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HCG – Human Chorionic Gonadotropin Explained

HCG (Human Chorionic Gonadotropin) is a hormone produced during pregnancy. It maintains progesterone production and forms the basis of all common pregnancy tests.

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Things worth knowing about "HCG"

HCG (Human Chorionic Gonadotropin) is a hormone produced during pregnancy. It maintains progesterone production and forms the basis of all common pregnancy tests.

What is HCG?

HCG stands for Human Chorionic Gonadotropin, a glycoprotein hormone primarily produced by the cells of the developing placenta (trophoblast) during pregnancy. It belongs to the family of gonadotropins and is structurally related to the hormones LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone).

In small amounts, HCG is also produced by certain tissues outside of pregnancy, particularly by some tumor cells.

Biological Functions

During early pregnancy, HCG performs several vital roles:

It maintains the corpus luteum (yellow body) in the ovary and stimulates it to produce progesterone.
Progesterone prevents shedding of the uterine lining, ensuring successful implantation of the embryo.
HCG supports the development of the placenta and modulates the immune system of the mother to prevent rejection of the embryo.
It stimulates the production of male sex hormones (androgens) in the male fetus.

HCG Levels During Pregnancy

HCG levels in the blood rise rapidly after fertilization, approximately doubling every 48 to 72 hours in the first weeks:

Week 3: approx. 5–50 mIU/ml
Week 4: approx. 10–750 mIU/ml
Weeks 6–8: peak values of 25,000–300,000 mIU/ml
From week 10: gradual decline to a stable plateau

A slower-than-expected rise or a drop in HCG levels may indicate a miscarriage or an ectopic pregnancy.

Diagnosis: Pregnancy Test

HCG is the foundation of all common pregnancy tests. Both urine and blood tests detect HCG:

Urine test (home test): Detects HCG from approximately 20–25 mIU/ml, usually from the first day of a missed period.
Blood test (quantitative beta-HCG test): Measures the exact HCG concentration in the blood and can yield a positive result just days after fertilization.

Medical Uses of HCG

HCG is also used as a medication in several clinical contexts:

Fertility treatment: HCG is used to trigger ovulation (ovulation induction) during assisted reproductive technologies such as IVF.
Male hypogonadism: HCG stimulates Leydig cells in the testes to produce testosterone and may be used to treat hormonal deficiency.
Cryptorchidism: In children with undescended testes, HCG can be used therapeutically to encourage testicular descent.

HCG as a Tumor Marker

Elevated HCG levels can also occur outside of pregnancy and may indicate certain tumors:

Choriocarcinoma (a rare tumor arising from placental tissue)
Germ cell tumors (e.g., testicular cancer)
Hydatidiform mole (an abnormal growth of placental tissue)

In these cases, HCG is used as a tumor marker for diagnosis and monitoring of treatment response.

Side Effects and Risks

When used as a medication, HCG may cause the following side effects:

Nausea and headaches
Ovarian Hyperstimulation Syndrome (OHSS) in women undergoing fertility treatment
Local reactions at the injection site
In rare cases, blood clot formation (thrombosis)

References

Cole, L.A. (2010): Biological functions of hCG and hCG-related molecules. In: Reproductive Biology and Endocrinology, 8:102. PubMed.
World Health Organization (WHO): Medical Eligibility Criteria for Contraceptive Use. 5th Edition. WHO Press, Geneva.
Stenman, U.H. et al. (2006): The clinical use of human chorionic gonadotropin (hCG) in reproductive medicine. In: Human Reproduction Update, 12(6):695–709.

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