intramuscular injections.
When measuring the effect of hCG on overall testosterone levels in his patients, Shippen divided them into those who would undergo testosterone replacement therapy and those who simply needed to "revitalize" their testicles with hCG to achieve normal testosterone levels.
Here's how he defines the functions of Leydig cells (testes):
1. If taking hCG causes less than a 20% increase in total testosterone levels, we notice minimal preservation of Leydig cell function (primary hypogonadism or egonandotrophic hypogonadism indicates a combination of central and peripheral factors).
2. A 20-50% increase in total testosterone levels indicates sufficient reserve but a slightly suppressed response, associated mainly with central inhibition, but sometimes perhaps with a testicular response.
3. More than a 50% increase in total testosterone levels primarily indicates centrally mediated suppression of testicular function.
Then, depending on the patients' response to hCG, he suggests the following treatment options:
1. If there is an inadequate response (20%), testosterone replacement therapy will be performed.
2. The area between 20 and 50% generally requires an increase in hCG over time, plus natural increases or “partial” replacement options.
Dr. Shippen believes that testosterone replacement therapy is always the last option in borderline cases, as improvement can often be seen over time and Leydig cell regeneration can occur. He argues that many of these factors depend on age. Up to 60 years of age, an increase is almost always observed. It does not always happen in the 60-75 age range, but the outcome is usually fairly predictable once the results of stimulation tests are obtained. In addition, with adequate treatment of underlying processes (depression, obesity, alcoholism, etc.), diseases associated with decreased testosterone output can be completely reversible. He argues that this beneficial effect will not occur if the primary therapy comes in the form of testosterone replacement therapy.
3. If there is an adequate response, expressed in more than 50% increase in testosterone, then the body has a very good supply of Leydig cells. HCG therapy is likely to be successful in restoring full testosterone production without replacement therapy, the best option for long-term use and more natural restoration of biological fluctuations for optimal response.
4. Chorionic hCG can be prescribed independently and the dosage can be adjusted according to the body’s response. In younger users with a high response rate (T > 1100 ng/dL), hCG can be taken every third or fourth day. This also minimizes its conversion to estrogen. Responders in the lower level (600-800 ng/dL), or those with a higher estradiol output associated with a full dosage of hCG, may be prescribed the following course of administration: 300 - 500 units Mon-Wed-Fri. Sometimes low responders may require higher doses to achieve better testosterone production.
Dr. Shippen tests salivary free testosterone levels on the day before the injection to determine effectiveness and adjust the dose accordingly. He states that later, as Leydig cell recovery occurs, a reduction in dose or frequency of administration may be necessary.
5. To assess the effectiveness of treatment, he recommends monitoring testosterone and estradiol levels 2 to 3 weeks after changing hCG, as well as periodically during continuous use. He argues that saliva testing more fully reflects the true levels of free estrogen and testosterone in the body. Most insurance companies do not cover saliva testing. A blood test is the standard way to check testosterone and estradiol levels.
6. Apart from reports of antibodies developing against hCG (the author mentions that he has never encountered such a problem), it is stated that there are no side effects with chronic use of hCG.
Dr. Shippen's book was published in the late 90s. I don't know any doctor who uses this dosage method. I don't know if it's effective or not. The idea that testicular function can be improved through hCG cycles in men with low testosterone levels caused by sluggish Leydig cell function is quite an interesting concept that needs to be explored. Because this protocol requires very careful monitoring, many doctors avoid this use. The very nature of this off-label use of hCG can also make it expensive for patients, who will have to pay out-of-pocket for its use and monitoring.

Other uses of hCG in bodybuilding

A very well known physician in the field of testosterone replacement therapy, Dr. John Chrysler, recommends 250 IU of hCG twice a week for all testosterone replacement therapy patients on the day of, and also the day before, weekly testosterone cypionate injections. After reviewing numerous laboratory tests and subjective patient reports, as well as studying information about hCG, he moved the regimen forward one day. In other words, his patients using injectable testosterone cypionate were now taking 250 IU doses of hCG two days before, as well as on the day immediately preceding their weekly intramuscular injections. All patients received hCG subcutaneously, and the dosage could be adjusted as needed (he reports that dosages of more than 350 IU twice a week were rarely required).
For men using testosterone gels, the same dosage every third day helped maintain testicular size (gel dose should be adjusted after a month of hCG use to compensate higher level testosterone caused by taking hCG).
Some doctors believe that stopping testosterone replacement therapy for a few weeks, during which weekly doses of 1,000 to 2,000 IU of hCG are used, provides good stimulation of testicular function without continuous use of hCG. However, there is no data to support such claims. Others believe that cyclic use of hCG while maintaining testosterone replacement therapy can prevent a decrease in the number of Leydig cells in the testicles. Again, there is no data or published reports to prove this point.
According to Dr. Chrysler, the use of hCG alone does not provide the same subjective benefits in terms of sexual function as testosterone, even in the presence of similar serum androgen levels. However, when added to more "traditional" transdermal or parental agents, testosterone, when combined with properly dosed hCG, stabilizes blood levels, prevents testicular atrophy, helps balance the expression of other hormones, and promotes significant increases in well-being and libido. But in excess, hCG can cause acne, water retention, bad mood and gynecomastia (enlarged breasts in men).
Many men complain that their doctors do not know about hCG and its use. Some people spend a lot of time trying to find doctors who could write such a prescription. One good way to find out which doctor in your area can prescribe these drugs is to call your local compounding pharmacy and ask which doctors call them about their patients' prescriptions.
If you decide (in consultation with your doctor) that you want to use hCG with testosterone replacement therapy at a dose of 500 IU per week, then you will need 2000 IU of the substance per month. The quality of hCG may deteriorate over time after mixing with bacteriostatic water, even when stored in the refrigerator. Thus, a bottle containing 3000 or 3500 IU should last 6 weeks.
Using HCG requires a lot of discipline, as you must remember to use it once a week in addition to your weekly or biweekly testosterone injections. However, many men can feel quite comfortable with smaller testicles as long as testosterone helps improve their sex drive. And some lucky people do not experience any testicular atrophy at all when using testosterone (users with large testicles experience less discomfort from their shrinkage than men with smaller testicles). So, in the end, it's a personal matter.
HCG is also used in combination with Clomiphene and to lead to own production testosterone levels return to normal after stopping testosterone or anabolic steroids after prolonged use. This method only works for those who started taking testosterone or anabolic steroids with normal baseline testosterone levels (bodybuilders and athletes), and does not work for those who experience testosterone deficiency (hypogonadism).
There is no consensus on the correct dosage and frequency of use of hCG.
HCG not only restores testicular size but also increases sex drive. It is worth remembering, however, that if you stop using the drug, testicular atrophy will begin again. It is recommended to use hCG in small quantities (250 IU twice a week subcutaneously). HCG can also increase estradiol levels in the blood, so it is very important to test both indicators after starting to use the drug. When using hCG along with testosterone, it may be necessary to reduce testosterone dosages, since hCG may additionally affect testosterone levels in the blood.

"HCG Diet"

Using hCG for weight control

All the controversy, as well as the lack of injectable HCG for weight loss in the market, has led to a significant proliferation of “Homeopathic HCG” for weight management on the Internet. It is often unclear what ingredients these products are made from, but if they are made from real hCG through homeopathic dilution, they will either contain no hCG at all or only contain trace amounts of it.
The US FDA has stated that unlicensed products containing hCG are illegal and ineffective for weight loss. Such preparations are not homeopathic and have been declared illegal substances. HCG itself is classified as a drug in the United States and has not been approved by the FDA for sale as a weight loss aid or for any other purpose, and therefore neither HCG pure form, no drugs containing hCG can be found commercially in the United States except as prescribed by a doctor. In December 2011, the FDA and FTC began taking action to remove unapproved hCG products from the market. Subsequently, some suppliers switch to "non-hormonal" versions of weight loss products, where the hormone is replaced with a mixture of free ones.

Instructions for use of hCG

General provisions
Human chorionic gonadotropin is usually administered as an intramuscular injection. Subcutaneous injections are also used and it has been recognized that this route of administration is therapeutically approximately equivalent to intramuscular injections.
Peak concentrations of human chorionic gonadotropin are achieved approximately 6 hours after intramuscular injection, and 16-20 hours after subcutaneous injection.

For men
For the treatment of hypogonandotropic hypogonadism, current FDA-recommended protocols recommend either a short 6-week program or a long-term program of up to 1 year, depending on the individual needs of the patient. Prescribing guidelines for short-term use recommend 500 to 1000 units 3 times a week for 3 weeks, followed by the same dose twice a week for 3 weeks. For long-term use, dosages of 4000 units 3 times a week are recommended for 6 to 9 months, after which the dose is reduced to 2000 units 3 times a week and used for an additional 3 months.
Bodybuilders and athletes use hCG either during a cycle to maintain testicular integrity when using steroids, or after a cycle to more quickly restore hormonal homeostasis. Both types of use are considered effective when used correctly.

After the end of the cycle
Human chorionic gonadotropin is often used with other drugs as part of an advanced post-cycle therapy program aimed at restoring endogenous testosterone production as quickly as possible at the end of a steroid cycle. Restoring endogenous testosterone production is important at the end of each cycle when subnormal androgen levels (associated with steroid-induced suppression) can be very taxing on the body. The main problem is the effect of cortisol, which is largely balanced by the influence of androgens. Cortisol sends messages opposite to testosterone to the muscles, or promotes the breakdown of protein in the cell. If not controlled low level testosterone, cortisol can quickly reduce much of your muscle gain.
Post-cycle hCG protocols typically call for 1500-4000 IU every 4 or 5 days, for no more than 2 or 3 weeks. When used long-term or when used in too high doses, the drug may help to reduce the sensitivity of Leydig cells to luteinizing hormone, which will prevent further return to homeostasis.

During the cycle
Bodybuilders and athletes may also use human chorionic gonadotropin during a steroid cycle to avoid testicular atrophy and the resulting decreased ability to respond to LH stimulation. Basically, this practice is used to avoid the problem of testicular atrophy, to prevent such a problem after the end of the cycle. It is important to remember that when used in this manner, the dosage must be carefully adjusted as high levels HCG can lead to increased aromatase in the testicles (increased estrogen levels) and also reduce the sensitivity of the testicles to LH. Thus, if used incorrectly, the drug can provoke primary hypogonadism,
significantly prolonging the recovery period.
Current protocols for the use of hCG therefore recommend 250 IU administered subcutaneously twice weekly (every 3rd or 4th day) throughout the steroid cycle. Some users may require higher doses, but in no case should they exceed 500 IU per injection.
These intra-cycle hCG protocols were developed by Professor John Chrysler, a renowned figure in the field of anti-aging and hormone therapy, for patients undergoing testosterone replacement therapy (TRT). Although TRT is often performed on a long-term basis, testicular atrophy is a common problem in most patients, regardless of maintenance of normal androgen levels. The hCG program proposed by Dr. Chrysler is designed to solve this problem with long-term use. For those interested specifically in the timing of hCG use in relation to a given testosterone replacement program, Dr. Chrysler recommends the following in his article “Update to the Chrysler HCG Protocol”: “In my analysis, patients undergoing TRT took hCG at doses of 250 IU two days before, as well as on the day immediately preceding the intramuscular injection. All patients used hCG subcutaneously, and the dose was adjusted if necessary (however, I have not yet seen the use of more than 350 IU per dose) ... Patients who prefer to use transdermal testosterone, or even testosterone tablets (although I am against such use), took hCG one in three day".

For women
When used to induce ovulation and pregnancy during anovulatory infertility in women, the day after taking the last dose of menotropins, take doses of 5,000 to 10,000 units. The timing is adjusted so that the hormone is received exactly at the right time in the ovulation cycle.
Human chorionic gonadotropin is not used by women for sports purposes.

Availability

HCG is always packaged in 2 different vials/ampoules (one with powder and the other with sterile solvent). They must be mixed before injection, and any remaining medication should be stored in the refrigerator for subsequent use. Make sure the product matches this
description. Human chorionic gonadotropin is widely manufactured and readily available on the black market. To date, the problem of counterfeits is small, although a few similar cases have occurred (all in multi-dose vials).
HCG comes in powder form in bottles of 3,500 IU, 5,000 IU, or 10,000 IU (numbers may vary depending on the pharmacy). You can call your compounding pharmacy and order a bottle containing the required amount of IU. They usually come complete with a 1 ml (or cc) bottle of bacteriostatic water to dilute the powder into a liquid solution. Bacteriostatic water (water with a preservative that comes with your prescription drug) is mixed with the powder to resuspend, or dissolve, before injection. This water can keep the solution preserved for 6 weeks when stored in the refrigerator. Some patients do not use the 1 ml bottles of water provided by commercial pharmacies and instead ask their doctors to prescribe them 30 ml bottles of bacteriostatic water so that they can dilute the hCG to a more workable concentration that is more practical for men using low doses of hCG weekly.
HCG is administered as an injection subcutaneously or intramuscularly (there is still debate about which method is better). The number of IU per injection will depend on how much bacteriostatic water is added to the dry powder. If we add 1 ml to 5000 IU of powder we get 5000 IU per ml, so 0.1 ml would be 500 IU. If we add 2 ml per 5000 IU powder, we get 2500 IU/ml; 0.1 ml (or cc) in an insulin syringe will equal 250 IU. If it is necessary to administer 500 IU, then 0.2 cc will be required. see this mixture.
For subcutaneous injection of hCG, syringes with an ultra-thin insulin needle are used, which makes administration of the drug easier even for patients who are afraid of injections. Typical sizes:
1 ml, 12.7 mm in length, size 30 and
0.5 ml, 8 mm, 31 sizes.
Syringes require a separate prescription. Some compounding pharmacies automatically include them in the kit, but be sure to ask about this in advance. Never use the same syringe for injection as the needle will already be worn out. Remember that you should also stock up on alcohol swabs to clean the injection area and the tip of the bottle. Typical injection sites are the abdominal area, close to the navel, or pubic fat tissue. Squeeze some fatty tissue in your hands where the abdominal muscles are and insert a syringe into this area, and then rub the area with a swab soaked in alcohol. Dispose of the syringe in a sharps container, which may be provided by your pharmacy.
As mentioned earlier, prescription hCG is a much cheaper option than commercially available pharmaceutical products. Additionally, commercially available hCG can sometimes be difficult to find in regular pharmacies.
A review of the literature demonstrates a wide range of hCG doses used, and there is significant disagreement among physicians on this issue. For the treatment of male infertility, doses range from 1250 IU three times a week to 3000 IU twice a week (men undergoing testosterone replacement therapy were not included in the study area).

Availability:

Human chorionic gonadotropin is widely available in various pharmaceutical and veterinary markets. Composition and dosage vary by country and manufacturer, but typically the drug contains 1000, 1500, 2500, 5000, or 10,000 international units (IU) per dose. All forms are supplied as a lyophilized powder, requiring reconstitution with sterile diluent (water) before use.

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

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

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

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

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

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

How do human chorionic gonadotropin levels change during pregnancy?

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

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

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

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

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

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

Human chorionic gonadotropin normal graph

Norms of human chorionic gonadotropin in blood serum

Note!

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

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

Tests to determine hCG levels

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

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

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

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

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

Serum levels of AFP and hCG during physiological pregnancy

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

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

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

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

Decoding

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

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

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

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

production of hCG by the pituitary gland of the examined woman testicular tumors
tumor diseases of the gastrointestinal tract
neoplasms of the lungs, kidneys, uterus
hydatidiform mole, relapse of hydatidiform mole
chorionic carcinoma
taking hCG drugs
the analysis was done within 4–5 days after the abortion, etc.
Usually, human chorionic gonadotropin is elevated if the test was performed 4–5 days after an abortion or due to taking hCG drugs.
Low hCG in pregnant women, it may mean incorrect timing of pregnancy or be a sign of serious disorders:
- ectopic pregnancy
- non-developing pregnancy
- delayed fetal development
- threat of spontaneous abortion (reduced by more than 50%)
- chronic placental insufficiency
- true post-term pregnancy
- fetal death (in the II-III trimester of pregnancy).
It happens that the test results show the absence of the hormone in the blood. This result may occur if the test was performed too early or during an ectopic pregnancy.
Whatever the result of the test for hormones during pregnancy, remember that only a qualified doctor can give the correct interpretation, determining which hCG norm is for you in combination with data obtained by other examination methods.

Video. Prenatal screening - hCG

In the body of each of us there are many complex biochemical processes that are regulated by special substances - hormones. Most of them are the same in both sexes, the sex hormones are different, and during pregnancy new substances appear, including hCG, human chorionic gonadotropin.

Without hormones, it is impossible to imagine proper metabolism, reactions to stress, and adaptation to constantly changing environmental conditions. Pregnancy is a very special state of the female body, placing increased demands on its functioning and requiring additional regulatory mechanisms. Appears in the body of the expectant mother hCG hormone produced by the tissues of the developing embryo and reflecting the normal course of pregnancy.

Chorionic gonadotropin is the most important substance that supports fetal growth; it is the first to “notify” expectant mother about her special condition. The pregnancy test is based on the appearance of hCG, so most women have heard of it one way or another.

HCG is produced by the membranes of the fetus, so it cannot be detected outside of pregnancy. Its contents determines physiological or impaired development of the embryo, and the appearance in the body of a man or a non-pregnant woman indicates the development of a tumor.

Properties and role of hCG in the body

After the fusion of the sperm and egg, intensive reproduction of embryonic cells begins, and by the end of the first week it is ready to attach to the inner wall of the uterus. At this stage, the embryo is represented by only a small vesicle, but the cells of its outer part (trophoblast) are already intensively producing a hormone that ensures normal growth.

The trophoblast is fixed to the endometrium and converted into chorion, which makes up the bulk of the placenta. Through the villous membrane, there is a connection between the blood flow of the mother and the fetus, metabolism, delivery of useful and removal of unnecessary metabolic products. The chorion secretes human chorionic gonadotropin throughout pregnancy., helping not only to develop the unborn baby, but also supporting the “pregnant” state of the woman.

When pregnancy occurs, the main regulatory substance in a woman becomes progesterone, which in the very first stages of its development is formed by the corpus luteum of the ovary. HCG during pregnancy is needed to maintain the function of the corpus luteum and a constant increase in the concentration of progesterone, so it is not surprising that the corpus luteum in a pregnant woman does not disappear, as during a normal menstrual cycle.

The biological properties of hCG are similar to those of luteinizing and follicle-stimulating hormone, but the effect on the corpus luteum is significantly predominant. In addition, it is more active than the “regular” luteinizing hormone, which is formed in the second phase menstrual cycle, because pregnancy requires significant concentrations of progesterone.

According to the chemical structure, hCG is represented by two subunits - alpha and beta. The first completely coincides with that of the gonadotropic hormones LH and FSH, the second - beta - is unique, which explains both the uniqueness of the functions performed and the possibility of qualitative analysis of hCG in the blood or urine.

The functions of hCG are:

Maintenance of the corpus luteum and its production of progesterone;
Implementation of correct implantation and formation of the chorionic membrane;
Increase in the number of chorionic villi, their nutrition;
Adaptation to the state of pregnancy.

A woman’s adaptation to a developing pregnancy involves increasing the production of adrenal hormones under the influence of hCG. Glucocorticoids provide immunosuppression - suppression of immune reactions on the part of the mother in relation to fetal tissues, because the embryo is half genetically foreign. These functions are performed by hCG, while “ordinary” gonadotropic hormones are not able to enhance the work of the adrenal cortex.

When chorionic gonadotropin is administered to a woman, ovulation and the formation of the corpus luteum are stimulated, and the production of endogenous sex steroids increases. If hCG is administered to a man, testosterone production increases and spermatogenesis increases.

A blood test for hCG is used to determine the presence of pregnancy and to monitor its progress. If tumors of the gonads are suspected, it may also be necessary to determine the concentration of this hormone. HCG in urine allows you to quickly and fairly reliably confirm the presence of pregnancy, so this method is applicable for express diagnostics.

Normal indicators

The level of hCG is determined by gender, duration of pregnancy, and the presence of a tumor. In men and non-pregnant women it is absent or does not exceed 5 mU/ml. During pregnancy, it appears approximately a week after conception, and its levels continuously increase, reaching a maximum by the end of the first trimester.

If pregnancy is suspected, it is possible to determine a negative hCG, the reason for which may be in the test performed too early or in the ectopic location of the embryo.

The weekly norm table is used to monitor hCG levels and timely detect deviations. In the first or second week it is 25-156 mU/ml, by week 6 it can reach 151,000 mU/ml, the maximum hCG occurs in the 11th week of gestation - up to 291,000 mU/ml.

Table: hCG norm by obstetric week

Gestation period, obstetric weeks	HCG level, honey/ml
Pregnancy is unlikely	0-5
Pregnancy is possible (1-2 weeks)	5-25
3-4 week	25-156
4-5 week	101-4870
5-6 week	1110-31500
6-7 week	2560-82300
7-8 week	23100-151000
8-9 week	27300-233000
9-13 week	20900-291000
13-18 week	6140-103000
18-23 week	4720-80100
23-41 weeks	2700-78100

Thus, this hormone first increases, and from the second trimester decreases slightly, since the need for it is highest at the time of formation of the placenta. The mature placenta from the second trimester of gestation itself forms required quantities progesterone and estrogens, so hCG gradually decreases, but it is still necessary for its nutritional role and stimulation of testosterone production by fetal tissues for the proper development of the gonads.

A blood test for hCG allows you to absolutely accurately confirm a short-term pregnancy. This substance appears in urine one to two days later, and to determine it, any woman can use a rapid test purchased at a pharmacy. To obtain a reliable result and eliminate errors, it is recommended to use not one, but several test strips at once.

The hCG level by day from conception is determined based on the average rate and rate of growth of the hormone for a given period. So, in the first 2-5 weeks, the hCG level doubles every day and a half. If there is more than one fetus, then the concentration will increase in proportion to the number of embryos.

Table: approximate hCG level by day from ovulation (conception)

Days after conception	Minimum hCG level, honey/ml	Maximum hCG level, honey/ml
7 days	2	10
8 days	3	18
9 days	5	21
10 days	8	26
11 days	11	45
12 days	17	65
13 days	22	105
14 days	29	170
15 days	39	270
16 days	68	400
17 days	120	580
18 days	220	840
19 days	370	1300
20 days	520	2000
21 day	750	3100
22 days	1050	4900
23 days	1400	6200
24 days	1830	7800
25 days	2400	9800
26 days	4200	15600
27 days	5400	19500
28 days	7100	27300
29 days	8800	33000
30 days	10500	40000
31 days	11500	60000
32 days	12800	63000
33 days	14000	68000
34 days	15500	70000
35 days	17000	74000
36 days	19000	78000
37 days	20500	83000
38 days	22000	87000
39 days	23000	93000
40 days	25000	108000
41 days	26500	117000
42 days	28000	128000

With pathology, it is possible to either increase or decrease the amount of hCG required at a particular stage of pregnancy. An increase in this hormone may indicate the presence of diabetes, gestosis, or an incorrectly determined gestational age. If a woman has had an abortion, and the hCG concentration does not decrease, then this is a sign of pregnancy progression.

Low hCG or its insufficient increase usually indicates a delay in fetal development, ectopic localization of the embryo, pathology of the placenta, and the threat of miscarriage.

When is hCG determination necessary?

It is necessary to determine the content of human chorionic gonadotropin:

To confirm the fact of pregnancy;
In order to control its flow;
In case of possible complications of the fetus (defects) or placental tissue;
To control the quality of medical abortion;
With amenorrhea of unknown origin;
When diagnosing neoplasms that secrete hCG.

In men and non-pregnant women, the hCG test is usually negative; in rare cases, trace amounts are possible, not exceeding 5 U per liter of blood. When the concentration of the hormone in a woman increases, we can conclude that pregnancy has occurred, and conception occurred at least 5-6 days ago. Then hCG continuously increases, its amount is compared with normal values for this period. For correct decoding data, you need to accurately calculate the time of conception.

The determination of hCG during pregnancy is part of the so-called triple test, which includes, in addition to hCG, indicators and estriol. A comprehensive assessment of deviations of these substances allows us to suspect possible violations on the part of the mother or embryo.

In non-pregnant women and males, the need to determine hCG may arise in case of suspected neoplasia of the ovaries, testes and other organs. Trophoblastic diseases (hydatidiform mole, chorionepithelioma) are also accompanied by changes in the amount of hCG.

Blood sampling from a vein for hCG is usually taken in the morning, on an empty stomach. It does not require any preparation. When diagnosing pregnancy, to obtain more reliable results, it is better to donate blood at the earliest 4-5 days after a missed period. It is prescribed to pregnant women in the second trimester. If it is necessary to monitor the degree of hCG increase in the first trimester of gestation, the analysis can be repeated every few days.

Deviations in hCG content

Any deviation from the hCG table data in a pregnant woman can be considered a sign of pathology both fetus and placental tissue, therefore requiring close attention and further examination.

HCG is elevated

Exceeding the normal hCG value is possible both during pregnancy and outside of it. In pregnant women, elevated hCG may indicate:

More than one developing embryo (hCG increases according to their number);
Prolonged pregnancy;
Availability ;
from the expectant mother;
Fetal malformations;
Taking hormonal medications.

If a woman is not pregnant, or the test was taken from a man, and hCG is elevated, the reason for this may be:

Medical abortion up to five days ago;
Taking medications containing hCG;
Growth of chorionic carcinoma;
Bubble drift;
Testicular seminoma;
Tumors of other localization - intestines, lungs, uterus.

It is known that during menopause, when jumps in hormone concentrations occur, an increase in the level of hCG in the blood is possible. In elderly patients with kidney pathology requiring hemodialysis, hCG can significantly exceed the norm (up to 10 times). This is due to a violation of the natural excretion of the hormone from the body and its accumulation in the blood, while its production by various tissues remains at a physiological level.

HCG is low

Pathology is indicated not only by an increase, but also by a decrease in the concentration of human chorionic gonadotropin. An insufficient amount of it causes a delay in the development of organs and tissues of the unborn baby, negatively affects the maturation of the placenta, and, therefore, blood flow, the exchange of nutrients and oxygen between the body of the mother and the fetus suffer. Intrauterine hypoxia can lead to serious deviations in the development of the embryo, so low hCG also requires increased attention to the patient.

A decrease in hCG production in a pregnant woman may indicate:

Ectopic embryo fixation;
Slowing down the development of the embryo;
“Frozen” pregnancy or intrauterine death in the second or third trimesters;
Threatened miscarriage;
Placental insufficiency;
Post-term pregnancy.

With an ectopic pregnancy, the embryo does not implant into the uterine mucosa; it develops in the fallopian tube, ovary, or even on the peritoneum. In these organs there are no conditions for normal fixation of the embryo, proper development of the trophoblast and chorion, therefore the level of hCG does not increase as it should be at a specific stage of gestation. The determination of hCG, along with ultrasound data, can serve as an important diagnostic criterion for ectopic pregnancy.

An increase in hCG in non-pregnant women and men indicates probable tumor growth. If a tumor is detected and the patient is undergoing treatment, then determining the hCG can help evaluate the effectiveness of therapy.

Human chorionic gonadotropin in pharmacology

Human chorionic gonadotropin is not only an important diagnostic indicator. This hormone can be successfully used in the treatment of certain diseases, and athletes decide to take the drug to achieve better training results.

Medicines based on hCG are obtained by isolating the hormone from the urine of pregnant women, or with the help of special microorganisms. The most common are pregnyl, choragon, and prophasia.

HCG, having a gonadotropic effect, stimulates ovulation, sperm maturation, improving their quality and quantity, increases the production of sex steroids, and affects the formation of secondary sexual characteristics.

Indications for prescribing a drug based on hCG may include:

Menstrual dysfunction in women due to decreased production of gonadotropic hormones;
Infertility;
Stimulation of the ovaries during the procedure of in vitro fertilization (IVF);
Threat of miscarriage;
Impaired development of the gonads in men (hypogonadism), sperm pathology.

Preparations based on hCG contraindicated with tumors of the gonads, decreased function thyroid gland and adrenal glands, . This hormone should not be taken by nursing mothers, and special care should be taken when prescribing it to adolescents and people suffering from impaired renal function.

HCG is usually administered intramuscularly, and the regimen, frequency and duration of treatment depend on the goals of treatment and the gender of the patient. To provoke ovulation or “superovulation” during IVF, the drug is administered once in a high dose (up to 10 thousand IU). If there is a threat of miscarriage, impaired sexual development in boys, or hypogonadism, hCG is administered for 1-3 months, the dose is determined by the indications.

It is no secret that athletes pay increased attention to various types of drugs that can improve training results. Using steroid hormones, it is possible to increase muscle mass and strength, however There are also side effects of this effect: decreased testosterone production, risk of testicular atrophy.

In order to reduce the side effects of steroids and “smooth out” the manifestations of withdrawal syndrome, athletes use hCG drugs, which increase the concentration of testosterone and prevent atrophic changes in the testicles. It is worth noting that hCG is not a panacea; it does not eliminate the loss of muscle mass and adverse reactions of taking steroids, but it can somewhat reduce them and only “delay” the withdrawal syndrome.

Experts have an extremely negative attitude towards the use of hCG drugs by athletes, after all, metabolic disorders after taking steroid hormones can become even worse. In addition, the risk of tumors increases under the influence of hormone therapy. It has been noted that testosterone levels may not increase, but excessive stimulation of the hypothalamic-pituitary system will result in adverse reactions.

Thus, athletes should not trust unverified information and advice from their colleagues who have decided to undergo such treatment. The effect of hCG drugs in athletes, and especially against the background of steroid therapy, has not been fully studied, so there is no reason to claim that it is effective and, most importantly, safe. No competent specialist will prescribe hormonal drugs without medical indications.

Video: HCG and other components of perinatal screening of pregnant women

Sections