Diagnostic Considerations in the Measurement of Human Chorionic Gonadotropin in Aging Women

Persistent Low Concentration of Human Chorionic Gonadotropin in a Nonpregnant Woman

“…Increased or positive hCG results occasionally occur, and these can unfortunately lead to delays in therapeutic procedures, undue worry, or unnecessary surgery or chemotherapy. The upper reference limits of hCG in older, nonpregnant women have been reported to be Յ8.0 IU/L during perimenopause (41-55 years) and Յ14.0 IU/L during menopause (Ͼ55 years) (9 ). This same study established the upper limit of hCG in nonpregnant premenopausal women (18 -40 years) to be Յ5.0 IU/L.…”

“…Although this case was readily resolved after several days by serial hCG measurements, the approach of Snyder et al (9 ) would have addressed the physician's concern regarding potential pregnancy from the outset. By using the serum hCG concentration in combination with the patient's age and FSH result, a rapid determination of pregnancy status can be accomplished by use of the algorithm shown in Fig.…”

“Background” Human Chorionic Gonadotropin in Healthy, Nonpregnant Women

“…The report by Snyder et al (1 ) in this issue of Clinical Chemistry solidifies at long last the use of 5 IU/L human chorionic gonadotropin (hCG) as a cutoff for detection of pregnancy. Although this cutoff has been widely used for many years, the studies to support it have included only limited numbers of nonpregnant women (2)(3)(4)(5).…”

“…Although this cutoff has been widely used for many years, the studies to support it have included only limited numbers of nonpregnant women (2)(3)(4)(5). This new study (1 ), for the first time, includes a large number of nonpregnant women (n ϭ 240) of peak child-bearing age (18 -40 years). Although the 97.5th percentile for this group was 2.5 IU/L and one woman had an hCG of 4.6 IU/L, the bulk of the cases had undetectable hCG, Ͻ2 IU/L.…”

“…Realistically, for pregnancy to be considered likely, hCG results need to exceed concentrations of at least 20 IU/L (1,6 ). For a successful term pregnancy, hCG should then at least double every 2 days until 8 weeks of gestation (12 ).…”