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Human chorionic gonadotropin (hCG) is a placental hormone initially secreted by cells that surround an implanted embryo in pregnancy. Its primary role is to maintain the function of the corpus luteum during the first 3 to 4 months of pregnancy. The protein has many other roles including stimulating the onset of fetal gonadal steroidogenesis.
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Human chorionic gonadotropin (hCG)
Human chorionic gonadotropin (hCG) is a heterodimeric glycoprotein with an alpha subunit (identical to that of LH, FSH and TSH) and a unique β(beta)-subunit. The hormone is secreted as soon as the trophoblast implants in the uterine wall and it is at its highest concentration between the 7th and 10th weeks of pregnancy. The urine of women in the first month of pregnancy contains enough hCG to be detected by ELISA.
Total hCG is commonly used to confirm and monitor pregnancy, but it also has clinical utility in detecting miscarriages, preeclampsia, neoplasms, and trophoblastic diseases. Quantitative free β-hCG tests can also be used as tumor marker tests in gestational trophoblastic disease and in certain testicular tumors where the ratio of the free β subunit to intact hCG can be abnormally high. Free β-hCG may also have clinical utility in first-and second-trimester prenatal screening for Down syndrome and other chromosomal anomalies.
Diagnosis
Qualitative hCG assays are based on the two-site sandwich enzyme immunoassay principle typically using lateral flow technology and can detect hCG levels as low as 10 mIU/mL-100ml U/mL. They are prone to heterophile antibody interference, resulting in occasional false-positive results, and in rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.
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