Chorionic gonadotropin

International name:

Dosage form:

Pharmachologic effect:

Indications:

gonacore

International name: Gonadotropin chorionic (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmachologic effect: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates the synthesis...

Indications: Hypofunction of the gonads (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory...

Pregnil

International name: Gonadotropin chorionic (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmachologic effect: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates the synthesis...

Indications: Hypofunction of the gonads (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory...

Profazi

International name: Gonadotropin chorionic (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmachologic effect: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates the synthesis...

Indications: Hypofunction of the gonads (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory...

Horagon

International name: Gonadotropin chorionic (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmachologic effect: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates the synthesis...

Indications: Hypofunction of the gonads (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory...

gonacore

Dosage form: lyophilisate for solution for intramuscular injection

Pharmacological action: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates synthesis.

Indications: Hypofunction of the sex glands (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory.

Pregnil

International name: Chorionic gonadotropin (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmacological action: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates synthesis.

Indications: Hypofunction of the sex glands (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory.

Profazi

International name: Chorionic gonadotropin (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmacological action: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates synthesis.

Indications: Hypofunction of the sex glands (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory.

Horagon

International name: Chorionic gonadotropin (Gonadotrophin chorionic)

Dosage form: lyophilisate for solution for intramuscular injection

Pharmacological action: A hormonal drug excreted from the urine of pregnant women. It has a luteinizing and follicle-stimulating effect. Stimulates synthesis.

Indications: Hypofunction of the sex glands (due to impaired activity of the hypothalamus and pituitary gland). In women: dysmenorrhea, ovarian dysfunction, anovulatory.

hCG (human chorionic gonadotropin)

Pharmacological group: gonadotropic hormones.

Pharmacological action: prevention and treatment of infertility, stimulation of ovulation in women and spermatogenesis in men.

Effects on receptors: luteinizing hormone receptor

In molecular biology, human chorionic gonadotropin (hCG) is a hormone produced by a fertilized egg after conception. Later, during pregnancy, hCG is produced during the development of the placenta, and then through the placental component of the syncytiotrophoblast. This hormone is produced by some cancerous tumors; thus, elevated levels of the hormone in the absence of pregnancy may indicate a diagnosis of cancer. It is not known, however, whether the production of the hormone is a cause or a consequence of cancerous tumors. The pituitary analogue of hCG, known as luteinizing hormone (LH), is produced in the pituitary gland of men and women of all ages. On December 6, 2011, the FDA banned the sale of "homeopathic" and unlicensed hCG-containing diet products, declaring them illegal.

Description

Human chorionic gonadotropin (hCG) is a prescription drug containing naturally occurring (human) chorionic gonadotropin. Chorionic gonadotropin is a polypeptide hormone that is usually found in the body of a woman in the first months of pregnancy. It is synthesized in placental syncytiotrophoblast cells and is responsible for increasing the production of progesterone, a hormone important for maintaining pregnancy. Chorionic gonadotropin is present in significant amounts in the body only during pregnancy, and is used as an indicator of pregnancy in a standard pregnancy test. The level of chorionic gonadotropin in the blood becomes noticeable already on the seventh day after ovulation, and gradually reaches a peak at about 2-3 months of pregnancy. After that, it will gradually decrease until the moment of birth.

In molecular biology, human chorionic gonadotropin (hCG) is a hormone produced by a fertilized egg after conception. Later, during pregnancy, this hormone is produced during the development of the placenta and then through the placental component of the syncytiotrophoblast. Some cancers produce this hormone; thus, elevated levels of the hormone in the absence of pregnancy may indicate a diagnosis of cancer. It is not known, however, whether the production of the hormone is a cause or a consequence of cancerous tumors. The pituitary analogue of hCG, known as luteinizing hormone (LH), is produced in the pituitary gland of men and women of all ages. On December 6, 2011, the US FDA banned the sale of "homeopathic" and unlicensed hCG-containing diet products, declaring them illegal.

Although the hormone has a slight, close to FSH (follicle-stimulating hormone) activity, the physiological action of human chorionic gonadotropin is basically similar to luteinizing hormone (LH). As a clinical drug, hCG is used as an exogenous form of LH. It is usually used to support ovulation and pregnancy in women, especially those suffering from infertility due to low concentrations of gonadotropins and inability to ovulate. Because of LH's ability to stimulate the Leydig cells in the testes to produce testosterone, hCG is also used by men to treat hypogonadotropic hypogonadism, a disorder characterized by low testosterone levels and insufficient LH release. The drug is also used to treat prepubertal cryptorchidism (undescended one or both testicles into the scrotum). Male athletes use hCG for its ability to increase endogenous testosterone production, mainly during or at the end of a steroid cycle when natural hormone production is interrupted.

Structure

Human chorionic gonadotropin is a glycoprotein consisting of 237 amino acids with a molecular weight of 25.7 kDa.

It is a heterodimeric compound, with an alpha subunit identical to luteinizing hormone (LH), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), and a unique beta subunit.

The alpha subunit consists of 92 amino acids.

The beta subunit of hCG gonadotropin contains 145 amino acids encoded by six highly homologous genes located in tandem and inverted pairs on chromosome 19q13.3 - CGB (1, 2, 3, 5, 7, 8).

These two subunits create a small, hydrophobic core surrounded by an area with a high surface to volume ratio: 2.8 times that of a sphere. The vast majority of external amino acids are hydrophilic.

Function

Human chorionic gonadotropin interacts with the luteinizing hormone/chorionic gonadotropin receptor and contributes to the maintenance of the corpus luteum in early pregnancy. This allows the corpus luteum to produce progesterone during the first trimester of pregnancy. Progesterone enriches the uterus with a thick lining of blood vessels and capillaries so that it can support the growing fetus. Due to its highly negative charge, hCG can repel the cells of the mother's immune system, protecting the fetus during the first trimester of pregnancy. It is also suggested that hCG may act as a placental link for the development of local maternal immunological tolerance. For example, hCG-treated endometrial cells cause an increase in apoptosis in T cells (dissolution of T cells). These results suggest that hCG may be a link in the development of immune tolerance and may promote trophoblast invasion, which is known to accelerate fetal development in the endometrium. It is also suggested that the level of hCG is associated with such a symptom as morning sickness in pregnant women.

Due to its similarity to LH, hCG can also be used clinically to induce ovulation in the ovaries as well as testosterone production in the testes. Some organizations collect the urine of pregnant women to extract hCG from it for further use in the treatment of infertility.

Human chorionic gonadotropin also plays an important role in cell differentiation/proliferation and can activate apoptosis.

Production

Like other gonadotropins, the substance can be extracted from the urine of pregnant women or from cultures of genetically modified microorganisms with recombinant DNA.

In laboratories such as Pregnyl, Follutein, Profasi, Choragon and Novarel, it is extracted from the urine of pregnant women. In the laboratory, the Ovidrel protein is produced by microbes with recombinant DNA.

It is naturally produced in the placenta in the syncytiotrophoblast.

Story

Chorionic gonadotropin was first discovered in 1920 and about 8 years later was identified as a hormone important in the pregnancy process. The first preparation containing human chorionic gonadotropin came in the form of an extract of the pituitary gland extracted from animals, developed as a commercial product by Organon. In 1931, Organon introduced the extract to the market under the trade name Pregnon. However, disputes over the trademark forced the company to change its name to Pregnyl, which appeared on the market as early as 1932. Pregnyl is still marketed by Organon, but is no longer available as a pituitary extract. In the 1940s, manufacturing techniques were improved to make it possible to obtain the hormone by filtering and purifying the urine of pregnant women, and by the end of the 1960s, this technology was adopted by all manufacturers previously using animal extracts. In subsequent years, the manufacturing process has improved, but in general, hCG is produced today in the same way as it was several decades ago. Since modern preparations are of biological origin, the risk of biological contamination is considered to be low (however, cannot be completely ruled out).

Previously, indications for the use of chorionic gonadotropin preparations were much wider than they are now.

Product literature dating back to the 1950s and 60s recommended the use of drugs for the treatment of uterine bleeding and amenorrhea, Frohlich's syndrome, cryptorchidism, female infertility, obesity, depression and male impotence, among others. A good example of the widespread use of human chorionic gonadotropin is illustrated in Glukor, which was described in 1958 as "three times more effective than testosterone. Designed for men suffering from male menopause and older men. It is used for impotence, angina pectoris and ischemic disease, neuropsychosis, prostatitis, [and] myocarditis.

Such recommendations, however, reflect a period when drugs were less regulated by government agencies and their release to the market was less dependent on the success of clinical trials than it is now. Today, FDA-approved indications for the use of hCG are limited to the treatment of hypogonadotropic hypogonadism and cryptorchidism in men and anovulatory infertility in women.

HCG does not show significant thyroid-stimulating activity, and is not an effective fat loss agent. This is especially noted because hCG has been widely used in the past to treat obesity. This trend becomes popular in 1954, after the publication of an article by Dr. A.T.W. Simons, in which he stated that human chorionic gonadotropin is an effective dietary supplement. According to the results of the study, with a low-calorie diet and the use of the drug, effective suppression of hunger was observed. Inspired by articles like these, people all over the world soon after began putting themselves through the rigors of calorie restriction (500 calories per day) while taking hCG injections. Soon, the hormone itself is beginning to be considered the main component that promotes fat burning. In fact, by 1957, hCG was the most commonly prescribed weight loss drug. More recent and comprehensive studies, however, refute the existence of any anorexic or metabolic effects with the use of hCG, and the drug is no longer used for this purpose.

Back in 1962, the Journal of the American Medical Association issued a consumer warning about the Simon diet, which includes the use of hCG, and states that severe calorie restriction leads to the fact that the muscles and tissues of the body do not receive the required amount of protein, which in itself is even more dangerous than obesity. By 1974, the FDA receives enough claims for the use of hCG for fat loss, and issues an order requiring the following notice to be printed on prescribing information: “HCG HAS NOT BEEN DEMONSTRATED AS A ADDITIONAL THERAPY FOR THE TREATMENT OF OBESITY. THERE IS NO SUFFICIENT EVIDENCE THAT THE DRUG INCREASES WEIGHT LOSS WITHOUT CALORIE RESTRICTION, OR THAT IT CAUSES A MORE DESIRABLE OR "NORMAL" FAT DISTRIBUTION, OR THAT IT DECREASES

HUNGER OR DISCOMFORT ASSOCIATED WITH CALORIE RESTRICTION.” This warning appears on all products currently sold in the US.

Human chorionic gonadotropin is a very popular drug today, due to the fact that it remains an integral part of ovulation therapy in many cases of female infertility. Currently popular drugs in the US include Pregnyl (Organon), Profasi (Serono), and Novarel (Ferring), although many other trade names for chorionic gonadotropin drugs have been popular over the years. The drug is also widely sold outside of the US and can be found under many additional brand names, all of which cannot be listed here. Due to the fact that the drug is not regulated at the federal level, athletes and bodybuilders in the United States, unable to find a local doctor who is ready to prescribe a drug for the treatment of steroid-induced hypogonadism, often order the product from other international sources. Given that the drug is relatively cheap and rarely counterfeited, most international sources are fairly reliable. Although recombinant forms of human chorionic gonadotropin have been introduced to the market in recent years, the widespread availability and low cost of biological hCG continues to make it a staple for both off-label and off-label uses.

HCG analysis

HCG is measured using blood or urine tests, such as during pregnancy tests. A positive result indicates blastocyst implantation and embryogenesis in mammals. It can help in the diagnosis and monitoring of tumor germ cells and trophoblastic diseases.

Pregnancy tests, blood counts, and most accurate urine tests usually detect hCG between days 6 and 12 after ovulation. However, it must be taken into account that the total hCG level can vary over a very wide range during the first 4 weeks of pregnancy, which can lead to false results during this period of time.

Trophoblastic diseases such as chorionademon ("molar pregnancy") or choriocarcinoma can lead to high levels of beta-hCG (due to the presence of syncytial trophoblasts - the villi that make up the placenta), despite the absence of an embryo. This, and some other conditions, can lead to elevated hCG levels in the absence of pregnancy.

HCG levels are also measured during the triple test, a screening test for certain fetal chromosomal abnormalities/birth defects.

Most tests use monoclonal antibodies specific for the hCG beta subunits (beta hCG). This procedure is done to make sure that the similarity of hCG with LH and FSH is not overlooked during testing (the latter two substances are always present in the body in varying amounts, while the presence of hCG almost always indicates pregnancy.)

Many immunological tests of hCG are based on the sandwich principle, when antibodies labeled with an enzyme or with a conventional or luminescent dye are attached to hCG. Urine pregnancy tests are based on the lateral shift technique.

The urinalysis can be immunochromatographic or otherwise and can be done at home, office, clinical, or laboratory. The threshold degree of detection is from 20 to 100 mIU / ml, depending on the brand of the test. Early in pregnancy, more accurate results can be obtained by testing the first urine in the morning (when hCG levels are highest). When the urine is dilute (specific gravity less than 1.015), the hCG concentration may not be indicative of the blood concentration and the test may be false negative.

Serum tests, using 2-4 ml of venous blood, usually include a chemiluminescent or fluorimetric immunoassay, which can detect beta-hCG levels below 5 mIU/ml and allow quantitative determination of beta-hCG concentration. Quantitative analysis of beta-hCG levels is useful for monitoring fetal-in-cell and trophoblastic tumors, in follow-up therapy after miscarriage, and in the diagnosis and follow-up therapy after treatment of ectopic pregnancy. The absence of a visible fetus on vaginal ultrasound at beta-hCG levels reaching mIU/ml is indicative of an ectopic pregnancy.

Concentrations are usually measured in thousand international units per milliliter (mIU/mL). The international unit of hCG was created in 1938 and revised in 1964 and 1980. Currently, 1 international unit is equal to about 2.35×10−12 mol, or about 6×10−8 grams.

The use of hCG in medicine

tumor marker

Human chorionic gonadotropin can be used as a cancer marker because its beta subunits are secreted in several types of cancer, including seminoma, choriocarcinoma, germ cell tumors, chorionadenomas, choriocarcinoma teratoma, and islet cell tumors. For this reason, a positive result in men may indicate testicular cancer. The normal level for men is 0-5 mIU/mL. In combination with alpha-fetoprotein, beta-hCG is an excellent marker for monitoring germ cell tumors.

HCG and ovulation

Human chorionic gonadotropin is widely used parenterally in place of luteinizing hormone as an ovulation inducer. In the presence of one or more mature ovarian follicles, ovulation can be induced by the administration of hCG. If ovulation occurs between 38 and 40 hours after a single hCG injection, procedures such as intrauterine insemination or sexual intercourse may be scheduled. In addition, patients undergoing IVF (in vitro fertilization) usually take hCG to start the ovulation process, however, there is a recovery of oocytes between 34 and 36 hours after injection, a few hours before the testicles are released from the ovary.

Since hCG supports the corpus luteum, administration of hCG has been used in certain circumstances to increase progesterone production.

In men, hCG injections are used to stimulate the Leydig cells that synthesize testosterone. Intratesticular testosterone is required for spermatogenesis from Sertoli cells. Typically, hCG in men is used in cases of hypogonadism and in the treatment of infertility.

During the first few months of pregnancy, transmission of the HIV-1 virus from a woman to her fetus is extremely rare. It is assumed that this is due to the high concentration of hCG, and that the beta subunits of this protein are active against HIV-1.

Warning for women taking HCG preparations (HCG Pregnyl) to induce ovulation:

a) Infertile patients undergoing reproductive health care (especially those requiring in vitro fertilization), often suffering from tubal anomalies, may experience an ectopic pregnancy after the use of this drug. That is why early ultrasound confirmation at the beginning of pregnancy (whether the pregnancy is in utero or not) is critical. Pregnancy occurring after treatment with this drug will present with a higher risk of multiplets. Women suffering from thrombosis, obesity and thrombophilia should not be prescribed this medicine, as in this case there is an increased risk of developing arterial or venous thromboembolism after or during the use of HCG Pregnyl.

b) After treatment with this drug, women tend to be more prone to miscarriages.

In the case of male patients: Long-term use of HCG Pregnyl is known to generally lead to an increase in androgen production. Therefore: Patients suffering from overt or occult heart failure, hypertension, renal dysfunction, migraine and epilepsy should not take this drug or are advised to take it at lower doses. In addition, the drug should be used with extreme caution in the treatment of sexually mature adolescents in order to reduce the risk of precocious sexual development or premature closure of the growth zone of the epiphysis. This type of skeletal maturation of patients should be closely and regularly monitored.

The drug should not be prescribed to both men and women suffering from: (1) hypersensitivity to the drug or to any of its main ingredients. (2) known or possible androgen-dependent tumors, such as male breast cancer or prostate carcinoma.

Chorionic gonadotropin in bodybuilding

Testosterone replacement therapy causes the hypothalamus to stop producing GnRH (gonadotropin-releasing hormone). Without GnRH, the pituitary stops releasing LH. Without LH, the testes (testicles or gonads) stop producing testosterone. In men, hCG has a close resemblance to LH. If, after prolonged use of testosterone, the testicles have a wrinkled appearance, then most likely, shortly after hCG therapy, testosterone production will begin to increase again. HCG promotes the testicles' own production of testosterone and increases their size.

HCG can be extracted from the urine of pregnant women or through genetic modification. The product is available by prescription under the brand names Pregnyl, Follutein, Profasi and Novarel. Novire is another brand that is a recombinant DNA product. Some pharmacies can also make prescription hCG in various bottle sizes. Branded hCG preparations in a regular pharmacy cost more than $100 per IU. The same amount of IU by special prescription can be purchased for $50. Many insurance companies do not cover hCG because its use is necessary for testicular atrophy during testosterone-rehabilitation therapy, which is considered off-label use. And most men buy the drug from prescription pharmacies, which sell it much cheaper.

HCG is on the illegal drug lists in some sports.

Professional athletes tested positive for hCG have been temporarily suspended from competition, including a 50-game MLB ban for Manny Ramirez in 2009 and a 4-game ban from the NFL for Brian Cushing.

Chorionic gonadotropin and testosterone

How long does testosterone rise after hCG injection? Scientists have looked into this issue and tried to determine whether high doses are more effective in maintaining this spike. Following administration of 6000 IU hCG, plasma levels of testosterone and hCG were studied in normal adult males in two different applications. In the first variant, seven patients received one intramuscular injection each. There was a sharp increase in plasma testosterone levels (1.6 ± 0.1 times) within 4 hours. Then the testosterone level decreased slightly and remained unchanged for at least 24 hours. A delayed peak in testosterone levels (2.4 ± 0.3-fold increase) was observed between hours. After that, the testosterone level decreased and reached the initial level in 144 hours.

In the second case, six patients received two intravenous injections of hCG (at doses 5-8 times higher than the doses administered to the first group) with a 24-hour interval. The initial increase in plasma testosterone after the first injection was the same as in the first case, despite the fact that the plasma levels of hCG in this case were 5-8 times higher. Within 24 hours, testosterone levels were again reduced compared to those observed 2-4 hours after injection, and the second intravenous injection of hCG did not cause a significant increase. A delayed peak in plasma testosterone (2.2 ± 0.2-fold increase) was seen about 24 hours later than in the first case. So the study shows that when it comes to dosing hCG, more is not better. In fact, high doses can desensitize Leydig cells in the testicles. Blood testosterone levels have also been shown to peak not once, but twice after an injection of hCG.

Chorionic gonadotropin and Leydig cells

HCG can not only increase testosterone levels, but also increase the number of Leydig cells in the testicles. Leydig cell clusters in adult testicles are known to increase significantly during hCG treatment. However, in the past it was not clear whether this increased the number of Leydig cells, or all cells in the body. A study was conducted in which adult male Sprague-Dawley rats were injected subcutaneously with 100 IU of hCG daily for 5 weeks. The volume of Leydig cell clusters increased 4.7-fold within 5 weeks of treatment. The number of Leydig cells (initially equal to an average of 18.6 x 106/cc testicles) increased 3 times.

Chorionic gonadotropin and replacement therapy

There are currently no guidelines for prescribing hCG for men undergoing testosterone replacement therapy who wish to maintain normal testicular size. A study using 200mg/week injections of testosterone enanthate with hCG at doses of 125, 250, or 500IU every other day in healthy young men found that 250IU every other day maintained normal testicular function (without altering their size). It is not known if this dose is effective in older men. In addition, there are no long-term studies on the use of hCG for more than 2 years.

Due to its effect on testosterone levels, hCG use may also increase estradiol and dihydrotestosterone levels, although there is no data to demonstrate whether this increase is proportional to the dose used.

Thus, the best dose of hCG to maintain normal testicular function while maintaining a minimum level of estradiol and dihydrotestosterone conversion has not yet been established.

Some doctors recommend that men who are concerned about testicular size or who want to maintain fertility while on testosterone replacement therapy use HCG IU twice a week. Higher doses have also been used, such as 1,000-5,000 IU twice a week. This dosage is believed to cause side effects commonly associated with estrogens and dihydrotestosterone, and possibly decrease testicular sensitivity with long-term HCG use. Scientists have begun to investigate whether the use of estrogen receptor modulators Tamoxifen (brand name Nolvadex) or Anaztrozole (brand name Arimidex) is necessary to counteract the increase in estradiol levels. High levels of estradiol can cause breast enlargement and fluid retention in men, but in acceptable amounts is an important link in maintaining bone and brain health.

Shippen test for stimulation of human chorionic gonadotropin (in men under 75 years of age)

Despite the fact that the required doses of hCG have not been approved and clinically proven, Dr. Eugene Shippen (author of The Testosterone Syndrome) developed his own method of using the drug, based on his personal experience.

Dr. Shippen found that a typical three-week course of treatment works best for patients who respond well to hCG. 500 units are administered daily by subcutaneous injection, Monday through Friday for three weeks. The patient is taught to self-inject with 50-unit insulin syringes with 30-gauge needles into the anterior side of the thigh while sitting with hands free. Testosterone levels, total and free, plus E2 (estradiol) are measured before starting use and on the third Saturday after 3 weeks of use (the author states that saliva testing may be more accurate for dose adjustment). Studies have shown that subcutaneous injections are as effective as intramuscular injections.

In measuring the effect of hCG on total testosterone levels in his patients, Shippen divided them between those who would be undergoing testosterone replacement therapy and those who simply needed to "revitalize" their testicles with hCG to get normal testosterone levels.

This is how he defines the functions of Leydig cells (testicles):

1. If hCG intake causes less than 20% increase in total testosterone levels, we notice minimal preservation of Leydig cell function (primary hypogonadism or egonandotrophic hypogonadism indicates a combination of central and peripheral factors).

2. A 20-50% increase in total testosterone indicates a sufficient reserve, but a slightly suppressed response, associated mainly with central inhibition, but sometimes, perhaps, with the reaction of the testicles.

3. Greater than 50% increase in total testosterone is primarily indicative of centrally mediated suppression of testicular function.

Then, depending on the response of patients to hCG, he suggests the following treatment options:

1. If there is an inadequate response (20%), then testosterone replacement therapy will be performed.

2. The area between 20 and 50% usually requires an increase in hCG for some time, plus natural increase or "partial" replacement options.

Dr. Shippen believes that testosterone replacement therapy is always the last option in borderline cases, as improvement can often be seen over time and Leydig cell regeneration can occur. He argues that many of these factors depend on age. Up to 60 years, an increase is almost always observed. In the age range of years, it does not always happen, but the result is usually quite predictable after receiving the results of stimulation tests. In addition, with adequate treatment of underlying processes (depression, obesity, alcoholism, etc.), diseases associated with a decrease in testosterone output can be completely reversible. He argues that this beneficial effect will not occur if the primary therapy is in the form of testosterone replacement therapy.

3. If there is an adequate response, expressed in more than a 50% increase in testosterone, then there is a very good supply of Leydig cells in the body. HCG therapy is likely to be successful in restoring full testosterone production without replacement therapy, the best option for long-term use and a more natural restoration of biological fluctuations for optimal response.

4. Chorionic hCG can be administered independently and dosages can be adjusted according to the body's response. In younger users with a high response rate (T > 1100 ng/dl), hCG can be taken every third or fourth day. It also minimizes its conversion to estrogen. Low level responders (ng/dl), or those with higher estradiol output associated with full hCG dosing, may be given the following dosing regimen: Units Mon-Wed-Fri. Occasionally, non-responsive users may require higher doses to achieve better testosterone production.

Dr. Shippen tests free testosterone levels in saliva on the day of injection prior to injection to determine effectiveness and adjust dose accordingly. He states that later, when Leydig cells are regenerated, a reduction in dose or frequency of administration may be necessary.

5. To evaluate the effectiveness of treatment, he recommends monitoring the levels of testosterone and estradiol weeks after the change in hCG, as well as periodically during continuous use. He claims that saliva testing more fully reflects the true levels of free estrogen and testosterone in the body. Most insurance companies do not pay for saliva testing. A blood test is the standard way to check testosterone and estradiol levels.

6. Apart from reports of antibodies developing against hCG (the author mentions that he has never encountered such a problem), it is claimed that there are no side effects with the constant use of hCG.

Dr. Shipppen's book was published in the late 90s. I don't know of any doctor who would use this dosing method. I don't know if it's effective or not. The idea that testicular function can be improved with hCG cycles in men with low testosterone levels caused by sluggish Leydig cell function is quite an interesting concept that needs to be explored. Since this protocol requires very careful monitoring, many physicians avoid such use. The very nature of this off-label use of hCG can also make it expensive for patients who will have to pay out-of-pocket for its use and monitoring.

Other ways to use hCG in bodybuilding

A very well known physician in the field of testosterone replacement therapy, Dr. John Chrysler, recommends 250 IU HCG twice a week for all patients on testosterone replacement therapy on the day of, and also the day before, weekly testosterone cypionate injections. After reviewing numerous lab tests and subjective patient reports, as well as researching information about hCG, he moved the regimen forward by one day. In other words, his injectable testosterone cypionate patients were now taking 250 IU hCG two days prior and also on the day immediately preceding their weekly intramuscular injections. All patients administered hCG subcutaneously, and the dosage could be adjusted as needed (he reports that doses of more than 350 IU twice a week were rarely required).

For men using gels containing testosterone, the same dosage every third day helped to maintain testicular size (the dose of the gel should be adjusted after a month of hCG use to compensate for the increased testosterone levels caused by taking hCG).

Some physicians believe that discontinuing testosterone replacement therapy for several weeks, during which 00 IU doses of hCG are used weekly, provides good stimulation of testicular function without continuous use of hCG. However, there is no data to support such claims. Others believe that cyclical use of hCG while maintaining testosterone replacement therapy may prevent the decrease in the number of Leydig cells in the testicles. Again, there is no data or published reports to support this view.

According to Dr. Chrysler, the use of hCG alone does not confer the same subjective benefits in terms of sexual function as testosterone, even in the presence of similar serum levels of androgens. However, when supplemented with more "traditional" transdermal or parenteral agents, testosterone, when combined with properly dosed hCG, stabilizes blood levels, prevents testicular atrophy, helps balance the expression of other hormones, and contributes to a significant increase in well-being and libido. But in excess, hCG can cause acne, water retention, bad mood, and gynecomastia (breast enlargement in men).

Many men complain that their doctors are unaware of hCG and its uses. Some people spend a lot of time trying to find doctors who can write such a prescription. One good way to find out which doctor in your area can prescribe these drugs is to call your local prescription pharmacy and ask which doctors call them about their patients' prescriptions.

If you decide (in consultation with your doctor) that you want to use hCG with testosterone replacement therapy at a dose of 500 IU per week, respectively, you will need 2000 IU of the substance per month. The quality of hCG may deteriorate over time after mixing with bacteriostatic water, even when stored in the refrigerator. Thus, a vial containing 3000 or 3500 IU should last for 6 weeks.

The use of hCG requires a lot of discipline, as you must remember to use it once a week in addition to your weekly or biweekly testosterone injections. However, many men can be quite comfortable with smaller testicles as long as testosterone improves sex drive. And some lucky ones don't experience any testicular atrophy at all when using testosterone (users with large testicles experience less discomfort from shrinking testicles than men with smaller testicles). So, in the end, this is a personal matter for everyone.

HCG: level and norm, deviations - increased and decreased, in women and men

In the body of each of us, there are many complex biochemical processes that are regulated by special substances - hormones. Most of them are the same in both sexes, the sex ones are different, and during pregnancy new substances appear, including hCG, human chorionic gonadotropin.

Without hormones, it is impossible to imagine the correct metabolism, reactions to stress, adaptation to constantly changing environmental conditions. Pregnancy is a very special state of the female body, which places increased demands on its functioning and requires additional regulatory mechanisms. In the body of the expectant mother appears the hCG hormone produced by the tissues of the developing embryo and reflecting the normal course of pregnancy.

Chorionic gonadotropin is the most important substance that supports the growth of the fetus, it is the first to "notify" the expectant mother of her special condition. The pregnancy test is based on the appearance of hCG, so most women have heard of it in one way or another.

HCG is formed by the membranes of the fetus, so it cannot be detected outside of pregnancy. Its content determines the physiological or impaired development of the embryo, and the appearance in the body of a man or a non-pregnant woman indicates the development of a tumor.

Properties and role of hCG in the body

After the fusion of the spermatozoon and the egg, intensive reproduction of the embryo cells begins, and by the end of the first week it is ready to attach to the inner wall of the uterus. At this stage, the embryo is represented by only a small bubble, but the cells of its outer part (trophoblast) already intensively produce a hormone that ensures normal growth.

The trophoblast is fixed to the endometrium and is transformed into the chorion, which makes up the bulk of the placenta. Through the villous membrane, the connection between the blood flow of the mother and the fetus, metabolism, delivery of useful and removal of unnecessary metabolic products is carried out. Chorion secretes chorionic gonadotropin throughout pregnancy, which helps not only to develop the unborn baby, but also supports the "pregnant" state of the woman.

When pregnancy occurs, the main regulatory substance in a woman becomes progesterone, which at the very first stages of its development is formed by the corpus luteum of the ovary. HCG during pregnancy is needed to maintain the function of the corpus luteum and a constant increase in the concentration of progesterone, so it is not surprising that the corpus luteum in a pregnant woman does not disappear, as in a normal menstrual cycle.

The biological properties of hCG are similar to those of the luteinizing and follicle-stimulating hormone, but the effect on the corpus luteum is significantly predominant. In addition, it is more active than the "ordinary" luteinizing hormone, which is formed in the second phase of the menstrual cycle, because pregnancy requires significant concentrations of progesterone.

According to the chemical structure, hCG is represented by two subunits - alpha and beta. The first completely coincides with that of the gonadotropic hormones LH and FSH, the second - beta - is unique, which explains both the peculiarity of the functions performed and the possibility of a qualitative analysis of hCG in the blood or urine.

The functions of hCG are:

• Maintenance of the corpus luteum and the formation of progesterone by it;
• Implementation of the correct implantation and formation of the chorionic membrane;
• An increase in the number of chorionic villi, their nutrition;
• Adaptation to the state of pregnancy.

The adaptation of a woman to a developing pregnancy is to increase the production of hormones of the adrenal cortex under the influence of hCG. Glucocorticoids provide immunosuppression - suppression of immune responses from the mother in relation to fetal tissues, because the embryo is half genetically alien. These functions are performed by hCG, while "ordinary" gonadotropic hormones are not able to enhance the work of the adrenal cortex.

With the introduction of preparations of chorionic gonadotropin to a woman, ovulation and the formation of a corpus luteum are stimulated, and the production of endogenous sex steroids increases. If hCG is administered to a man, then there is an increase in testosterone production and spermatogenesis is enhanced.

A blood test for hCG is used to determine the presence of pregnancy and to monitor its course. If you suspect a tumor of the gonads, it may also be necessary to determine the concentration of this hormone. HCG in the urine allows you to quickly and fairly reliably confirm the presence of pregnancy, so this method is applicable for express diagnosis.

Norm indicators

The level of hCG is determined by gender, duration of pregnancy, the presence of a tumor. In men and non-pregnant women, it is absent or does not exceed 5 mU / ml. During pregnancy, it appears about a week after conception, and its indicators are continuously increasing, reaching a maximum by the end of the first trimester.

If a pregnancy is suspected, it is possible to determine a negative hCG, the reason for which may be in a too early test or in an ectopic localization of the embryo.

The table of norms for weeks is used to control the level of hCG and timely detection of deviations. In the first or second week, it is 25-156 mU / ml, by the 6th week it can reach 151,000 mU / ml, the maximum hCG falls on the 11th week of gestation - up to 291,000 mU / ml.

Table: hCG norm for obstetric weeks

Pregnancy, obstetric weeks	HCG level, honey / ml
Pregnancy is unlikely	0-5
Pregnancy is likely (1-2 weeks)	5-25
3-4 weeks	25-156
4-5 weeks	101-4870
5-6 week	1110-31500
6-7 week	2560-82300
7-8 week	23100-151000
8-9 weeks	27300-233000
9-13 weeks	20900-291000
13-18 weeks	6140-103000
18-23 weeks	4720-80100
23-41 weeks	2700-78100

Thus, this hormone first increases, and from the second trimester it decreases slightly, since the need for it is highest at the time of formation of the placenta. The mature placenta from the second trimester of gestation itself forms the necessary amounts of progesterone and estrogen, so hCG gradually decreases, but it is still necessary for the nutritional role and stimulation of testosterone production by fetal tissues for the proper development of the gonads.

A blood test for hCG allows you to absolutely accurately confirm a short term pregnancy. In the urine, this substance appears one or two days later, and to determine it, any woman can use an express test purchased at a pharmacy. To obtain a reliable result and eliminate errors, it is recommended to use not one, but several test strips at once.

The level of hCG by day from conception is determined based on the average norm and the rate of growth of the hormone for a given period. So, in the first 2-5 weeks, the level of hCG doubles every day and a half. If the fetus is not one, then the concentration will increase in proportion to the number of embryos.

Table: approximate level of hCG by day from ovulation (conception)

days after conception	The minimum level of hCG, honey / ml	The maximum level of hCG, honey / ml
7 days	2	10
8 days	3	18
9 days	5	21
10 days	8	26
11 days	11	45
12 days	17	65
13 days	22	105
14 days	29	170
15 days	39	270
16 days	68	400
17 days	120	580
18 days	220	840
19 days	370	1300
20 days	520	2000
21 day	750	3100
22 days	1050	4900
23 days	1400	6200
24 days	1830	7800
25 days	2400	9800
26 days	4200	15600
27 days	5400	19500
28 days	7100	27300
29 days	8800	33000
30 days	10500	40000
31 days	11500	60000
32 days	12800	63000
33 days	14000	68000
34 days	15500	70000
35 days	17000	74000
36 days	19000	78000
37 days	20500	83000
38 days	22000	87000
39 days	23000	93000
40 days	25000	108000
41 days	26500	117000
42 days	28000	128000

In pathology, it is possible either to increase or decrease the amount of hCG required at a particular stage of pregnancy. An increase in this hormone may indicate the presence of diabetes, preeclampsia, or an incorrectly set gestational age. If a woman has had an abortion, and the concentration of hCG does not decrease, then this is a sign of pregnancy progression.

Low hCG or insufficient growth usually indicates a delay in fetal development, ectopic localization of the embryo, pathology of the placenta, and the threat of miscarriage.

When is hCG determination necessary?

It is necessary to determine the content of chorionic gonadotropin:

1. To confirm the fact of pregnancy;
2. In order to control its course;
3. With probable complications from the fetus (malformations) or placental tissue;
4. To control the quality of medical abortion;
5. With amenorrhea of ​​unknown origin;
6. When diagnosing neoplasms that secrete hCG.

In men and non-pregnant women, the test for hCG is usually negative, in rare cases, trace amounts of it are possible, not exceeding 5 units per liter of blood. With an increase in the concentration of the hormone in a woman, it can be concluded that the onset of pregnancy, while the conception occurred at least 5-6 days ago. Then hCG continuously increases, its amount is compared with normal values ​​for this period. To correctly decipher the data, you need to accurately calculate the time of conception.

The determination of hCG during pregnancy is included in the so-called triple test, which includes, in addition to hCG, indicators and estriol. A comprehensive assessment of deviations of these substances makes it possible to suspect possible violations on the part of the mother or the embryo.

In non-pregnant women and males, the need to determine hCG may arise in case of suspected neoplasia of the ovaries, testicles and other organs. Trophoblastic diseases (cystic drift, chorionepithelioma) are also accompanied by a change in the amount of hCG.

Blood sampling from a vein for hCG is usually taken in the morning, on an empty stomach. It does not require any preparation. When diagnosing pregnancy, in order to obtain more reliable results, it is better to donate blood as early as 4-5 days after a missed period. It is prescribed to pregnant women in the second trimester. If it is necessary to control the degree of increase in hCG in the first trimester of gestation, the analysis can be repeated every few days.

Deviations in the content of hCG

Any deviation from the data of the hCG table in a pregnant woman can be considered a sign of pathology both fetus and placental tissue, therefore, requires close attention and further examination.

hCG elevated

Exceeding the normal value of hCG is possible both during pregnancy and outside it. In pregnant women, elevated hCG may indicate:

• More than one developing embryo (hCG rises according to their number);
• Prolonged pregnancy;
• Stock ;
• at the expectant mother;
• Defects in the formation of the fetus;
• Taking hormonal drugs.

If a woman is not pregnant, or the analysis is taken from a man, and hCG is elevated, the reason for this may be:

1. Medical abortion up to five days ago;
2. Taking medications containing hCG;
3. Growth of choriocarcinoma;
4. Bubble skid;
5. seminoma of the testis;
6. Tumors of other localization - intestines, lungs, uterus.

It is known that during menopause, when there are jumps in hormone concentrations, an increase in the content of hCG in the blood is possible.. In elderly patients with kidney pathology requiring hemodialysis, hCG can significantly exceed the norm (up to 10 times). This is due to a violation of the natural excretion of the hormone from the body and its accumulation in the blood, while its production by different tissues remains at the physiological level.

HCG lowered

Pathology is evidenced not only by an increase, but also by a decrease in the concentration of chorionic gonadotropin. An insufficient amount of it causes a delay in the development of the organs and tissues of the unborn baby, negatively affects the maturation of the placenta, which means that blood flow, the exchange of nutrients and oxygen between the mother and fetus suffer. Intrauterine hypoxia can lead to serious deviations in the development of the embryo, so low hCG also requires increased attention to the patient.

A decrease in hCG production in a pregnant woman may indicate:

• Ectopic fixation of the embryo;
• Slowing down the development of the embryo;
• "Frozen" pregnancy or intrauterine death in the second or third trimesters;
• Threatening miscarriage;
• Placental insufficiency;
• Post-term pregnancy.

With an ectopic pregnancy, the embryo does not implant in the uterine mucosa, it develops in the fallopian tube, ovary, or even on the peritoneum. In these organs, there are no conditions for normal fixation of the embryo, the proper development of the trophoblast and chorion, so the level of hCG does not increase as it should be at a specific gestational age. The determination of hCG, along with ultrasound data, can serve as an important diagnostic criterion for ectopic pregnancy.

An increase in hCG in non-pregnant women and men indicates a likely tumor growth. If a neoplasm is detected and the patient is being treated, then the determination of hCG can help evaluate the effectiveness of therapy.

Human chorionic gonadotropin in pharmacology

Chorionic gonadotropin is not only an important diagnostic indicator. This hormone can be successfully used in the treatment of certain diseases, and athletes decide to take the drug to achieve better training results.

Medicines based on hCG are obtained by isolating the hormone from the urine of pregnant women, or with the help of special microorganisms. The most common pregnyl, horagon, profazi.

HCG, having a gonadotropic effect, stimulates ovulation, sperm maturation, improving their quality and quantity, increases the production of sex steroids, affects the formation of secondary sexual characteristics.

Indications for prescribing a drug based on hCG can be:

1. Violation of menstrual function in women due to a decrease in the production of gonadotropic hormones;
2. Infertility;
3. Stimulation of the ovaries during the procedure of in vitro fertilization (IVF);
4. The threat of termination of pregnancy;
5. Violation of the development of the gonads in men (hypogonadism), pathology of spermatozoa.

Preparations based on hCG contraindicated with tumors of the gonads, decreased function of the thyroid gland and adrenal glands,. You can not take this hormone to nursing mothers, and special care should be taken when prescribing it to adolescents, people suffering from impaired kidney function.

Typically, hCG is administered intramuscularly, and the regimen, frequency and duration of treatment depend on the goals of treatment and the gender of the patient. To provoke ovulation or "superovulation" during IVF, the drug is administered once in a high dose (up to 10 thousand IU). With the threat of abortion, impaired sexual development in boys, hypogonadism, hCG is administered for 1-3 months, the dose is determined by the indications.

It's no secret that athletes are showing increased attention to various kinds of drugs that can improve training results. Using steroid hormones, it is possible to increase muscle mass and strength, however there are also side effects: decreased testosterone production, risk of testicular atrophy.

In order to reduce the side effects of steroids and “smooth out” the manifestations of the withdrawal syndrome, athletes use hCG preparations that increase the concentration of testosterone and prevent atrophic changes in the testicles. It is worth noting that hCG is not a panacea, it does not eliminate the loss of muscle mass and adverse reactions of taking steroids, but it allows you to somewhat reduce them and only “delay” the withdrawal syndrome.

Specialists are extremely negative about the use of hCG preparations by athletes, after all, metabolic disorders after taking steroid hormones can be even more aggravated. In addition, the risk of tumors under the influence of hormone therapy increases. It has been noted that testosterone levels may not increase, but excessive stimulation of the hypothalamic-pituitary system will result in adverse reactions.

Thus, athletes should not trust unverified information and the advice of their colleagues who have decided on such treatment. The action of hCG preparations in athletes, and even more so against the background of steroid therapy, has not been fully studied, so there is no reason to assert that it is effective and, most importantly, safe. No competent specialist will prescribe hormonal drugs without medical evidence.

Human chorionic gonadotropin contributes to the maintenance of the corpus luteum, an endocrine structure involved in the production of progesterone, a hormone that plays a vital role during pregnancy. HCG is able to reject the mother's immune cells, protecting the fetus in the first trimester of pregnancy, until the placenta is fully formed. Chorion, which produces hCG, is its predecessor. Scientists also put forward a hypothesis, the evidence of which has been more and more lately, that it is hCG that helps the mother to form immune tolerance to. It is believed that chorionic gonadotropin is responsible for the famous bouts of nausea, and at one time, hCG was also credited with the “magic” ability to “program” the body to get rid of excessive fat deposits that could harm the unborn child. Some hCG diets have even been developed on this alleged property, but further scientific research has not confirmed this hypothesis.

Although hCG is produced by the chorion, there are other forms of the hormone, such as those produced by the pituitary gland or, in the case of cancers, secreted by cancer cells.

Types of tests for hCG

There are two main types of hCG tests: urine and blood. Urinalysis is a very general analysis, working with large values. Urine analysis, for example, is not up to 12-14 days after conception, moreover, with “diluted” urine, the test can be false negative even in the later ones. Urinalysis is able to give a result at a concentration of at least 20 mIU / ml.

HCG is measured in milliseconds of international units per milliliter (mIU/mL)

Blood tests for hCG are qualitative and quantitative. The human chorionic gonadotropin test, also known as the beta-hCG test, can detect even trace amounts of the hormone. The analysis is done, as a rule, every two days and helps not only to confirm the pregnancy, but also to show whether it is normal. A qualitative study only confirms the presence of the hormone and is almost as effective as a good urinalysis.

How to take blood for hCG

A blood test for hCG is usually taken from a vein, usually from the inside of the elbow or the back of the arm. The puncture site is cleaned with an antiseptic, the arm is pulled with a tourniquet around the shoulder to make the veins swell, and the health worker gently inserts the needle into the vein. The sample is collected in a sealed vial, then the needle is removed and the tourniquet is removed, and a cotton swab with a disinfectant is applied to the puncture site. Special preparation for the analysis is not required, but it is necessary to refrain from eating 4-6 hours before the test.

Many doctors recommend donating blood for hCG in the morning and on an empty stomach.

The risks of a blood test for hCG are the same as for all tests obtained from a vein. You may feel some degree of discomfort from the puncture, you may feel dizzy, sometimes even fainting, and a hematoma may form at the puncture site. The analysis has no special risks.

What drugs can affect the level of hCG

Medications that can decrease the level of hCG in a blood test are:
- the antihistamine drug promethazine, also sold as pipolfen or diprazine;
- various diuretics, diuretics.

Medications that increase hCG levels include:
- promethazine (it is able to influence the hormone in both directions);
- sleeping pills;
- anticonvulsants, including prophylactic;
- drugs for the treatment of Parkinson's disease;
- prescription medicines containing hCG, used most often for the treatment of infertility;
- phenothiazine preparations.

Why is a blood test for hCG prescribed?

In addition to diagnosing pregnancy at an early stage, the doctor may prescribe an hCG test to make sure that it is normal, if there is a threat of miscarriage or ectopic pregnancy. HCG is included in the test, where it serves for prenatal diagnosis of fetal malformations. This analysis is taken after an induced abortion to assess its completeness. Also, the analysis is prescribed not only for women, but also for men, for the diagnosis of certain types of tumors. Another case when an hCG blood test is taken is from athletes suspected of using certain types of doping.

What does low hCG mean?

For pregnant women, the normal level of hCG from week 3 is considered to be 5-50 mIU / ml, then the amount of the hormone grows exponentially up to 10-12 weeks, and then decreases. A level below the norm in pregnant women can indicate an incorrect setting of the term, as well as a number of violations of the course of pregnancy, such as:
- ectopic or frozen pregnancy;
- delay in fetal development;
- risk of miscarriage;
- placental insufficiency;
- overdressing.

What does high hCG mean?

For pregnant women, a high level of hCG in the blood is typical for multiple pregnancies, it can also indicate an incorrectly set period. A high level of hCG can make a doctor suspect:
- pathologies of fetal development, including Down's syndrome;
- pregnancy diabetes;
- preeclampsia or toxicosis.

In women, elevated hCG occurs with certain types of cancer, including ovarian cancer in women and testicular cancer in men, as well as seminomas, teratoma, choriocarcinomas, germ cell tumors, and hydatidiform mole. The normal range of hCG in non-pregnant women is 0-5 mIU/ml, in postmenopausal women from 9.5 mIU/ml.

Having received the results of the analysis for hCG, in no case should you engage in self-diagnosis. An accurate interpretation of the analysis can only be done by a qualified specialist familiar with your medical history. In addition, no one is immune from laboratory errors, and if a blood test for hCG alerted you, you should not immediately fall into despair.

It is not necessary to wait for an ultrasound, a doctor's examination or a test result to find out about the long-awaited conception. The fastest and most accurate result will give a blood test for hCG, which is done after ovulation and shows how long the pregnancy is. This analysis determines the level of the hormone hCG in the blood of a woman, which is produced by the chorion - one of the fetal membranes of the embryo. Pregnancy tests work on the same principle, but their sensitivity is not as great, and besides, they can give a false positive or false negative result. In this regard, a blood test will be much more accurate and will be able to determine pregnancy much faster than tests. Its value is quite large:

• If you donate blood for several days, with an interval of a day, then by the growth of hCG you can determine whether a pregnancy is developing.
• The analysis will be able to tell at a fairly early date whether your pregnancy is multiple or not.
• According to the results of the study in dynamics, it is possible to determine whether the pregnancy is frozen or not.
• In addition, monitoring hCG in dynamics will help determine whether the fetal egg has been removed from the uterine cavity, or whether the pregnancy continues to progress. This is indicated in cases where the pregnancy had to be terminated for medical reasons at a short time.
• An increase in hCG in non-pregnant men and in men will indicate the possible development of various diseases, and this will allow such people to see a doctor as soon as possible.

Thus, a blood test for hCG is important not only during pregnancy or its planning, but also in other situations that require medical supervision.

When to take an hCG test

Despite the fact that the level of hCG in the blood is most likely to announce the presence of pregnancy, this does not mean that you can take it a few hours after intercourse during ovulation. The fact is that this hormone begins to be produced only when the implantation of the fetal egg occurs to the wall of the uterus (or to the wall of the fallopian tube, if the pregnancy is ectopic). Implantation does not occur in the first hours of conception. IN in the vast majority of cases, it does not occur even in the first two or three days after the fertilization of the egg. According to observations, implantation of the fetal egg can occur no earlier than 4 days after ovulation, and the main percentage falls on days 5-6-7. In total, implantation can occur on any day from day 4 to day 12 after ovulation.

If you keep a graph of basal temperature, then it may have a characteristic decrease in temperature during this period: for one day it will drop by 0.3 - 0.4 degrees. For example, it may fall from 37.4 to 37.0 degrees. This is called implantation retraction, and it means that from now on, the fetus begins to produce the hormone hCG, which can now be detected in the blood of its mother.

In this regard, many women are wondering: when to take a blood test for hCG? Experts recommend doing this no earlier than a week after the expected ovulation. And it is advisable to donate blood not once, but at least twice, in order to make sure that the pregnancy is alive and progressing in its development. A little later, sensitive pregnancy tests can become an indicator of an increase in hCG: at first, their test strip will be dim, but if you repeat the procedure with a test of the same brand after 48 hours, you can notice progress in color.

It is important to know some features of blood sampling for this analysis:

1. HCG is given on an empty stomach, the break should be at least 5 hours, starting from the last meal;
2. for analysis, blood is taken from a vein;
3. an analysis for hCG should be taken no earlier than 7 days after the expected ovulation;
4. It is advisable to donate blood in the morning, when the break between meals will be quite large.

Now you can get the results of hCG tests by e-mail, just a few hours after blood sampling. This helps to act quickly if the hormone is suddenly detected, and a woman, for example, has a lack of progesterone.

HCG hormone and preparations containing progesterone

There is a category of women who have and in the second phase of the cycle they have to take special drugs that artificially increase the level of this hormone in the blood. As a rule, it is either Duphaston or Utrozhestan in various dosages that the doctor prescribes. In this regard, such women often ask themselves the question: how to take hCG if you have to take hormonal drugs? Will they affect the result of the analysis?

To answer this question, let's turn to what constitutes progesterone. This is a hormone produced by the adrenal glands and which is indispensable during pregnancy: it helps her to hold on, successfully implant and develop, bypassing detachment and regression. In turn, we know that hCG is a hormone that is secreted not by the woman herself, but by the fetal egg. Thus, it is obvious that taking Dufaston or Utrozhestan is not able to affect the blood test for hCG, causing the result to be false positive.

However, these two hormones are related, but only in the sense that progesterone helps the pregnancy to stay in the uterus and develop. Accordingly, the level of hCG is also growing, because the unborn baby is alive. If there is no pregnancy, and progesterone is being taken, then the result of the analysis will still be negative.

HCG rise during ectopic pregnancy

With an ectopic pregnancy, the increase in the level of hCG in the blood has a completely different dynamics. With the uterine attachment of the fetal egg, the hormone doubles its amount in the woman's body every 48 hours. However, during a pregnancy located in the fallopian tube, the growth of hCG will not be as fast. If a woman watches the dynamics of several of her tests, she will notice that the level of this hormone will double not after 48 hours, but only after a few days. Of course, the final diagnosis can only be made by ultrasound and after examination on a gynecological chair, but early monitoring of a blood test for hCG in dynamics will make it possible to determine an ectopic pregnancy much earlier than it usually does. This will help remove the fetal egg from the fallopian tube, avoiding its rupture and thus bypassing the direct threat to the woman's life.

The rise and fall of hCG during frozen pregnancies

Frozen pregnancy only in rare cases gives a slight increase in hormone levels. Deciphering the analysis in dynamics usually shows that immediately after the death of the embryo, this hormone begins to break down in the woman's body. For some time, its quantity can be unchanged and remain at the same level. Then hCG drops, which will finally indicate that the pregnancy has died.

In other cases, the level of chorionic gonadotropin begins to decrease immediately, on the first day after the end of the life of the fetal egg.

It is characteristic that, unlike an ectopic, a frozen pregnancy may have absolutely no signs. A woman may not have bleeding and pain, even all the signs of pregnancy (toxicosis, breast tenderness) may still persist. It happens that she may not even know for two or three weeks that the pregnancy has died. It is in these cases that the state of the embryo can be diagnosed by monitoring the dynamics of a blood test for hCG, and by weeks of pregnancy, when deciphering the data, it will become clear whether the embryo is alive or dead.