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If you are pregnant, you may be asking yourself, “What is hCG and why is it important?” HCG stands for human chorionic gonadotropin and it is the hormone that is detected in your urine when you take a pregnancy test at home or at the doctor’s office. It is the hormone that is released when the pregnancy implants.
For most women, all they need is that positive or negative urine test result and they can move on, but for others that urine pregnancy test may not provide enough information because it cannot provide the EGA (estimated gestational age of the pregnancy).
Let’s say that you have taken a couple of home pregnancy tests, and they are all negative – but you have not had a period in a month or two and you are having pregnancy symptoms. Or, you have taken a few home tests and some are positive and some negative; that is super frustrating since it doesn’t give you clarity.
For those women the next step is often a blood pregnancy test called a qualitative hCG. That test provides you with a positive or negative result and because the result is from a blood test, we can assume it is accurate. Depending on where you live, you may be able to get this blood test without a doctor’s order.
This next part may seem like I am veering off topic, but I will get back to discussing hCG, so hang in with me.
Once a woman has a positive pregnancy test, the next step is typically getting an ultrasound for confirmation. The 3 pieces of important information gained from the early limited OB ultrasound are:
If the ultrasound is inconclusive, it could mean a few things, such as but not limited to:
This is when the quantitative (quant) hCG levels are needed. Quant hCG levels are obtained from a blood test. The amount of hCG in the blood should correlate with how many weeks pregnant the woman is at that time; of course, there are always exceptions to the “rule”, but we aren’t going down that rabbit trail.
The quant level is typically repeated in 48 hours to see if the level is going up or going down. This process may be repeated multiple times to determine what direction the pregnancy is going, and the doctor may repeat the ultrasound.
If the number is going up, it indicates the pregnancy is progressing – but that does not mean that it is in the uterus. If the level is going down, it is often assumed that the pregnancy is not progressing as it should and may end in a miscarriage
It is the combination of the ultrasound and the quant hCG levels that are needed for the bigger picture.
So, let’s say the ultrasound did not show anything in the uterus and the quant hCG level is 200 mIU/mL*, that would not be an unusual ultrasound finding. That quant level indicates that the pregnancy is in the 3-4 week range of development and you would not expect to see anything in the uterus at that EGA.
Now on the flip side, if an ultrasound did not show anything in the uterus and the quant hCG level was say 63,000 mIU/mL*, that would be concerning/suspicious for an ectopic pregnancy. With an hCG level that high you would expect to see a 7-8 week pregnancy, which would be visible on ultrasound.
If the patient is not having any symptoms of an ectopic pregnancy, the doctor may repeat the quant level in 48 hours to see which direction it is trending, or they may want to intervene. The doctor would determine what to do next.
There are more reasons that a quant hCG level may be ordered by a doctor, and if you are interested in more information, drop us a comment at the link below – if enough of you are interested maybe we can write a blog addressing your questions. I hope that this information gives you some insight into the importance of an ultrasound and the importance of quant hCG levels if the ultrasound is inconclusive.
We here at Alcove Health Women’s Clinic want to be your first call when you see the positive home pregnancy test. We provide lab-grade urine-based pregnancy testing and ultrasounds to help you get the most information you can to protect your reproductive health. Call or click here to request your free and confidential medical appointment today.
* Each lab provides its own scale for hCG levels, and they are meant to be used only as a reference.
📞 Call us or request your free appointment online now.
📍 Alcove Health Women’s Clinic – 11101 Warwick Boulevard, Newport News, VA 23601
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