Human chorionic gonadotropin (hCG) is one of the types of sex hormones of protein origin, which is produced during pronounced changes in the human reproductive system.

The substance is found in both male and female female body. Depending on gender, the place of synthesis is the placenta or the pituitary lobes of men. Causes may include pregnancy, tumors, cysts of the epididymis and prostate.

Normal hCG levels

For men, the natural level of human chorionic hormone is 0-5 mU/ml. This concentration is considered optimal, allowing us to speak with confidence about satisfactory human health.

For non-pregnant women of childbearing age, the presence of no more than 5 mU/ml in the blood is considered normal. substances. The onset of menopause increases this level to 9 mU/ml.

Attention! The presence of hCG in the body is more than 5 mU/ml. (in the absence of pregnancy) indicates the development of pathological processes. This is a serious reason to see a doctor!

During pregnancy, hCG is determined 7-10 days after fertilization has occurred. The indicator constantly increases throughout the first trimester, the peak occurs at 10-11 weeks of embryo development. In this case, the normal level of human chorionic gonadotropin corresponds to the following data:

• 1-2 weeks – 25-200 honey/ml.
• 2-3 weeks – 102-5000 honey/ml.
• 3-4 weeks – up to 30,000 mU/ml.
• 4-5 weeks – 2500-82000 honey/ml.
• 5-6 weeks – 23000-150000 mU/ml.
• 6-7 weeks – up to 200,000 honey/ml.
• 7-10 weeks - up to 300,000 honey/ml.
• 11-15 weeks – 6000-103000 mU/ml.
• 16-20 weeks – up to 80,000 mU/ml.
• 21-39 weeks – 2685–78075 honey/ml.

Important! When diagnosing in different laboratories, the data may differ. Therefore, it is necessary to be guided by the rating scales used by medical personnel at the place of testing.

Interpretation of the analysis for hCG levels

Interpretation of the examination results consists of comparing the received readings with the normative ones and establishing possible reasons deviations.

A low hCG value in the blood is an alarming symptom only for women carrying a child. For all other categories of patients it does not pose any danger.

You should take the increased value of the substance seriously. The critical level is more than 10 mU/ml. In this quantity, it acts as a tumor marker and is regarded as evidence of the occurrence of cancer.

Diseases in which the proportion of hCG in the blood plasma increases in men and non-pregnant women:

• A benign or malignant tumor (teratoma, seminoma), localized in the testicles or uterus of the patient.
• Oncological processes in the gastrointestinal tract, kidneys, and genitourinary system.
• Cancers in the respiratory system.
• A continuous increase in the level of chorionic hormone is a real sign of the spread of tumor cells to neighboring internal organs.

When taking medications containing hCG, blood levels are also exceeded.

Attention! Analysis and correct interpretation of diagnostic studies is entirely the responsibility of your attending physician. Self-diagnosis and self-medication are unacceptable. Exceeding the level of hCG cannot be 100% the cause of cancer. To clarify the entire clinical picture, laboratory parameters must be considered in conjunction with other diagnostic methods.

HCG analysis and interpretation of results in pregnant women

Common pregnancy tests, which are sold in every pharmacy, detect the fact of fertilization only after a delay in the menstrual cycle. While a blood test for hCG allows you to verify conception at a later stage early stages.

The hormone itself consists of 2 constituent units - alpha and beta particles. Beta-hCG is responsible for determining the “interesting position”.

To correctly interpret the data, it is necessary to compare the examination results with the standards specific to this period of pregnancy. If deviations are greater or lesser, the doctor will prescribe additional studies.

The reasons for the increase in the content of this hormone in the blood of women may be:

1. The likelihood of developing a multiple pregnancy (two or more fetuses).
2. Pathology and abnormalities of the fetus (genetic and chromosomal diseases, Down syndrome).
3. Diabetes mellitus in a woman in labor.
4. Severe toxicosis in the early stages of pregnancy.
5. Hydatidiform mole (trophoblastic disease, which results in uncontrolled growth of the outer germinal membrane).
6. Preeclampsia (a complication, the symptoms of which are swelling, hypertension, high protein content in the urine).
7. Incorrect gestational age (discrepancy between stated and actual).
8. Taking medications that contain hCG (usually hormonal gestagens - Duphaston, Utrozhestan, Norkolut, etc.).
9. An atypically long pregnancy, without post-term pregnancy (due to the individual properties of the female body, the length of the cycle).

Possible signs of an abnormal decrease in hCG:

1. Ectopic pregnancy.
2. A fruit frozen in development.
3. Risk of miscarriage.
4. Intrauterine embryonic death.
5. Postmaturity of the fetus.

Important! To exclude ectopic pregnancy, which can threaten the health and life of a woman, if the level of hCG is low, it is necessary to be examined by ultrasound.

Analysis options

There are 2 types of blood tests common in medical practice:

• General. This type of study is recommended for detecting pregnancy in the early stages. If the process proceeds without complications, then the concentration of hCG increases by 2 times every 48 hours. The analysis is carried out in combination with prenatal screening - a set of biochemical and ultrasound procedures aimed at identifying the risks of fetal pathologies.
• Free. Prescribed in case of suspected tumor formation in the placental area. Another reason to visit the laboratory is oncological formations in the ovaries of women or the testicles of men.

Attention! If the test result for free hCG is positive, this does not guarantee that the child has pathological disorders.

Rules for taking the analysis

Blood is drawn from a vein. Enzyme immunoassay is used as a laboratory research method. For the correct result and an objective medical opinion, it is important to fulfill several simple requirements.

Preparation for a blood test for chorionic hormone content includes the following rules:

• The best option is to take the test in the morning. It is allowed to take it at other times, but you should refrain from eating 6 hours before. until blood is drawn.
• The analysis is carried out on an empty stomach.
• The day before, you should limit your consumption of heavy, fatty foods and alcohol-containing drinks.
• It is necessary to warn staff about taking medications containing hormones. This may lead to false research results.
• It is not recommended to carry out analysis after suffering nervous stress, strong emotions, or physical activity.
• There is no need to worry immediately before collecting venous blood; it is best to sit quietly for a few minutes.
• If you feel dizzy, weak, or faint before the tests, you must notify the nurse.

Indications for examinations are routine diagnostics of an ongoing pregnancy. It is mandatory to prescribe procedures in case of threat of spontaneous miscarriage and accompanying phenomena - bloody discharge from the reproductive system, heaviness and nagging pain in the lower abdomen.

If there is no question about childbearing, then the doctor may send patients with menstrual irregularities or women who have undergone an induced abortion for analysis. When it comes to the male part of the population, swelling of the testicles and discomfort in this area can be the starting point for hCG analysis.

Duration of research

As a rule, it takes a laboratory assistant 3-4 hours to analyze a person’s blood. This is the time to prepare the sample, reagents and test tubes for them. If the laboratory conducts the research itself, the result becomes known on the same day.

Human chorionic gonadotropin (abbreviated as hCG, hGT, HCG in English language, HGL in Ukrainian) is a hormone that, when in good condition the body is produced exclusively during pregnancy. The hCG hormone is produced after conception - it is synthesized by the fertilized egg, and after it is formed trophoblast (this is the precursor of the placenta), this hormone is produced by its tissues. That is why the level of hCG is determined only after conception.

Human chorionic gonadotropin consists of two different subunits - alpha And beta . Moreover, alpha is identical to the subunits of alpha hormones. When we talk about hCG - what it is, its B-subunit is considered. It is important to understand when considering what beta hCG is that it is a unique subunit, so it cannot be confused with other hormones. When talking about testing for human chorionic gonadotropin, we mean that there is no difference between hCG and beta-hCG.

What is hCG during pregnancy? Its definition and decoding is a very important stage in the diagnosis of a number of pathologies of both the fetus and the woman. In some conditions that will be described in this article, hCG values ​​are either greatly reduced or increased. When considering what kind of analysis this is, you need to take into account that with small deviations from the norm, this study has no diagnostic value. Therefore, some diseases and conditions expectant mother (post-term pregnancy , intrauterine infection, chronic fetoplacental insufficiency ) determined by other methods.

After the hCG results have been received, they are interpreted over time, since each woman’s hCG level changes differently during pregnancy. Therefore, one result cannot judge the situation as a whole.

It is important that the result of the hCG pregnancy test be reviewed by a qualified specialist. After all, decoding the hCG test is very important, as it allows you to correct some problems in fetal development.

Since the free beta subunit of gonadotropin is unique, the test that determines the norm of hCG during pregnancy is also called beta-hCG. The norm is if during pregnancy HCGb appears in the blood a few days after conception. But, nevertheless, if, for example, hCG is 8, what does this mean cannot be definitely said after the first analysis. A repeat test will be needed to confirm pregnancy. In general, the fb-HCG norm is a very important indicator of fetal development.

When taking hCG at Invitro, Hemotest, Helix and other clinics, a woman needs to understand what this indicator is, when such a test will show pregnancy, etc. This will be discussed in the article below.

What is hCG used for?

When determining HCGb levels, you need to understand what human gonadotropin is needed for. Wikipedia states the following:

• this hormone at the beginning of pregnancy stimulates the process of synthesis and;
• prevents disappearance corpus luteum ;
• prevents aggression maternal body against fetal cells;
• initiates physiological and anatomical changes in the pregnant woman’s body;
• stimulates the adrenal glands and gonads of the fetus;
• participates in the process of sexual differentiation in male fetuses.

Why is this test prescribed?

The analysis is prescribed to women for the purpose of:

• early diagnosis of pregnancy;
• monitoring the dynamics of how pregnancy progresses;
• determination of developmental defects (fetal anatomy);
• development exceptions ectopic pregnancy ;
• the need to assess whether the artificial one was completely carried out;
• establishing that there is a threat;
• diagnostics And tumors .

For male patients, such analysis is necessary to diagnose testicular tumors .

HCG levels during pregnancy

The function of human chorionic gonadotropin in the body is very important. Its indicators begin to increase in the early stages, as it is produced by a fertilized egg. It is hCG that makes it possible for pregnancy to develop, since it triggers all the processes necessary for bearing a baby.

Already 9 days after ovulation, hCG can be detected in the blood plasma. That is, already when the fertilized egg has penetrated the endometrium, there is a slow increase in the levels of this hormone. And if it is determined low level in the early stages, the concentration doubles every two days. What exactly its level should be in a certain week, how hCG should grow, whether slow or fast growth is noted, can be found out from the corresponding tables.

The increase in hCG during pregnancy occurs until 8-10 weeks from the last menstruation, when its peak is noted - 50,000-10,000 IU/l. Then the hormone level begins to decrease, by 18-20 weeks it is already reduced by half. Then the hCG level remains stable throughout the entire pregnancy.

During pregnancy, gonadotropin is excreted from the body by the kidneys, and therefore is excreted in the urine. It can be determined by performing a urine test in the range of 30-60 days after the last menstruation. The highest rates are observed on days 60-70. This is why, when hCG begins to be produced, you can do a pregnancy test strip or other urine tests.

HCG levels during pregnancy later may reach repeated peak levels. Previously, doctors considered this to be normal. However, it has now been proven that elevated hCG in later stages may indicate developmental pathology. In particular, a high level of the hormone in the last weeks of gestation sometimes means that there is a reaction of the placenta to placental insufficiency in the case of Rhesus conflict .

Therefore, it is necessary to promptly identify this disease and carry out treatment.

The main signs of hydatidiform mole are:

• Constant, indomitable vomit , much more painful than with normal.
• Uterine bleeding (severe spotting) in the early stages.
• The size of the uterus is larger than normal at this stage.
• Symptoms preeclampsia (Sometimes).
• Trembling fingers, palpitations, weight loss (rare).

When the signs described above are noted, it is important to consult a gynecologist, undergo an ultrasound and be tested for hCG.

If pregnancy develops normally, then the level of this hormone rarely increases above 500,000 IU/l. There is an approximate calculation of hormone norms for each period. But if a hydatidiform mole develops, the hCG level is different, several times higher than these norms.

To cure a hydatidiform mole, all trophoblast must be removed from the uterus. To do this, curettage or other surgical interventions are performed.

It may happen that a benign hydatidiform mole turns into malignant chorionic carcinoma . As a rule, metastases appear very quickly with this tumor. But it responds well to treatment with chemotherapy .

There are the following indications for chemotherapy:

• HCG level is above 20,000 IU/L one month after the hydatidiform mole was removed.
• An increase in the level of this hormone after a hydatidiform mole has been removed.
• Metastases to other organs.

Chorionic carcinoma

Chorionic carcinoma may appear both after a hydatidiform mole and after childbirth or abortion. If a woman develops this disease, then 40 days after the pregnancy ends, the hCG level has not fallen, but has increased. Uterine bleeding may also be observed, signs that indicate metastases. In such a situation, there are indications for chemotherapy and surgery. In the future, the patient should remain under observation. The doctor decides how long it should last.

Use of drugs containing human chorionic gonadotropin

Like all human hormones, human chorionic gonadotropin levels can depend on various factors. Thus, the test result is influenced by whether the woman takes medications containing human gonadotropin orally.

As a rule, such drugs are prescribed to women with, as well as during the period when preparations are underway for IVF, in order to increase hormone levels.

In rare cases, such medications are taken if there is a threat of miscarriage. In any case, if a woman uses such medications, then before carrying out any measurements and tests, you need to warn the doctor about this.

Taking a variety of medications, many women are interested in whether they can affect the levels of this hormone. For example, it is often asked whether to the hCG level. According to experts, Duphaston may slightly affect the level of this hormone, since this drug controls the level progesterone . However, if hCG does not meet the norm, this cannot be attributed to the influence of the drug, since it may be a pathological condition.

The level of this hormone is not affected.

Hormonal medications active component of which human chorionic gonadotropin is, these are means Profasi , Humegon , Horagon , Khoriogonin , Menogon . They restore the ovulatory process and activate the hormonal activity of the corpus luteum. At what size of the follicle the injection is given is determined by the doctor.

Initially, studies are carried out on hormones, their norm in women and deviations. If certain abnormalities occur, in particular, progesterone is below normal, what this means, the doctor will explain during the consultation and prescribe specific treatment.

If necessary, to stimulate ovulation, hCG injections from 5000 to 10000 IU are prescribed, in order to maintain pregnancy - from 1000 to 3000 IU. Individual dose selection is important. Therefore, if the 10,000 injection was given, when is ovulation, if the 5,000 injection was given, how long after ovulation, the specialist will explain.

Currently, human chorionic gonadotropin is also used by athletes, since under its influence it increases in the male body.

False positive test result

Those who are interested in what stage of pregnancy a test for this hormone shows, should take into account that in some situations the tests can be false positive.

This happens in the following cases:

• Some experts say that when taking oral contraceptives, hormone levels may increase. However, there is no proven evidence that taking contraception affects hCG.
• As a rule, after childbirth or abortion, hormone levels decrease for seven days. In some cases, the doctor waits 42 days, after which tests are taken and he can make a diagnosis. If the analysis shows that hCG has not decreased or increased, then we can talk about a trophoblastic tumor.
• Levels may remain elevated when metastases occur chorionic carcinoma , hydatidiform mole .
• Other tumors can also develop from germinal tissues, but they rarely produce an increase in hormone levels. Therefore, if there is a formation in the brain, stomach, lungs and a high level of human chorionic gonadotropin, first of all, a suspicion of trophoblastic tumors with metastases arises.

Thus, the hCG level in non-pregnant women should not be higher than those that are normal. The normal level of hCG in non-pregnant women is from 0 to 5. The level of this hormone in a non-pregnant woman may be higher in the first days after an abortion, when taking certain medications, as well as with the development of certain pathological conditions.

Immunity against hCG

In rare cases (units) the female body produces to chorionic hormone. They are an obstacle to the normal attachment of a fertilized egg in the uterus and its subsequent development.

Therefore, if in two or more cases the pregnancy ended in spontaneous miscarriage, it is important to take a test to determine antibodies to hCG and find out if there are any certain abnormalities. If the result is positive, treatment is carried out during the first trimester.

The woman is prescribed glucocorticoids And low molecular weight heparins . However, it is important to consider that organisms producing antibodies to hCG are rare. Therefore, in the absence of pregnancy, you must initially undergo all tests and exclude the influence of other factors on women’s and men’s health.

conclusions

Thus, an analysis for hCG is a very important study during the period of bearing a baby. It is understandable that after receiving research results, patients have many questions. For example, why hCG increases but does not double, how to correctly decipher hCG by DPO, etc., does fibroids affect the level of the hormone, etc. You need to ask a gynecologist about everything, who will help decipher the tests and give comprehensive answers to all questions.

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. Thanks to its high negative charge HCG may repel the mother's immune system cells, 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 drugs' use for the treatment of, among other things, uterine bleeding and amenorrhea, Frohlich's syndrome, cryptorchidism, female infertility, obesity, depression and male impotence. Good example wide application 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 period when drugs were less regulated. government agencies and their release to market was less dependent on the success of clinical trials than is currently the case. 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 an effective fat loss aid. 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.) is not ignored.
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 marker cancerous tumor, as its beta subunits are secreted in several types of cancer, including seminoma, choriocarcinoma, germ cell tumors, chorioadenoma, teratoma with elements of choriocarcinoma, 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 procedures medical care reproductive specialists (especially those in need of in vitro fertilization), who often suffer from tubal anomalies, may experience an 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. Following administration of 6000 IU hCG, plasma levels of testosterone and hCG were studied in normal adult men under two different dosing regimens. 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 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 size testicles. 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, usually associated with estrogens and , and may decrease testicular sensitivity with long-term use of hCG. Scientists have begun to investigate whether the use of estrogen receptor modulators is necessary ( trademark Nolvadex) or Anaztrozole (brand name Arimidex) 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 self-inject with 50-unit insulin syringes and 30-gauge needles into the anterior thigh while sitting with his 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, a better option for long-term use and a 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. For younger users with high percentage response (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 doctor in the field of testosterone replacement therapy, Dr John Chrysler recommends 250 IU of hCG twice weekly for all patients using testosterone replacement therapy on the day and 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. There is one good way Finding out which doctor in your area can prescribe such 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 bring your own testosterone production back to normal after you stop taking testosterone or anabolic steroids after long-term 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 correct use are considered effective.

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 low testosterone levels are left unchecked, 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. During long-term use or when using too high doses, medicine may help 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 dosage must be carefully adjusted when used in this manner, as high levels of hCG can lead to increased testicular aromatase (increased estrogen levels) as well as decreased testicular sensitivity 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 of required quantity ME. 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.

Once pregnant, a woman undergoes many tests, some even several times. This can be a cause for concern: maybe something is wrong? One such test that may need to be taken more than once is the hCG test during pregnancy.

HCG (human chorionic gonadotropin) is a hormone secreted by the chorion after the attachment of a fertilized egg to the wall of the uterus. This happens almost from the moment of conception, so hCG is a reliable indicator for early diagnosis pregnancy, provided that the test result is reliable.

Then why is the hCG level measured during pregnancy, not only in the 1st, but also in the 2nd and even 3rd trimester? The fact is that there are certain norms for hCG levels in different periods pregnancy, allowing you to find out whether it is proceeding normally and whether the fetus has any pathologies.

HCG contains alpha and beta particles. It is the beta unit that has a unique structure, so it is precisely the b-hCG during pregnancy. This laboratory test can be carried out already on the 2-3rd day of missed menstruation, if conception has occurred and 6-10 days have passed since then, the hCG level will certainly be elevated. If higher accuracy is needed, repeat analysis and ultravaginal ultrasound are recommended.

By the way, home rapid pregnancy tests (what would we do without them?) are also based on detecting hCG during pregnancy, however, for a hormone contained not in the blood, but in the urine, where its concentration is half lower, which is why the accuracy of this method inferior to laboratory examination, but still quite reliable.

HCG levels during pregnancy

After fertilization of the egg, its outer membrane (chorion) begins to actively secrete gonadotropin, and at a very fast pace: in the 1st trimester, the level of hCG during pregnancy doubles every 2 days. At 7-10 weeks, this indicator reaches its peak, and then gradually decreases, without changing significantly in the 2nd half of pregnancy. That is why, by the rate of growth of hCG during pregnancy, doctors can judge its normal development or lag. At weeks 14-18, this indicator may signal the development of pathology. Therefore, by prescribing this test again, your doctor is simply playing it safe, so don’t be alarmed.

As for hCG norms, this is a very relative concept. The fact is that almost every laboratory has its own standards. For example, here is a table of hCG norms; it will help you roughly navigate this issue. However, remember that only a qualified specialist can say the final word about the conformity or deviations from the norm of your tests.

Normal hCG levels by day after ovulation

Deviations from the norm of hCG during pregnancy

What if the hCG analysis during pregnancy showed some deviation from the norm in one direction or another? Of course, this is not very good - both an increased and a decreased indicator should alert you, because all this indicates some problems and complications in the woman’s body. The main thing is to make sure that the gestational age is set correctly, otherwise comparison with the norm will lose all meaning.

Too much high hCG levels during pregnancy- this is, in best case scenario, index multiple pregnancy: Usually the level of the hormone in the blood increases in proportion to the number of embryos.

In addition, hCG levels above normal may indicate the following pathologies:

• fetal developmental abnormalities, such as Down syndrome;
• post-term pregnancy.

HCG levels may increase if the expectant mother is suffering diabetes mellitus and takes synthetic gestagens.

False positive hCG test result

If it turns out that you are not pregnant and your hCG level is high (false positive test result), it may be due to one of the following factors:

• taking certain hormonal medications, including oral contraceptives;
• residual phenomenon after a previous pregnancy or abortion;
• chorionic carcinoma;
• hydatidiform mole or its relapse;
• tumor of the ovaries, uterus, kidneys, lungs.

In any case, this is a reason to see a doctor.

Reduced hCG during pregnancy may indicate an ectopic pregnancy, a threatened miscarriage, or post-term pregnancy. This may also be a symptom of such an unpleasant phenomenon as chronic placental insufficiency.

HCG during frozen pregnancy

Also, the level of hCG drops during a frozen pregnancy. A frozen or regressing pregnancy is a case when the fetus died for one reason or another. The hormone stops being produced, and the analysis shows a drop in hCG levels. Usually, if a frozen pregnancy is suspected, dynamic studies are carried out, that is, tests are taken several times, and the doctor can clearly determine how the level of the hormone in the blood changes.

However, do not rush to panic - perhaps the hCG levels are outside the normal range for your gestational age only because it was set incorrectly. This happens, therefore, to determine a regressing pregnancy, an ultrasound is prescribed, but it is not on its basis that the final conclusion is made. In addition, there are cases where, during a frozen pregnancy, hCG increases, although other signs have already disappeared.

Sometimes the analysis results show HCG 0 (negative) during pregnancy, most likely, this is also an error and you will need to do the analysis again.

HCG level during early pregnancy: low, high. What does a decrease in level indicate?

What else does low hCG mean? Not excluded. This means the following: fertilization took place, but for some reason the body recognized the fetus as unviable and rejected it even before the missed period. A woman, most often, does not even suspect that a new life is maturing in her. True, in some women in this case, menstruation changes its character somewhat (due to the start and failure of implantation):

• discharge becomes abundant;
• there is pain in the lower abdomen;
• The discharge lasts a little longer than usual.

There is no need to regret the termination of such a pregnancy: the body was able to recognize the defects of the unborn fetus that were incompatible with life and eliminated everything without consequences for the life and health of the mother.

Decrease in hCG in early pregnancy

An unfavorable sign is a decrease in hCG levels before the 11th week. HCG drops in early pregnancy for reasons:

• beginning miscarriage;
• disturbances in the blood supply to the fetus.

If hCG is more than half the normal level, this is a reason to observe the woman for a week. If there are signs of a spontaneous abortion that has begun, the woman is admitted to the hospital for preservation.

Elevated hCG during early pregnancy

It would seem that increased hCG during early pregnancy is good. The fetus has successfully established itself, the hormone is actively released, increases rapidly - everything is fine. Indeed, most often the body can increase the level of the hormone during pregnancy with twins or triplets. In this case, when a multiple pregnancy is confirmed by ultrasound, the woman can rejoice - the increase is physiological.

But large hCG also occurs under other circumstances:

• development of tumors (including malignant);
• Down syndrome in a developing fetus;
• other developmental anomalies - in particular, neural tube defects;
• hydatidiform mole.

What level of hCG is considered really high - in each specific situation you need to ask your doctor. It is unacceptable to diagnose yourself.

It is imperative to monitor hCG over time, since this hormone is a marker of a normal, progressive pregnancy. If you want to make sure that everything is in order, get tested periodically until the 11th week, and then you will have much less reason to worry. And if the mother is calm, everything will be fine with the child too.

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