Human Chorionic Gonadotropin (quantitative) Test

What is Human Chorionic Gonadotropin?

Human chorionic gonadotropin (hCG) is a glycoprotein hormone found in the blood and urine. hCG is produced during pregnancy and has a major role in maintaining the pregnancy. It is made by trophoblastic cells that surround a fertilised egg (embryo), attach the embryo to the womb, and eventually form the placenta.

Small amounts of hCG are also found in the blood and reproductive tract (testis, prostate) of men. In men, hCG stimulates testosterone and sperm production.

What is a Human Chorionic Gonadotropin test?

The quantitative hCG test measures the exact concentration of hCG in the blood. “Quantitative” simply means that the test is a “measurement”.

Some hCG tests measure the amount of hCG in urine, although these tests are not as sensitive or specific as the tests using blood.

Why is a Human Chorionic Gonadotropin test important?

The hCG test is used as an indicator of pregnancy. It has an important role in providing information about the pregnancy and the health of the foetus, including to:

• Determine the age of the foetus when in the early stages of pregnancy
• Monitor the progress of the pregnancy, particularly if there is a high risk of miscarriage or after a miscarriage
• Distinguish between a normal and an abnormal pregnancy, such as an ectopic pregnancy (when a fertilised egg implants outside of the womb) and a molar pregnancy (where abnormal tissue grows in the womb)
• Detect problems with the foetus, such as genetic conditions (e.g., Down syndrome and birth defects like cleft lip)
• Help diagnose certain cancers, such as choriocarcinoma (develops from certain placental cells) and germ cell tumours (develop from cells that turn into eggs)

Additionally, for a woman undergoing in vitro fertilisation, a single injection of hCG is usually given to trigger maturation of the eggs and stimulate ovulation.

Who should have their Human Chorionic Gonadotropin level tested?

An hCG test is done if a healthcare provider wants to determine the exact amount of hCG in the blood.

The test is used to confirm a pregnancy or to monitor when a woman is at high risk of miscarriage, particularly if she has an infection, diabetes, or problems with the thyroid, womb or cervix. It is also useful to confirm that a woman is not pregnant, such as before receiving a medical treatment that may harm the foetus.

The test might be needed if a medical problem with the pregnancy is suspected, such as if symptoms (e.g., abnormal vaginal bleeding, pain in the abdomen, lower back or pelvis) suggest an ectopic pregnancy or molar pregnancy. Additionally, following the termination of an ectopic or molar pregnancy, it is important to monitor the decrease in hCG level to ensure that the medicine or procedure has worked.

An hCG test might also be done for a woman who is having fertility treatments to confirm the pregnancy and that implantation is successful and early pregnancy progression is normal.

How to test for Human Chorionic Gonadotropin?

The quantitative hCG test requires a small blood sample. The sample is easily collected by you at home using a blood sample collection kit provided by The Online Clinic. By following the instructions, a prick to the finger yields a few blood drops that can be collected into a vial. Packaging for sample posting to the laboratory is also provided. Alternatively, blood samples are collected at a clinic by a healthcare professional. This involves inserting a fine needle into a vein in your arm, with the blood sample collected directly into a tube. All results of the test are sent to the healthcare professional, providing you with the opportunity to discuss your results and what they mean.

What are normal Human Chorionic Gonadotropin test results?

hCG levels in non-pregnant women are typically less than 5 milli-international units per millilitre (mIU/mL) of blood. In healthy men they are less than 2 mIU/mL. Higher than normal levels in non-pregnant women and in men can be due to a malignancy, including cancers of the testis (men), ovaries or bladder, and neuroendocrine tumours.

Length of pregnancy influences hCG concentration in blood. hCG level begins to increase 6–10 days after conception. It increases very quickly in the early weeks of pregnancy, with levels doubling around every 24 hours in the first 8 weeks. hCG typically peaks around 10 weeks, then decreases to about week 16, after which it remains relatively stable until birth. Following birth or pregnancy termination, the level of hCG declines to an undetectable level between 7 and 60 days. While there is some variation between testing laboratories, typical hCG level ranges for gestational age are:

• 5–72 mIU/mL at 3 weeks
• 10–708 mIU/mL at 4 weeks
• 31,366–149,094 mIU/mL at 8 weeks
• 44,186–170,409 mIU/mL at 10 weeks
• 8,904–55,332 mIU/mL at 16 weeks
• 8,240–51,793 mIU/mL at 17 weeks

The test can flag any potential problems with the pregnancy because the rate at which hCG level increases is important:

• hCG levels higher than expected for gestational age may indicate that there is more than one foetus, a malignancy (e.g., ovarian cancer or choriocarcinoma), or a molar pregnancy.
• Lower than expected hCG levels may indicate a potential miscarriage, an incomplete miscarriage, an ectopic pregnancy, or death of the foetus.

However, rarely the test is incorrect, indicating that you are pregnant when you are not (false positive; hCG detected) or that you are not pregnant when you are (false negative; hCG not detected). Possible reasons for a false positive result include production of hCG by a malignancy or that you are taking fertility medicines. A false negative result may mean that the hCG measurement was done too early after conception.

References

Berger P, Gruschwitz M, Spoettl G, et al. Human chorionic gonadotropin (hCG) in the male reproductive tract. Mol Cell Endocrinol. 2007;260-262:190-186.

Betz D, Fane K. Human Chorionic Gonadotropin. [Updated 2025 Apr 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532950/

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