HCG Levels in Pregnancy: What do They Really Mean?

So you’ve peed on the stick and got that positive sign, now what? Next step is to make an appointment with your health care provider where they will order blood work to be completed. This blood work includes hCG (Human Chorionic Gonadotropin) level, which is the pregnancy hormone as it is made by cells produced by the placenta. These levels can first be detected by a blood test 11 days after conception. An hCG level of less than 5 is considered negative for pregnancy, anything above 25 is considered positive for pregnancy. Levels between 5-25 are considered indeterminate, and a repeated test is required.

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These levels are expected to double every 72 hours, peaking around the 10 to 12 week mark of pregnancy, then slowly decline and level off for the remainder of the pregnancy. For example, if your hCG level at 4 weeks since your last menstrual period was 200, in 72 hours we would expect it to be around 400. Because these levels drastically increase in the first trimester, some say it’s the reason many women experience stronger pregnancy symptoms during this time. 

Keep in mind that levels vary from woman to woman, that’s because hCG levels depend on what is normal for that woman, how her body responds to pregnancy, as well as how many embryos she is carrying. If there is a multiple pregnancy like in the case with twins, a higher hCG level would be expected. 

Simply taking a single reading does not give your health care provider accurate information regarding the health of a pregnancy. Levels of hCG should be repeated every 48-72 hours to grasp the trend of the pregnancy. A low hCG level can mean a miscalculation of pregnancy dating, an ectopic pregnancy, or a possible miscarriage or blighted ovum. Keep in mind that unfortunately there is nothing a person can do to treat low levels of hCG.

Attention must be taken when relying solely on hCG levels. A normal pregnancy may have low hCG levels and result in a perfectly healthy baby. High hCG levels may be an indicator of someone carrying multiple pregnancies, a miscalculated pregnancy dating, or a molar pregnancy. The results from an ultrasound after 5-6 weeks gestation are much more accurate than using hCG levels alone. 

Healthcare providers do not routinely continue to check the levels throughout a pregnancy after the initial tests, unless there are signs of a potential problem such as bleeding, experiencing severe cramping, or a history of miscarriages. Many of these instances are not preventable, or caused by something a woman has done in her pregnancy. 

If undergoing fertility treatment, your healthcare provider will likely order a level on a specific day of your cycle or so many days past treatment, like when an embryo was transferred. 

If you are pregnant, it’s important not to compare your hCG level to others around you, or rely on this number solely without pairing it with an ultrasound to confirm a pregnancy diagnosis. 

I wish you all healthy rising hCG numbers, and remember mama’s, you got this!

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