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"Background" Human Chorionic Gonadotropin in Healthy, Nonpregnant Women

¹ USA hCG Reference Service, University of New Mexico, Albuquerque, NM 87104

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The report by Snyder et al. (1) in this issue of Clinical Chemistry solidifies at long last the use of 5 IU/L human chorionic gonadotropin (hCG) as a cutoff for detection of pregnancy. Although this cutoff has been widely used for many years, the studies to support it have included only limited numbers of nonpregnant women (2)(3)(4)(5). This new study(1), for the first time, includes a large number of nonpregnant women (n = 240) of peak child-bearing age (18–40 years). Although the 97.5th percentile for this group was 2.5 IU/L and one woman had an hCG of 4.6 IU/L, the bulk of the cases had undetectable hCG, <2 IU/L. Clearly, to make a close to absolute detection of pregnancy in women 18–40 years of age, the serum hCG must be >5 IU/L to exceed the "background" hCG concentrations that are present in serum of healthy, nonpregnant women.

Some applications for hCG testing, such as monitoring gestational trophoblastic diseases, require more sensitive hCG detection (6). These are applications looking for recurrence or persistence of disease in women with a demonstrated history of gestational trophoblastic disease. With this consideration, many manufacturers’ hCG tests report results as low as 1 IU/L. Considering these important findings, it is critical that all reported hCG results note that use of . . . [Full Text of this Article]

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