MLAB 320 – Clinical Chemistry III

hCG

Question: What is it?

Answer: Human Chorionic Gonadotrophin (Molecular weight = 45,000)
Pronounced Human KOREEONIK GO-NAD-O-TRO-FIN

It is a glycoprotein secreted by the syncytiotrophoblastic cells of the normal placenta.

It consists of two subunits and . These subunits are not similar. The
subunit is common to three other hormones…

• LH Luteinizing Hormone.
• FSH Follicle Stimulating Hormone.
• TSH Thyroid Stimulating Hormone The subunit is unique to
hCG

The detection of urinary HCG is widely as a sensitive test for the early recognition of
pregnancy.

Introduction.

Pregnancy usually begins in the middle of the Fallopian tubes when fertilization
occurs. Sperm penetrates the ovum (female egg). The sperm’s tail breaks off and the
nuclei of both the sperm and the ovum, fuse. A genotype cell of 46 chromosomes is
formed. The cell divides to form a BLASTOCYST. This BLASTOCYST moves
towards the uterus by ciliary movement and peristalsis of the Fallopian tubes. Outer
layers of cells are formed and they are called the TROPHOBLAST. (fig 1)
The TROPHOBLAST layer of cells is made up of two layers of cells. The inner layer
is called the CYTOTROPHOBLAST and the outer layer is called the
SYNCYTIOTROPHOBLAST. i.e.

1. CYTOTROPHOBLAST (inner layer of cells) TROPHOBLAST

2. SYNCYTIOTROPHOBLAST (outer layer of cells)

Syncytiotrophobla

O Sperm Foetal

Cytotrophoblas

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 MLAB 320 – Clinical Chemistry III
Fig 1.

About seven days after the fertilization of the ovum, the blastocyst implants in the
uterus. It does this by secreting enzymes from the syncytiotrophoblastic cells, which
erode on the wall of the uterus. This allows implantation of the Foetal Embryo.

The syncytiotrophoblast also produces other placental hormones including…..

• Progesterone.
• Oestriol
• Human Placental Lactogen (HPL)
• B HCG

Function of HCG
HCG has an important role in maintaining the function of the of the ovum until the
placenta starts producing it’s own progesterone.

Clinical Applications of hCG.

Measurement of hCG in bodily fluids such as sera and urine may be used for a
number of reasons……
1. To diagnose early pregnancy.
2. To monitor a normal pregnancy.
3. To help diagnose and monitor ectopic pregnancy or possible abortions.
4. To help diagnose and monitor trophoblastic disease.

HCG in a normal pregnancy.

Detectable amounts of hCG of approximately 5IU/L are present 8 - 11 days after
conception (fertilization) . HCG reaches it’s peak between 8 - 10 weeks from the last
menstrual period (LMP) and reaches a level of about 100,000 IU/L in the serum of a
pregnant woman. HCG then starts to decline and by the end of the 2nd Trimester a
90% reduction has occurred. Levels are now low but constant during the 3rd
Trimester.
LMP
Deliver
Fertilizatio
Implantation of ovum in HPL

hCG Oestriol

Progesterone

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 MLAB 320 – Clinical Chemistry III

0 14 21 70 180 260 Days

st nd rd
1 Trimester 2 Trimester 3 Trimester
There are three common problems affecting the prostate gland. These may be listed
as:

Answer the following questions:

1. How high are the levels of hCG in women who are pregnant with twins
compared to a single pregnancy?

2. What is the principle of the test?

3. What are the reagents in the kit?

4. How should the kit be stored?

5. What kind of sample is needed?

6. Follow the procedure in the handout.

What is the time limit for reading the test?

7. Use the standard values and absorbances to draw a curve. Read your
controls and patient values from your curve.

8. Each group of 2 students will discuss one of the following:

a. Twin to twin transfusion syndrome
b. How do identical twins develop? How do non-identical twins develop?
c. How do conjoined twins develop?