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hCG Pregnancy

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Also known as: Pregnancy Test; Qualitative hCG; Quantitative hCG; Beta hCG; Total hCG; Total beta hCG
Formal name: Human Chorionic Gonadotropin

Were you looking instead for hCG Tumor Markers, used to help diagnose and monitor therapy for certain cancers?

At a Glance

Why Get Tested?

To confirm a pregnancy; to help identify an ectopic pregnancy; to monitor a pregnancy that may be at risk of failing; occasionally to screen a woman for pregnancy prior to some medical treatments; as part of a panel of tests used to screen for fetal abnormalities (see First Trimester Down Syndrome Screen and Second Trimester Maternal Serum Screening)

When to Get Tested?

When you suspect that you are pregnant (testing can be done reliably by 10 days after you miss your menstrual period and some methods can detect hCG even earlier); when you have signs and symptoms that suggest you may have an ectopic pregnancy or a pregnancy that is failing; prior to some medical treatments

Sample Required?

A urine sample collected first thing in the morning or a blood sample drawn from a vein in your arm

Test Preparation Needed?

Do not drink large amounts of fluid before collecting a urine sample for a pregnancy test because overly diluted urine may result in a false negative; no preparation is needed for a blood sample.

The Test Sample

What is being tested?

Human chorionic gonadotropin (hCG) is a hormone produced by the placenta of a pregnant woman. Early in pregnancy, the level of hCG increases in the blood and is eliminated in the urine. A pregnancy test detects hCG in the blood or urine and confirms or rules out pregnancy.

During the early weeks of pregnancy, hCG is important in maintaining function of the corpus luteum. Production of hCG increases steadily during the first trimester (8-10 weeks) of a normal pregnancy, peaking around the 10th week after the last menstrual cycle. Levels then fall slowly during the remainder of the pregnancy. hCG is no longer detectable within a few weeks after delivery.

When a pregnancy occurs outside of the uterus (ectopic), the level of hCG in the blood increases at a slower rate. When an ectopic pregnancy is suspected, measuring the level of hCG in the blood (quantitative test) over time may be useful in helping to make a diagnosis of ectopic pregnancy.

Similarly, the hCG blood level may be abnormal when the developing baby (fetus) has a chromosome defect such as Down syndrome. An hCG test is used routinely in conjunction with a few other tests as part of screening for fetal abnormalities. (See First Trimester Down Syndrome Screen or Second Trimester Maternal Serum Screening for more on this.)

How is the sample collected for testing?

Preferably, a urine sample is collected first thing in the morning or a blood sample is drawn from a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed. However, do not drink large amounts of fluid before collecting a urine sample for a pregnancy test. This is because overly dilute urine may result in a false negative.

The Test

Common Questions

Ask a Laboratory Scientist

Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

Farinde, A. (Updated 2014 July 2). Human Chorionic Gonadotropin (hCG). Medscape Drugs & Diseases [On-line information]. Available online at http://emedicine.medscape.com/article/2089158-overview through http://emedicine.medscape.com. Accessed September 2014.

(Updated 2014 June 5). Pregnancy. U.S. Food and Drug Administration Medical Devices [On-line information]. Available online at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/InVitroDiagnostics/HomeUseTests/ucm126067.htm through http://www.fda.gov. Accessed September 2014.

Grenache, D. and Lehman, C. (Updated 2012 November). hCG Testing – hCG. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/hCG.html?client_ID=LTD through http://www.arupconsult.com. Accessed September 2014.

Rollins, G. (2012 March 8). Taking a New Look at the hCG Discriminatory Level. Clinical Laboratory Strategies [On-line information]. Available online at http://www.aacc.org/publications/strategies/archives/2012/Documents/030812CLS.pdf through http://www.aacc.org. Accessed September 2014.

Grenache, D. (2013). Identifying the Pregnant Patient, There's More to Know than "Yes" or "No." AACC Presentation [On-line information]. Available online at http://www.aacc.org/members/loc_sections/ncalifornia/LSNCMtgAnnouncements/Documents/Grenache_hCG_POC_BayChem_2013.pdf through http://www.aacc.org. Accessed September 2014.

Grenache, D. (2011). Human Chorionic Gonadotropin. Clinical Chemistry Trainee Council Pearls of Laboratory Medicine [On-line information]. Available online at http://www.aacc.org/publications/clin_chem/ClinChemTrainCouncil/pearls/Documents/Pearls_Grenache_Script.pdf through http://www.aacc.org. Accessed September 2014.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 558-560.

Manual of Laboratory and Diagnostic Tests, 8th ed. (2009) Lippincott Williams & Wilkins: Philadelphia.

Sepilian V (September 2, 2014). Ectopic Pregnancy. Medscape Reference. Available online at http://emedicine.medscape.com/article/2041923-overview through http://emedicine.medscape.com. Accessed September 2014.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

(2003 June 23). Free Beta-Subunit of Human Chorionic Gonadotropin (Free b-hCG) Enzyme Immunoassay Test Kit. BioCheck, Inc. [On-line package insert]. PDF available for download at http://www.biocheckinc.com/inserts/bc-1023_fbhcg.pdf through http://www.biocheckinc.com.

Newberger, D. (2000 August 15). Down Syndrome: Prenatal Risk Assessment and Diagnosis. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20000815/825.html through http://www.aafp.org.

Qin, Q., et. al. (2002). Point-of-Care Time-resolved Immunofluorometric Assay for Human Pregnancy-associated Plasma Protein A: Use in First-Trimester Screening for Down Syndrome [Pages 1-3 of 20]. Clinical Chemistry 48:473-483 [On-line journal]. Available online at http://www.clinchem.org/cgi/content/full/48/3/473 through http://www.clinchem.org.

(2000). Down Syndrome Screening. NTD Laboratories, Inc. [On-line information]. Available online at http://www.ntdlabs.com/dscreen.html through http://www.ntdlabs.com.

Hoffman, B. and Johnson, J. (2004). Toronto's Mount Sinai Hospital offers First-Trimester Screening Across Ontario. Healthcare Quarterly 7(2). PDF available for download at http://www.mountsinai.on.ca/Resources/HQ72MtSinaiProfile.pdf through http://www.mountsinai.on.ca.

Paralloi, A. (August 13, 2003, Edited) Second Trimester Maternal Serum Screening Programmes for the Detection of Down's Syndrome. Geneva Foundation for Medical Education and Research [On-line information, 8th Post Graduate Course]. Available online through http://www.gfmer.ch.

First Trimester Prenatal Screening. Alfigen, The Genetics Institute, Laboratory Services [On-line information]. Available online at http://www.alfigen.com/laboratory_4_3.html through http://www.alfigen.com.

(1999 March 18). Prenatal Program Pushes the Frontiers of Diagnosis. Cedars-Sinai Medical Center [On-line News release]. Available online at http://www.newswise.com/p/articles/view?id=PREDIAG.CED through http://www.newswise.com.

Free beta hCG [I-125] IRMA kit (RK-820CT) - coated tube. IZOTOP [On-line test information]. Available online at http://www.izotop.hu/print/rk820c.htm through http://www.izotop.hu.

Beta-hCG, Serum Quantitative=. ARUP's Guide to Clinical laboratory Testing [On-line information]. Available online at http://www.arup-lab.com/guides/clt/tests/clt_al98.jsp#1145363 through http://www.arup-lab.com.

Spencer, K. What is Free Beta hCG. Down Syndrome Screening Research [On-line information]. Available online at http://ourworld.compuserve.com/homepages/kevin_spencer/freebeta.htm through http://ourworld.compuserve.com.

Ultra-Screen First Trimester Prenatal Screening. Center for Medical Genetics [On-line brochure]. PDF available for download at http://www.geneticstesting.com/pdfs/UltraScreen_Brochure.pdf through http://www.geneticstesting.com.

Vankrieken, L., et. al. (2000). HCG and Subunits: DPC Assay Specificities and Clinical Utility in Obstetrical Care and Oncology. Immulite [DPC Technical Report]. PDF available for download through http://www.dpcweb.com.

Framarin, A. (2003) First-trimester prenatal screening for Down syndrome and other aneuploidies. Agence d’e’valuation des technologies et des modes d’intervention en sante’ [On-line report, Quebec]. PDF available for download through http://www.aetmis.gouv.qc.ca.

(2000). What is Ultra-Screen. NTD Laboratories, Inc. [On-line information]. Available online at http://www.ntdlabs.com/ultraphys.html through http://www.ntdlabs.com.

Shaskan, J. (2004 May 31). Amniocentesis and CVS Tests Decline Despite Increase in Number of Older Mothers. ACOG [On-line news release]. Available online at http://www.acog.org/from_home/publications/press_releases/nr05-31-04-1.cfm through http://www.acog.org.

Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 252-255.

Vorvick, L. (Updated 2010 November 21) HCG blood test – qualitative. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003509.htm. Accessed March 2011.

Gaufberg, S. (Updated 2010 April 16) Early Pregnancy Loss. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/795085-overview through http://emedicine.medscape.com. Accessed March 2011.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 558-560.

Grenache, D. et. al. (Updated 2011 January) hCG Testing – hCG. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/hCG.html?client_ID=LTD through http://www.arupconsult.com. Accessed March 2011.

(© 1995–2011). Unit Code 80678: Human Chorionic Gonadotropin (hCG), Quantitative, Pregnancy, Serum Mayo Clinic, Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/80678 through http://www.mayomedicallaboratories.com. Accessed March 2011.

Ann M. Gronowski, Corinne R. Fantz, Curtis A. Parvin, Lori J. Sokoll, Carmen L. Wiley, Mark H. Wener, and David G. Grenache. Use of Serum FSH to Identify Perimenopausal Women with Pituitary hCG. Clin. Chem., Apr 2008; 54: 652 - 656.

One-Year Experience with Day-of-Surgery Pregnancy Testing Before Elective Orthopedic Procedures. Kahn, RL et al. Anesthesia & Analgesia April 2008. Vol. 106. No. 4 Pp 1127-1131.

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