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hCG, Total, Quantitative (Beta-hCG)

The pregnancy hormone, measured as a number. It rises quickly in early pregnancy, so a trend over days tells more than a single value.

AI-verified against cited sources. Awaiting expert reviewAlso called β-hCG, B-hCGLOINC 21198-7

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What it is

Human chorionic gonadotropin (hCG) is made by the placenta after a fertilized egg attaches inside the uterus. A quantitative test measures how much hCG is in your blood. A qualitative test only says yes or no. In early pregnancy hCG rises fast and typically peaks at 100,000 to 200,000 mIU/mL around weeks 8 to 10, then settles at a lower level. In people who aren't pregnant, it is very low, usually 5 mIU/mL or less.

Why it matters

Clinicians use hCG numbers to confirm a very early pregnancy, to follow a pregnancy that has a higher risk of miscarriage, and to look into an ectopic or molar pregnancy. The ranges for any week of pregnancy are very wide, so the direction over several days matters more than one number. hCG is also part of prenatal screening, and it is checked in some non-pregnancy conditions, such as certain tumors.

If it’s low

In early pregnancy, a level lower than expected for your dates, or a slower rise, is often just a matter of timing. Ovulation or implantation can happen later than your dates assume. But a low or slowly rising level can also be linked to an ectopic pregnancy or a pregnancy loss. One low number can't tell these apart, so clinicians repeat the test and often add an ultrasound.

Common causes

  • Testing very early, before hCG has had time to rise
  • Ovulation or implantation later than your dates assumed
  • A slower-than-average rise that still ends in a healthy pregnancy
  • Ectopic pregnancy or pregnancy loss
  • A falsely low reading when hCG is extremely high (the hook effect, rare)

What can help

  • Ask whether to repeat the test in about 2 days, on the same lab's assay
  • Ask whether an ultrasound should be done and when
  • Ask about warning signs to watch for while you wait for the repeat

If it’s high

In pregnancy, high numbers are expected, and the normal range for any week is very wide. A level above the non-pregnant range in someone who isn't pregnant has several possible explanations, and many are not serious. Your clinician can sort through them with a repeat test, a urine test and your history. Rarely, a level that stays high or keeps rising outside pregnancy can be linked to an abnormal growth of pregnancy tissue or to a tumor.

Common causes

  • Pregnancy, including a very early one
  • A recent pregnancy loss or delivery, while hCG is still falling
  • Fertility medicines
  • Pituitary hCG in women around and after menopause, which gives a low positive result
  • Test interference from heterophile antibodies, called a phantom hCG
  • A molar pregnancy (an abnormal growth of tissue in the uterus), when a level is much higher than expected for dates
  • Gestational trophoblastic disease or some ovarian and testicular tumors (rare)

What can help

  • Ask whether a urine hCG test, a repeat blood test or an ultrasound is the next step
  • If you aren't pregnant, tell your clinician your age, menopause status and any fertility medicines, since these change how the number is read
  • Ask whether the lab can run the sample on a second assay if the result doesn't fit your situation

Usual ranges

What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.

The usual range depends on sex and age. Choose women or men to see the one that applies.

Children and teens 1 ranges

See Beta-hCG by age and sex, with the U.S. survey numbers where they exist.

What can affect your result

  • How far along the pregnancy is: levels climb quickly for about 10 weeks
  • The starting level: in one study, the slowest normal rise over 2 days was larger when the first level was low and smaller when it was high
  • Age and menopause: non-pregnant hCG creeps up with age in women, from a pituitary source
  • Bleeding, pain and a prior miscarriage were linked to differences in hCG curves in one study
  • Fertility medicines and rare conditions such as molar pregnancy or hCG-making tumors
  • The assay: methods detect different forms of hCG and can disagree
  • Heterophile antibodies in a sample can cause a false positive, sometimes called a "phantom hCG". A negative urine hCG together with a positive blood result supports this, because these large antibodies generally do not pass into urine (Oyatogun 2021).
  • Hook effect: an extremely high hCG, for example above about 500,000 mIU/mL in a molar pregnancy, can read falsely low or negative. The lab can repeat the test on a diluted sample if the result doesn't fit the picture (Cole 2009).
  • High-dose biotin supplements can falsely lower results on sandwich immunoassays that use biotin chemistry (Ghazal 2022). Ask your clinician before stopping any supplement.
  • Pituitary hCG in women near or after menopause can give a low positive result (Snyder 2005, Oyatogun 2021).
  • Fertility medicines can affect pregnancy test results (MedlinePlus).
  • Different assays detect different forms of hCG and can give very different numbers, especially in trophoblastic disease or cancer (Cole 2009).

Any time of day. Use the same lab and assay for repeat tests, so the numbers can be compared. In early pregnancy hCG keeps rising for about 10 weeks, almost doubling every 3 days (MedlinePlus). It peaks around 8 to 10 weeks and then settles lower (Oyatogun 2021).

When to talk to a clinician

If you are or might be pregnant and have vaginal bleeding, pain in your lower back or belly, or cramping on one side of the pelvis, contact a clinician promptly. These can be symptoms of an ectopic pregnancy (a pregnancy that starts outside the uterus), which can be a medical emergency (MedlinePlus, ACOG). If you feel faint, call 911 or your local emergency number. If hCG is positive and you are not pregnant, are past menopause, or are male, ask your clinician about follow-up.

Questions you could ask

  • Should I use the same lab for every repeat test?
  • What symptoms should make me call you or go to urgent care while I wait?
  • Could this level be from something other than pregnancy?
  • Should we repeat the blood test, or check a urine test or an ultrasound?
  • Should we repeat the test in about 2 days to see how it changes?
  • Do I need an ultrasound, and when?

Questions people ask

How fast should hCG rise in early pregnancy?

Early on, hCG almost doubles every 3 days and keeps rising for about 10 weeks (MedlinePlus). In one study of women with confirmed healthy pregnancies, even the slowest 1% rose by at least 49%, 40% or 33% in 2 days, depending on the starting level (under 1,500, 1,500 to 3,000, or over 3,000 mIU/mL). Your clinician also looks at an ultrasound.

Why can hCG be positive when I'm not pregnant?

Several reasons are possible. Women near or after menopause make a little hCG in the pituitary gland. Fertility medicines, a recent pregnancy loss and test interference called phantom hCG can also do it. Less often, a tumor or an abnormal growth of pregnancy tissue is the cause. Your clinician can check with a urine test and a repeat blood test.

Is a higher hCG number better?

Not necessarily. The normal range for any week is very wide, and a single number can't tell you how a pregnancy is going. Clinicians look at how the number changes over several days, along with ultrasound. Compare results only from the same lab.

Show the science and sources

Units

  • 1 mIU/mL = 1 mIU/mL
  • 1 mIU/mL = 1 IU/L

For clinicians and researchers

hCG is a heterodimer of an alpha subunit shared with LH, FSH and TSH and a beta subunit that is over 80% homologous to LH beta. Commercial pregnancy assays usually measure total hCG, which is intact hCG, hyperglycosylated hCG and free beta subunit, while some tumor-marker assays separate them (Oyatogun 2021). Serum levels typically peak at 100,000 to 200,000 mIU/mL at 8 to 10 weeks and stay above about 5,000 mIU/mL for the rest of the pregnancy. In symptomatic women with a confirmed viable intrauterine pregnancy, the slowest 1% rose by 49%, 40% and 33% over 2 days when the starting hCG was under 1,500, 1,500 to 3,000 and over 3,000 mIU/mL (Barnhart 2016), so slower rises than a doubling are not by themselves abnormal. Non-pregnant values rise with age because of pituitary hCG (under 2.0 to 13.1 IU/L over age 55); in that study, all 19 non-pregnant women over 40 with hCG of 5.0 IU/L or higher had FSH above 32.4 IU/L (Snyder 2005). Persistent low-level hCG of about 100 to 300 mIU/mL outside pregnancy can come from quiescent gestational trophoblastic disease (Oyatogun 2021). The hook effect can produce falsely low results above about 500,000 mIU/mL, which a 1:1000 dilution can resolve (Cole 2009). mIU/mL and IU/L are numerically identical.

LOINC 21198-7 (primary), 19080-1, 83086-9, 45194-8. Specimen: serum.

Sources

  1. Beta-hCG, Quantitative (Pregnancy) (test 3016579), ARUP Laboratories
  2. Diagnostic considerations in the measurement of human chorionic gonadotropin in aging women, Clinical Chemistry (2005)
  3. Differences in Serum Human Chorionic Gonadotropin Rise in Early Pregnancy by Race and Value at Presentation, Obstetrics & Gynecology (2016)
  4. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy, American College of Obstetricians and Gynecologists (Obstetrics & Gynecology) (2018)
  5. A rational diagnostic approach to the "phantom hCG" and other clinical scenarios in which a patient is thought to be pregnant but is not, Therapeutic Advances in Reproductive Health (Oyatogun et al.) (2021)
  6. New discoveries on the biology and detection of human chorionic gonadotropin, Reproductive Biology and Endocrinology (Cole) (2009)
  7. Pregnancy Test, MedlinePlus (National Library of Medicine)
  8. Hormone Immunoassay Interference: A 2021 Update, Annals of Laboratory Medicine (Ghazal, Brabant, Prie, Piketty) (2022)

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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