Recognition of Early Pregnancy: Human Chorionic Gonadotrophin

  • P. G. Whittaker


The issues discussed in this chapter are those associated with the recognition of pregnancy by the clinician. How soon after conception can pregnancy be detected by measurement of human chorionic gonadotrophin (hCG)? Can pregnancy be detected in this way before it is manifest clinically? Can hCG levels predict impending failure in early pregnancy?


Obstet Gynecol Early Pregnancy Ectopic Pregnancy Human Chorionic Gonadotrophin Last Menstrual Period 
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  1. Ahmed AG, Klopper A, Francesco D (1984) Determination of the stage of gestation by the assay of hCG and Schwangerschafts protein 1. Br J Obstet Gynaecol 91: 1234–1239PubMedCrossRefGoogle Scholar
  2. Armstrong EG, Ehrlich PH, Birken S et al. (1984) Use of a highly sensitive and specific immunoradiometric assay for detection of hCG in urine of normal, non-pregnant and pregnant individuals. J Clin Endocrinol Metab 59: 867–874PubMedCrossRefGoogle Scholar
  3. Aspillaga M, Whittaker P, Lind T (1986) Placental hormones and early pregnancy failure. Placenta 7: 458–459CrossRefGoogle Scholar
  4. Batzer FR, Schlaff S, Goldfarb AF, Corson SL (1981) Serial 0-subunit hCG doubling time as a prognosticator of pregnancy outcome in a infertile population. Fertil Steril 35: 307–312PubMedGoogle Scholar
  5. Beling CG, Cederqvist LL, Fuchs F (1976) Demonstration of gonadotropin during the second half of the cycle in women using intrauterine contraception. Am J Obstet Gynecol 125: 855–858PubMedGoogle Scholar
  6. Braunstein GD, Karow WG, Gentry WC, Rasor J, Wade ME (1978) First trimester hCG measurements as an aid in the diagnosis of early pregnancy disorders. Am J Obstet Gynecol 131: 25–32PubMedGoogle Scholar
  7. Chartier M, Roger M, Barrat J, Michelon B (1979) Measurement of plasma hCG and 0-hCG activities in the late luteal phase: evidence of the occurrence of spontaneous menstrual abortions in infertile women. Fertil Steril 31: 134–137PubMedGoogle Scholar
  8. Cole LA, Krole TG, Ruddon RW, Hussa RO (1984) Differential occurrence of free beta and free alpha subunits of hCG in pregnancy sera. J Clin Endocrinol Metab 58: 1200–1202PubMedCrossRefGoogle Scholar
  9. Confino E, Demir RH, Friberg J, Gleicher N (1986a) The predictive value of hCG beta subunit levels in pregnancies achieved by in vitro fertilization and embryo transfer: an international collaborative study. Fertil Steril 45: 526–531PubMedGoogle Scholar
  10. Confino E, Demir RH, Friberg J, Gleicher N (1986b) Does cyclic hCG secretion indicate embryo loss in in vitro fertilization? Fertil Steril 46: 897–902PubMedGoogle Scholar
  11. Deutinger J, Neumark J, Reinthaller A et al. (1986) Pregnancy specific parameters in early pregnancies after in vitro fertilization: prediction of the course of pregnancy. Fertil Steril 46: 77–80PubMedGoogle Scholar
  12. Edmonds DK, Lindsay KS, Miller JF, Williamson E, Wood RI (1982) Early embryonic mortality in women. Fertil Steril 38: 447–453PubMedGoogle Scholar
  13. Englert Y, Roger M, Belaisch-Alart J, Jondet M, Frydman R, Testart J (1984) Delayed appearance of plasmatic hCG in pregnancies after in vitro fertilization and embryo transfer. Fertil Steril 42: 835–838PubMedGoogle Scholar
  14. Hay DL (1985) Discordant and variable production of hCG and its free alpha and beta subunits in early pregnancy. J Clin Endocrinol Metab 61: 1195–1200PubMedCrossRefGoogle Scholar
  15. Hussa RO, Rinke ML, Schwester PG (1985) Discordant hCG results: causes and solutions. Obstet Gynecol 65: 211–219PubMedGoogle Scholar
  16. Jones HW, Acosta AA, Andres MC et al. (1983) What is a pregnancy? A question for programs of in vitro fertilization. Fertil Steril 40: 728–733PubMedGoogle Scholar
  17. Klein TA, Mishell DR (1977) Absence of circulating hCG in wearers of intrauterine contraceptive devices. Am J Obstet Gynecol 129: 626–628PubMedGoogle Scholar
  18. Lagrew DC, Wilson EA, Fried AM (1984) Accuracy of serum hCG concentrations and ultrasonic fetal measurements in determining gestational age. Am J Obstet Gynecol 149: 165–168PubMedGoogle Scholar
  19. Landesman R, Continho EM, Saxena BB (1976) Detection of hCG in blood of regularly bleeding women using copper intrauterine contraceptive devices. Fertil Steril 27: 1062–1066PubMedGoogle Scholar
  20. Lenton EA, Neal LM, Sulaiman R (1982) Plasma concentrations of hCG from the time of implantation until the second week of pregnancy. Fertil Steril 37: 773–778PubMedGoogle Scholar
  21. Marshall JR, Hammond CB, Ross GT, Jacobsen A, Rayford P, Odell WD (1968) Plasma and urinary hCG during early human pregnancy. Obstet Gynecol 32: 760–764PubMedGoogle Scholar
  22. Miller JF, Williamson E, Glue J, Gordon YB, Grudzinskas JG, Sykes A (1980) Fetal loss after implantation: a prospective study. Lancet ii: 554–556Google Scholar
  23. Norman RJ, Poulton T, Gard T, Chard T (1985) Monoclonal antibodies to hCG: implications for antigenic mapping, immunoradiometric assays and clinical applications. J Clin Endocrinol Metab 61: 1031–1038PubMedCrossRefGoogle Scholar
  24. Okamoto SH, Healy DL, Morrow LM, Rogers PAW, Trounson AO, Wood EC (1987) Predictive value of plasma hCG beta-subunit in diagnosing ectopic pregnancy after in vitro fertilisation and embryo transfer. Br Med J 294: 667–6670CrossRefGoogle Scholar
  25. Orloff VS, Yamamoto S, Greenwood FC, Bryant-Greenwood GD (1979) hCG beta-subunit-like immunoreactive material in the plasma of women wearing an intrauterine progesterone contraceptive system. Am J Obstet Gynecol 134: 632–637Google Scholar
  26. Owens MO, Ryan KJ, Tulchinsky D (1981) Episodic secretion of hCG in early pregnancy. J Clin Endocrinol Metab 53: 1307–1309PubMedCrossRefGoogle Scholar
  27. Pittaway DE, Reish RL, Wentz AC (1985a) Doubling times of hCG increase in early viable intrauterine pregnancies. Am J Obstet Gynecol 152: 299–302PubMedGoogle Scholar
  28. Pittaway DE, Wentz AC, Maxson WS, Herbert C, Daniell J, Fleischer AC (1985b) The efficacy of early pregnancy monitoring with serial hCG determinations and real-time sonography in an infertility population. Fertil Steril 44: 190–194PubMedGoogle Scholar
  29. Romero R, Kadar N, Copel JA, Jeanty P, De Cherney AH, Hobbins JC (1986) The value of serial hCG testing as a diagnostic tool in ectopic pregnancy. Am J Obstet Gynecol 155; 392–394PubMedGoogle Scholar
  30. Segal SJ, Alvarez-Sanchez F, Adejuwon CA, Brache de Mejia V, Leon P, Fawndes A (1985) Absence of hCG in sera of women who use intrauterine devices. Fertil Steril 44: 214–218PubMedGoogle Scholar
  31. Seppälä M, Rutanen EM, Jalanko H, Lehtovirta P, Stenman UH, Engvall E (1978) Pregnancy-specific beta-glycoprotein and hCG-like immunoreactivity during the latter half of the cycle in women using intrauterine contraception. J Clin Endocrinol Metab 47: 1216–1219PubMedCrossRefGoogle Scholar
  32. Sharp NC, Anthony F, Miller JF, Masson GM (1986) Early conceptual loss in subfertile patients. Br J Obstet Gynaecol 93: 1072–1077PubMedCrossRefGoogle Scholar
  33. Sharp RM, Wrixon W, Hobson BM, Corker CS, McLean HA, Short RV (1977) Absence of hCGlike activity in the blood of women fitted with intrauterine contraceptive devices. J Clin Endocrinol Metab 45: 496–499CrossRefGoogle Scholar
  34. Tarlatzis BC, Cherney AH, MacLusky N, Fakih H, Barnea ER, Naftolin F (1986) Embryo-maternal interaction in conceptions after in vitro fertilization and embryo transfer. J In Vitro Fertil Embryo Transf 3: 196–197CrossRefGoogle Scholar
  35. Tyrey L, Hammond CB (1976) The hCG beta subunit radioimmunoassay: potential error in hCG measurement related to choice of labelled antigen. Am J Obstet Gynecol 125: 160–165PubMedGoogle Scholar
  36. Wehmann RE, Nisula BC (1981) Metabolic and renal clearance rates of purified hCG. J Clin Invest 68: 184–194PubMedCrossRefGoogle Scholar
  37. Whittaker PG, Taylor A, Lind T (1983a) Unsuspected pregnancy loss in healthy women. Lancet is 1126–1127Google Scholar
  38. Whittaker PG, Aspillaga MO, Lind T (1983b) Accurate assessment of early gestational age in normal and diabetic women by serum hPL concentration. Lancet ii: 394–396Google Scholar
  39. Wilcox AJ, Weinberg CR, Wehman RE, Armstrong EG, Canfield RE, Nisula BC (1985) Measuring early pregnancy loss: laboratory and field methods. Fertil Steril 44: 366–374PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1988

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  • P. G. Whittaker

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