The hormone HCG is a hormone secreted during pregnancy.

The hormone HCG is secreted at the time of implantation by the trophoblast cells (which later becomes the placenta), when the embryo attaches to the uterine wall. Main role : to maintain the corpus luteum (whose role is to secrete progesterone) which is necessary for implantation of the embryo.

 This is first hormone that detects pregnancy as it is present in the blood about ten days after fertilization, and in the urine a few days later. The most sensitive, accurate and reliable pregnancy test is a blood test for the presence of beta HCG (human chorionic gonadotropin), often just called "beta". Beta HCG levels vary according to the gestational age.

Beta HCG levels during pregnancy (more than 10 mIU/ml) in the blood can be detected as early as 2 days before the period is missed. Beta-HCG are typically about 100 mIU/ml 14 days after ovulation in a healthy singleton pregnancy. They should double every 48- 72 hours in a healthy pregnancy.

 The test for HCG to diagnose pregnancy, as well as other problems of pregnancy is done by determining the levels of -subunit (betasubunit) of hCG (-hCG).
This procedure is employed to ensure that tests do not make false positives by confusing hCG with the levels of LH (Luetenizing Hormone) and FSH (Follicle stimulating Hormone).

USES:

Fertility In themarker of one or more mature Tumor presence

Confirmation of pregnancy

ovarian follicles, ovulation can be triggered by Human chorionic gonadotropin can be used the a tumor marker, as its As ovulation will as administration of hCG. subunit is happen between 38 and 40 hours after a secreted by some cancers. single HCG injection, procedures can be For this reason a positive result in males can scheduledfor take advantage ofThe normal be a test to testicular cancer. this time sequence, men is between 0-5 mIU/mL. range for such as intrauterine insemination or sexual intercourse. Combined with alpha-fetoprotein, -HCG is an excellent tumor marker for the monitoring of germ cell tumors.

There are 2 pregnancy tests for HCG

Other names: Blood Test Urine Test Serial beta HCG Repeat quantitative beta HCG Human chorionic gonadotropin blood test Beta-HCG blood test Pregnancy test - blood

HCG Blood Test

QUALITATIVE
Just simply reports whether or not there is hCG present in the bloodstream .

QUANTITATIVE
reports the exact level of hormone that is present.
(MAJOR ADVANTAGE)

1. Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with antiseptic. The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

2. Next, the health care provider gently inserts a needle into the vein. The 2-4ml of blood collected into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.
2. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. 3. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

There is very little risk involved with having blood sample taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:
Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken)

 Quantitative HCG measurements can help to determine the exact age of the fetus and can diagnose abnormal preqnancies, such as ectopic pregnancies, molar pregnancies, and potential miscarriages. It is also used as part of a screening test for Down Syndrome. This test is also done to diagnose abnormal conditions unrelated to pregnancy that can raise HCG levels. The lack of a visible fetus on vaginal ultrasound after the hCG levels have reached 150,000 mIU/ml is strongly indicative of an ectopic pregnancy.

HCG Urine Test

The urine test may any of several other test formats, Commonly a home-, physician's office-, or laboratorybased. Home based urine test is the most common. of pregnancy test. type

Qualitative

Detection thresholds range from 20 to 100 mIU/ml, depending on the Only tells whether brand of test.

the pt is pregnant or not, without telling Early in pregnancy, more accurate the obtained by using results may beexact levels of B-HCG the first urine of the morning (when present. hCG levels are highest).

HCG Urine Test

Advantages:
urine pregnancy test kits are less expensive; and testing can be done at home by the patient herself. The kits available are very accurate and widely available and the test can be completed in about 3-5 minutes.

 Then the the brands for The majority of woman needs to wait a few minutes. Different brands the urine test tell the user to instruct the woman to wait different amounts of hold a stick in the urine stream. Others time. Once the time has passed, the user involve collecting urine should inspect the "result in a cup and then dipping the window." The user is pregnant a line stick into it. Another brandiftells or plus symbol is present. the woman to collect urine in a It does not matter how faint the line is. A cup and then put a few drops means the line, whether bold or faint, into a specialis positive. with a container result dropper.

How is a urine test accurate?

Home pregnancy tests (HPTs) can be quite accurate. But the accuracy depends on many things. These include:

How is it being used Who uses them -

When is it being used-

The time of fetal implantation The brand of the test-

How is a urine test not accurate?

Every woman ovulates at different times in her menstrual cycle. Plus, embryos implant in the uterus at different times. So, the accuracy of HPT results varies from woman to woman. Sometimes women get false negative results (when the test says you are not pregnant and you are) when they test too early in the pregnancy.

When the urine is dilute (specific gravity less than 1.015), the hCG concentration may not be representative of the blood concentration, and the test may be falsely negative.

weeks since LMP

mIU/mL

3 4 5 6

5 50 5 426 18 7,340 1,080 56,500

LOW

78 9 12 13 16 17 24 25 40 Non-pregnant females Postmenopausal females

HIGH

7,650 229,000 25,700 288,000 13,300 254,000 4,060 165,400 3,640 117,000 <5.0 <9.5

What do HIGH values of B-HCG means?

Normal Pregnancy. Numbers vary from person to person. Multiple Pregnancy
Spontaneous twins. Sometimes, the embryo splits and become identical twins. Fraternal twins.

Gestational trophoblastic disease like Hydatidiform moles ("molar pregnancy") Choriocarcinoma may produce high levels of hCG (due to the presence of syncytialtrophoblasts- part of the villi that make up the placenta) despite the absence of an embryo. Ovarian Cancer (women); Testicular Cancer (men)

What do LOW values of B-HCG means?

A reason for a low beta is that some embryos are "late" implanters. Typically, an embryo begins to The pregnancy may be ectopic -- outside of the implant andembryo canbegins outproduce hCG uterus. An your body travel to of the uterus between 8-10 days past conception. and up a fallopian tube, or even out into the Some research shows that are rare, but they abdominal cavity. Ectopics frozen embryos are slower/later to implant than fresh embryos. happen. The number may be low because of a chemical Fetal death pregnancy. Sadly, this is a very early miscarriage. It is estimated that up to 25% of pregnancies end Incomplete miscarriage early miscarriages - but researchers inThreatened spontaneous abortion aren't sure. Women can experience a chemical pregnancy without ever knowing it. Normal Pregnancy. The number may just be low, since B-HCG levels vary from person to person.

When does B-HCG hormone start to lower down and disappear?

Once a gestational sac is seen in normal pregnancies, B-HCG levels gradually decreases. The initial decrease in beta hCG (hCG) after full-term delivery is quite rapid, so that an hCG level following the delivery will have dropped to less than 50 mIU within 2 weeks, and hCG will be undetectable after 3 to 4 weeks In the case of first-trimester abortion, if hCG is clearing normally from the bloodstream as expected, the hCG level should decline steadily, halving at least every 48 hours. BhCG is likely to be detectable by sensitive tests, including commonly-used office urine test kits, for as long as 60 days after first-trimester abortion.

By: Cloudyn De Juan